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Skin wrinkles

What is intertrigo?

Intertrigo is the name given to a skin rash that affects the flexures or folds of the skin, such as under the arms, behind the ears, the folds of the neck, under the breasts, the groin, finger webs or toe spaces. It usually involves multiple sites.

What causes intertrigo?

The skin inflammation that occurs with intertrigo is caused initially by frictional forces and made worse by infectious, genetic or environmental factors. Frictional forces that can lead to intertrigo include two areas of skin rubbing against each other, the collection of sweat or water beneath a fold of skin, the continued presence of urine against the skin, or a component of clothing (such as nickel in bra wire) rubbing against the skin.

Intertrigo is common, and people at increased risk of developing the condition include those:

  • Who are obese
  • Who live in hot or humid climates
  • With a genetic tendency to skin diseases
  • With excessive sweating (hyperhidrosis).

Our skin has a microbiome, which is a collection of organisms that naturally live on our skin and typically cause no harm. Corynebacteria, other bacteria, and yeasts are present but normally kept in control by our immune system. If areas of skin become unusually warm or moist the organisms can multiply out of control and cause skin disease.

Intertrigo can develop as a result of:

  • Athlete's foot or other fungal infections of the skin
  • Atopic dermatitis
  • Boils (Staphylococcus aureus)
  • Contact irritant dermatitis
  • Candida albicans (thrush)
  • Flexural psoriasis
  • Folliculitis
  • Impetigo
  • Seborrheic dermatitis.

What are the symptoms of intertrigo?

Symptoms depend on the underlying cause and may include:

  • Inflamed and red skin
  • Cracks or fissures
  • Crusting
  • Itch
  • Moist looking skin that may start to slough away
  • Pain
  • Persistent, well defined smooth or shiny red patches; these may occur symmetrically
  • Scales on the surface of the skin
  • Skin peeling
  • Small blisters or pustules.

The rash may spread slowly over several weeks to months and infected intertrigo (such as impetigo) can be transferred to other people.

How is intertrigo diagnosed?

See your doctor if you develop a persistent skin rash and it does not resolve with over the counter typical products brought from a pharmacy

Your doctor will ask you about your symptoms and family history of any conditions (such as eczema). They may take a scraping or a swab of your skin to examine it under a microscope. A biopsy may be taken in some situations.

Intertrigo is also classified as acute (recent onset), relapsing (recurs), or chronic (persists for longer than 6 weeks).

What is the treatment for intertrigo?

Treatment depends on the underlying cause, if identified, and may include:

  • Topical or oral antibiotics, if the infection is bacterial
  • Topical or oral antifungal agents, if the infection is fungal
  • Antiperspirants, if sweating is the cause
  • Low potency corticosteroids
  • Combination products
  • Calcineurin inhibitors
  • Good skin hygiene including proper drying of the skin folds after bathing
  • Triple paste products that contain petrolatum, zinc oxide, and aluminum acetate solution to reduce friction, irritation, and sweating.