Intertrigo (intertriginous dermatitis): symptoms, causes, drugs, etc.

Definition

What is intertriginous dermatitis?

Intertriginous or intertrigo dermatitis is a rash that affects the folds of the skin. Excess friction and moisture in the skin folds makes the top layer of skin in this area more easily damaged. As a result, a reddish skin rash appears accompanied by inflammation.

Skin that has lost its protective layer is more susceptible to uncontrolled growth of bacteria, viruses, and fungi. This makes people with intertrigo more at risk of developing skin infections.

The initial symptom of this skin disease is a red or brown rash that appears on the skin folds. This rash is sometimes accompanied by itching or burning sensation. If the condition is severe or an infection has occurred, the skin may bleed, crack, or smell.

This condition is more experienced by diabetics or people who are overweight. People who wear splints, body supports, and artificial limbs are also more prone to experiencing them.

Mild intertrigo can be treated with lifestyle changes to keep skin healthy. Meanwhile, severe cases usually also require the use of drugs to prevent further infection and damage.

Symptoms

What are the signs and symptoms of intertrigo?

Intertrigo symptoms can be acute (appearing rapidly), recurring, or chronic (appearing within six weeks or more). The characteristics, duration and severity of symptoms usually depend on the causative factor.

Its main characteristic is inflamed skin which is a symptom of common dermatitis, looks red, and feels uncomfortable. The problematic skin may also look wet, cracked, and peeling. If there is a bacterial infection, the skin will smell bad.

Intertriginous dermatitis can affect any folds of skin where it rubs together frequently and feels moisturised. However, this condition is more often found in:

• between the fingers and toes,
• armpit,
• inner thighs,
• neck folds and indentations,
• butt folds,
• stomach folds,
• the lower part of the breast, as well
• groin and scrotum (scrotum).

Symptoms can appear in one or more folds at once. In infants, intertrigo usually occurs in the form of a diaper rash. This condition can get worse due to direct contact between the baby's skin and the surface of the diaper.

When should you see a doctor?

You should immediately see a doctor if you experience a reddish rash on the skin that indicates intertrigo. Further examination with a doctor will help determine the cause and diagnosis and prevent infection of the skin.

Cause

What causes intertrigo?

Intertriginous dermatitis is a condition caused by constant friction of the skin folds. Friction keeps the skin folds warm, moisturised, and irritated easily. This environment allows mold, bacteria, and yeast to thrive.

Intertrigo is not a contagious skin disease. However, microbes on the skin can still infect skin that has lost its protective layer. Therefore, people with intertrigo need to be more aware of the risk of infection on their skin.

Apart from being directly caused by friction on the skin, intertrigo can also be originated from the following skin diseases.

• Inverse psoriasis. Also known as intertriginous psoriasis, the symptoms of this disease appear on the skin folds.
• Hailey-Hailey disease. Genetic disorders make skin cells stick together so that the layers of the skin become more easily damaged.
• Pemphigus. The immune system attacks the cells in the top layer of the skin, causing blisters to develop.
• Bullous pemphigoid. Abnormalities in the immune system cause blisters on parts of the body that often bend.

Who is more at risk of developing intertrigo?

Intertriginous dermatitis can affect any age group, but this condition is more common in the following groups.

• Toddler.
• Elderly.
• The user of a splint, body support frame, or artificial limb.
• People who are frequently exposed to heat and high humidity.
• People with limited mobility.
• People who are overweight.
• People with weak immune systems.
• Diabetics.

Diagnosis and Treatment

How do doctors diagnose intertrigo?

Intertriginous dermatitis is diagnosed by a dermatologist. The doctor will initially examine your skin condition and ask questions about your symptoms, including when they first appeared and how severe they are.

The doctor will then carry out further tests if an infection is suspected. There is no specific test for this condition. The doctor will only take a skin or fluid sample to determine the type of bacteria or fungi that is causing the infection.

What treatment options are available?

Intertrigo management includes drug use and lifestyle changes. Doctors usually give corticosteroid ointments for use in the short term. This drug can relieve inflammation of the problematic skin area.

When an infection occurs, the doctor usually prescribes an antibiotic or antifungal drug in the form of an ointment. More severe infections may need to be treated with oral antibiotics or antifungal medications.

One report published in the Journal of the Dermatology Nurses' Association also suggests treatments to relieve intertrigo symptoms. Here are tips that you can apply:

• Clean the problem areas with shampoo containing ketoconazole 1% as soap. Leave it on the skin for 2-5 minutes, then rinse thoroughly.
• Mix equal amounts of 1% clotrimazole (or 1% miconazole) cream and 1% hydrocortisone cream, then apply a thin layer to the affected skin. Do it twice a day until the rash subsides, for about 3-8 weeks.
• Once the rash subsides, continue to use ketoconazole 1% shampoo as a soap on problem skin. Do it at least once a week.
• Use a hairdryer to dry your skin after showering or whenever it feels damp. Only use low level heat.

Prevention

How to prevent intertrigo?

The best way to prevent intertrigo is to keep the skin dry. In general, see the tips you can do to prevent intertriginous dermatitis below.

• Make sure the skin is completely dry after bathing.
• Using an antifungal powder after bathing.
• Using sweat-absorbing materials on parts of the body that are easily moist.
• Use antiperspirant for the armpits.
• Wash clothes using antibacterial soap.
• Trying to lose weight if you are obese.
• Do not wear tight clothes or shoes.

In contrast to other types of dermatitis, intertriginous dermatitis is inflammation of the skin folds due to constant friction. This condition can be overcome by keeping the skin clean and dry.