Intertrigo: Symptoms, Causes, and Treatment - Verywell Health

Intertrigo is an inflammatory rash that occurs between skin folds as a result of friction, moisture, and lack of airflow. It occurs on areas of the body where skin touches skin, such as the armpits, the groin, under the breasts, or within fat folds. The medical term for it is intertriginous dermatitis.

Because these folds are warm and moist, they provide ideal conditions for Candida albicans (yeast), other fungi, or bacteria to take hold. This can cause infection and make symptoms worse.

This article outlines the symptoms, diagnosis, and treatment of this uncomfortable rash, and how you can avoid making it worse.

Intertrigo Symptoms

Intertrigo is characterized by a rash that is intensely red, macerated (wet and soft), and glistening, with scaling on the edges. The rash extends just beyond where opposing skin folds overlap. The rash can itch, burn, and sting.

In babies and adults with incontinence, intertrigo can show up as diaper rash. In these cases, urine and feces can aggravate an existing rash and make healing difficult.

Satellite lesions (small areas of the same rash that are close to the main one but are not connected) are characteristic of intertrigo and Candida skin infections, though intertrigo is not directly caused by Candida.

Complications

Intertrigo itself is not a yeast or bacterial infection, but it does create an environment where both could grow. In fact, if your symptoms get worse, it could mean the area has become infected with yeast or bacteria. In that situation, crusting, erosions, and other complications can occur. In severe cases, infected areas may ooze or even have a foul odor.

In people with diabetes, infectious intertrigo may lead to cellulitis, a potentially serious infection that can cause red streaks, fever, nausea, and vomiting.

Intertrigo due to candida infection. Waikato District Health Board / DermNet / CC BY-NC-ND

Causes

You are at risk of getting intertrigo if you:

• Are overweight or obese
• Have diabetes
• Have psoriasis
• Have incontinence and wear absorbent undergarments
• Have a suppressed immune system due to chemotherapy or HIV
• Wear a splint, brace, or prosthetic limb 

Hot, humid weather can cause intertrigo, especially in those who have other risk factors. Skin that is exposed to urine or feces is also more vulnerable to infection.

You may be at a greater risk of developing intertrigo if you wear tight, abrasive underclothing or dirty or sweaty clothing. Poor hygiene—or not showering or bathing regularly, especially after exercise—also increases your risk.

Intertrigo may be a side effect of certain medications, so talk to your healthcare provider about making adjustments if you think any drug you're taking may be a factor. If you have psoriasis, speak to your healthcare provider about how to better manage that condition to prevent intertrigo from developing.

Recap

Certain conditions, such as being overweight or having a suppressed immune system, increase your risk of developing intertrigo. If you have a skin condition like psoriasis or there are areas of your body where the skin rubs together, talk to your healthcare provider about ways you can prevent this rash from forming.

Diagnosis

The majority of cases of intertrigo can be diagnosed based on how your rash looks and your risk factors.

If your healthcare provider suspects yeast or bacteria, they may perform additional tests, such as:

• KOH test. This painless test can be performed to detect the presence of yeast. Dead skin cells are scraped on to a slide, mixed with a potassium hydroxide solution, and heated before being examined under a microscope.
• Bacterial cultures. These tests can help diagnose secondary bacterial infections.

Treatment

Uncomplicated, uninfected intertrigo can be treated with barrier ointments, such as petrolatum (such as Vaseline) and zinc oxide (such as Desitin). Applying cotton compresses saturated with a drying solution such as Burow's solution to the skin folds for 20 to 30 minutes several times a day can also help the rash heal.

For Candida and other fungal infections, topical creams are used. Some come in both over-the-counter and prescription strengths. These include:

• Ecoza, Spectazole (econazole)
• Extina, Nizoral A-D (ketoconazole)
• Lotrimin AF (clotrimazole)
• Micostatin Topical, NyStop (nystatin)
• Oxistat (oxiconazole)
• Zeabsorb AF (miconazole)

Antibiotic ointments, available by prescription, are typically used to treat bacterial infections. These include:

• Bactroban (mupirocin)
• Erymax, Romycin (erythromycin)

Your healthcare provider may also prescribe a topical steroid cream, such as hydrocortisone, to reduce itching. In some cases, oral anti-fungal drugs and antibiotics are necessary to cure the infection.

Recap

If you have intertrigo, there are treatments available to help, from barrier ointments that soothe the skin and minimize friction to topical creams or medications that clear up bacterial or fungal infections. Prompt treatment can minimize the spread of the rash and prevent complications.

Prevention

Prevention is key. Once intertrigo sets in, it can be difficult to cure unless the root causes (such as obesity) are addressed. To prevent infection, take the following measures:

• Keep the skin folds as dry as possible.
• Change out of sweaty clothes promptly after exercising.
• Use an antiperspirant to keep armpits dry.
• Wash daily with an antibacterial soap.
• Apply anti-fungal powder to susceptible areas.
• Dry off well after bathing or showering.
• Reduce skin-to-skin contact.
• Wear loose, soft underclothing instead of tight bras and underwear.
• Wear a supportive bra if the skin under the breasts is infected.
• Change diapers frequently and clean the area well.
• If you have diabetes, make sure your blood sugar is well controlled.

Summary

Intertrigo is a common rash that develops under certain conditions, particularly on damp areas of the body where there is friction. Unfortunately, the rash is prone to secondary infections (like yeast and bacteria), so prevention is important.

A Word From Verywell

Intertrigo can be uncomfortable and stubborn, so try to be vigilant about taking preventive measures and doing what you can to eliminate the risk factors that are within your control. Even if you're certain that the skin condition is the culprit for your discomfort, it's best to consult a healthcare provider to get a proper diagnosis and an effective treatment plan.