From the Guidelines
Intertrigo treatment should prioritize keeping the affected area clean and dry, and for mild cases, applying over-the-counter antifungal creams containing clotrimazole or miconazole twice daily for 1-2 weeks, as supported by the most recent evidence 1. Intertrigo is a common inflammatory skin condition that occurs in skin folds where surfaces rub together, causing redness, irritation, and sometimes infection. Symptoms include redness, rawness, burning, itching, and occasionally a foul odor in affected areas like the groin, underarms, beneath breasts, between toes, or in neck folds. Some key points to consider in the treatment of intertrigo include:
- Keeping the affected areas clean and dry by gently washing with mild soap, patting dry thoroughly, and using a hair dryer on a cool setting if needed.
- Applying moisture-absorbing powders like zinc oxide or cornstarch to reduce friction.
- Using over-the-counter antifungal creams containing clotrimazole or miconazole for mild cases, as suggested by older guidelines 1.
- Considering the use of topical calcineurin inhibitors like pimecrolimus or tacrolimus for intertriginous areas, especially when steroid use is a concern, as indicated by more recent research 1. Prevention involves wearing loose-fitting, moisture-wicking clothing, changing wet clothes promptly, maintaining a healthy weight, and using barrier products like zinc oxide in susceptible areas. It is essential to seek medical attention if symptoms worsen, spread, or don't improve within a week of home treatment, as prescription-strength medications may be necessary.
From the Research
Intertrigo Symptoms
- Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation 2
- Bodily secretions, including perspiration, urine, and feces, often exacerbate skin inflammation 2
- Physical examination of skin folds reveals regions of erythema with peripheral scaling 2
- Excessive friction and inflammation can cause skin breakdown and create an entry point for secondary fungal and bacterial infections 2
Intertrigo Treatment
- Candidal intertrigo is commonly diagnosed clinically, based on the characteristic appearance of satellite lesions 2
- Diagnosis may be confirmed using a potassium hydroxide preparation 2
- Resistant cases require oral fluconazole therapy 2
- Fungal lesions are treated with topical nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole 2
- Secondary streptococcal infections are treated with topical mupirocin or oral penicillin 2
- Corynebacterium infections are treated with oral erythromycin 2
- Consider using moisture-wicking textiles within skin folds to reduce skin-on-skin friction, wick away moisture and reduce secondary infection 3
- Educate patients in skin fold management and adopt structured skin care routine 3
- Treat secondary infection with appropriate topical agent 3
Prevention
- Identify predisposing factors and educate patient in reducing these 3
- Investment in the development and adoption of clear skin care and skin fold management protocols can lead to improvements in the patient experience and better clinical outcomes 4
- Intertrigo can be prevented by reducing skin-on-skin friction and moisture in skin folds 4