What causes intertrigo (inflammation of skin folds) in the groin area and how can it be managed or prevented?

From the Guidelines

Friction rash in the groin area, often called chafing, is caused by repeated skin-to-skin or skin-to-clothing contact during physical activities, especially in hot, humid conditions, and can be treated and prevented with measures that reduce friction and keep the area clean and dry. To treat an existing rash, keep the area clean and dry, then apply an over-the-counter anti-chafing product like Desitin, Aquaphor, or zinc oxide cream 1. For painful inflammation, 1% hydrocortisone cream can provide relief when applied 2-3 times daily for up to a week. Prevention is key:

• wear moisture-wicking, seamless underwear that fits properly
• apply anti-chafing products like Body Glide or petroleum jelly before activities
• keep the area dry with cornstarch-based powder (avoid talc)
• shower promptly after sweating
• use separate (clean) towels for drying the groin and other parts of the body to reduce contamination 1. Loose-fitting cotton clothing helps reduce friction and allows airflow. These measures work by either reducing direct friction between surfaces or by creating a protective barrier that allows skin to glide smoothly without irritation. If the rash persists beyond a week, worsens, or shows signs of infection (increased pain, swelling, warmth, pus), consult a healthcare provider as prescription antifungal or antibiotic treatments may be needed. It's also important to note that the groin area can be colonized by enteric flora, especially in cases of surgical procedures such as hip prosthesis or vascular bypass, which may increase the risk of infection 1.

From the FDA Drug Label

Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema psoriasis poison ivy, oak, sumac insect bites detergents jewelry cosmetics soaps seborrheic dermatitis temporarily relieves external anal and genital itching Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily children under 2 years of age: ask a doctor for external anal and genital itching, adults: when practical, clean the affected area with mild soap and warm water and rinse thoroughly gently dry by patting or blotting with toilet tissue or a soft cloth before applying apply to affected area not more than 3 to 4 times daily children under 12 years of age: ask a doctor

The cause of friction rash on the groin is not explicitly stated in the provided drug labels. However, it can be inferred that minor skin irritations and inflammation may be related to friction. To fix or prevent friction rash, the labels suggest:

• Cleaning the affected area with mild soap and warm water
• Gently drying the area by patting or blotting with toilet tissue or a soft cloth
• Applying hydrocortisone to the affected area not more than 3 to 4 times daily 2 2 It is recommended to consult a doctor for further advice, especially for children under 12 years of age.

From the Research

Causes of Friction Rash on Groin

• Friction rash on the groin, also known as intertrigo, is a common inflammatory skin disorder caused by skin-on-skin friction in skin folds, due to moisture becoming trapped because of poor air circulation 3, 4.
• It can occur in any area of the body where two skin surfaces are in close contact with each other, such as the axillary, inframammary, umbilical, and inguinal areas 3, 4.
• Obesity is strongly associated with intertrigo, as it can lead to increased skin-on-skin friction and moisture trapping in skin folds 4.

Prevention of Friction Rash on Groin

• Identifying and reducing predisposing factors, such as obesity and poor air circulation, can help prevent intertrigo 3.
• Educating patients on skin fold management and adopting a structured skin care routine can also help prevent intertrigo 3.
• Using moisture-wicking textiles within skin folds can help reduce skin-on-skin friction, wick away moisture, and reduce secondary infection 3.

Treatment of Friction Rash on Groin

• Topical corticosteroids can be used to treat intertrigo, but their use should be carefully considered due to the risk of adverse effects, especially when used on sensitive areas such as the genitals 5.
• Petroleum jelly can be used as a moisturizer and barrier cream to help protect the skin and reduce friction 6.
• Treating secondary infections with appropriate topical agents is also important in managing intertrigo 3.