DermHelpCentral

Intertrigo: Prevention and Treatment

Intertrigo, an inflammatory dermatosis involving body folds that develops through friction of skin to skin is influenced by moist conditions. It is found primarily in the area under the breasts, groin, abdominal and perianal skin folds. Besides these large skin folds, intertrigo may also affect minor skin folds (such as the armpits). Intertrigo has been defined as 'an erythematous eruption in a skin fold, caused by warmth, moisture and chafing; it occurs most often in the skin folds under the breasts and in the groin or as “a cutaneous inflammatory process on opposing skin surfaces” or “an inflammatory dermatosis involving body folds.”

The moist damaged skin may become secondary infected by bacteria, yeast or fungi. Visual symptoms of intertrigo are redness in mirror format and moist skin. Patients may complain of itching, burning feeling, pain and odor.

This good article about intertrigo will provide a thorough understanding of the problem and is available free full-text online. BMC Nurs. 2010; 9: 12.
Prevention and treatment of intertrigo in large skin folds of adults: a systematic review.

Impetigo Treatment and Prevention

From the office of Stephen G. Werth, M.D.
South Shore Dermatology, Quincy, Massachusetts

Image from Health Living Website

Treatment of Flare
Hydrocortisone 1% cream
Lotrimin 1% cream (or any azole cream)
Directions:
Apply these together twice a day.
At night, cover evening application with a thin layer of zinc oxide ointment.

Prevention Directions:
A.M. – Zeasorb powder to affected area
P.M. – thin coat of zinc oxide ointment

For clinical information see: DermNet.

 

 

Intertrigo in Babies

Babies often get inflammation in skin folds.  This is especially common in neck folds and diaper area. See: Intertrigo on Dermnet, for an overview.

Brian Maurer, of Enfield, CT, is a pediatric practitioner.  Here is his easy approach for intertrigo in babies.

(1)     Cleanse the area 2 or 3 times daily with a mild soap (Dove unscented) and water.

(2)     Dry area with a hairdryer on low setting.

(3)     Apply a desiccant preparation.  Add cornstarch powder to an aluminum hydroxide antacid preparation (e.g. Mylanta, Maalox) to make a paste, which can be dabbed onto the area and allowed to dry.  Domeboro solution applied as a wet compress also works well.  Allow the area to air dry after application is complete.

(4)     Alternatively, if a fungal component is suspected, dust the area with Mycostatin powder. Caution: Take care when applying powder.  Shake a small amount onto finger and apply manually.  Avoid shaking powder directly onto skin at neck, as the infant might inhale the fine dust and develop a reactive pneumonitis.

 

Intertrigo Prevention

Dr. G. Michael Kent, Chief of Dermatology ar the Shreveport, Louisiana Veterans Administration Hospital has a useful therapeutic protocol to prevent recurrent intertrigo.

"For a number of  years I struggled to find an effective, practical treatment for intertrigo.   The use of topical steroids was helpful for a short period of time to reduce the inflammation.   Cool compresses were also helpful temporarily.  At times,  antifungal agents were appropriate and temporarily effective; however, trying to achieve a prophylactic treatment to prevent recurrence of the intertrigo seemed impossible.   Struggling with this enigma eventually gave way to a plausible solution which has worked for my patients with this problem for a number of years.  

The answer is the use of readily available underarm antiperspirants.    I tell my patients to avoid use of the antiperspirant until the acute inflammation has subsided as  the result of use of the above mentioned treatment products.  They should then apply a small amount of their favorite antiperspirant to a small area of the previously inflamed skin.   If this application results in no irritation to the test site after one week,  they may begin using the antiperspirant on the larger, previously inflamed area.  Usually it is not necessary to apply these products on a daily basis.   This approach has worked well for most of my intertrigo patients for many years.  I hope it is helpful to the readors of this site

About Antiperspitants:  See Dermnet.  Please note that deodorants are not antiperspirants. Deodorants do not prevent sweating. Their aim is to mask the smell produced by sweat-eating bacteria. Some antiperspirant preparations may also contain a deodorant.

Suggested Antiperspirants:

Xerac-AC is 6.25% Aluminum chloride (it is a pescription product)  There are many OTC products -- both solid and liquid.  The should contain one of the follwng:

It's the active ingredient that gives antiperspirants their sweat-blocking power. All antiperspirants have an aluminum-based compound as their main ingredient. If you look at the back of an antiperspirant container, the aluminum-based compound is always the first ingredient listed. Here are a few of the common active ingredients:

• Aluminum chloride
• Aluminum zirconium tricholorohydrex glycine
• Aluminum chlorohydrate
• Aluminum hydroxybromide