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Intertrigo

Definition

Intertrigo is inflammation of the skin folds. It tends to occur in warm, moist areas of the body where two skin surfaces rub or press against each other. Such areas are called intertriginous areas.

Causes

Intertrigo affects the top layers of skin. It is caused by moisture, bacteria, or fungus in the folds of the skin. Bright red, well-defined weeping patches and plaques are seen in the folds of the neck, armpits, elbow pits, groin, finger and toe webs, or backs of the knees. If the skin is very moist, it may begin to break down. In severe cases, there may be a bad odor.

The condition is most common in people who are obese. It may also occur in people who must stay in bed or who wear medical devices such as artificial limbs, splints, and braces. These devices may trap moisture against the skin.

Intertrigo is common in warm, moist climates.

Home Care

You may be able to treat mild cases of intertrigo that have not become infected at home.

• Separate skin folds with clean gauze or dry towels.
• Blow a fan or hair dryer on cool on moist areas.
• Wear loose clothing and moisture-wicking fabrics.
• Use antiperspirant cream or powder to help prevent sweating.
• Use skin creams or ointments with petroleum or zinc oxide to create a skin barrier to reduce friction.
• Use an over-the-counter (OTC) steroid cream (such as hydrocortisone) to help reduce inflammation.
• Use an OTC antifungal (such as clotrimazole or miconazole) or antibacterial (such as bacitracin) cream or ointment to help prevent fungal or bacterial growth.

When to Contact a Medical Professional

Contact your health care provider if:

• The condition does not go away, even with good home care.
• The area of affected skin spreads beyond a skin fold.

What to Expect at Your Office Visit

Your provider can usually tell if you have the condition by looking at your skin.

Other tests may include:

• A skin scraping and a test called a KOH examination to check for a fungal infection
• Looking at your skin with a special lamp called a Wood's lamp, to check for a bacterial infection called erythrasma
• In rare cases, a skin biopsy is needed to confirm the diagnosis

If the skin has become infected, treatment is based on what is causing the inflammation. Often there may be more than one cause.

Treatment options for skin infection from intertrigo include:

• Prescription antibiotic or antifungal cream applied to the skin
• Drying medicine, such as Domeboro soaks
• Low-dose steroid cream or immune modulating cream
• Creams or powders that protect the skin to help relieve discomfort
• Oral antibiotics or antifungal medicines to treat infection

References

Dinulos JGH. Superficial fungal infections. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 13.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Bacterial infections. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 14.

Paller AS, Mancini AJ. Skin disorders caused by fungi. In: Paller AS, Mancini AJ, eds. Paller and Mancini - Hurwitz Clinical Pediatric Dermatology. 6th ed. St Louis, MO: Elsevier; 2022:chap 17.

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