- The skin becomes very itchy and it stings, burns, and may even have a foul odor.
- In severe cases, it may lead to cellulitis, cracking up of the skin, and bleeding.
- The skin rash of an infected intertrigo appears asymmetrically.
Intertrigo is a skin rash caused by inflammation of the skin and appears as reddish-brown patches, swollen, and, sometimes, the rash may be itchy and painful. The skin rash of intertrigo is usually symmetrical.
What is intertrigo?
Intertrigo, also called sweat rash, is a type of skin inflammation that occurs when the skin is wet and has been subjected to friction. Intertrigo most typically arises where the skin folds and rubs together, and there is less air circulation.
The skin folds are always damp, such as:
- Under the armpits
- In the groin
- Under the breasts
- Between abdominal skin folds
- Between the buttocks
- Between the toes
Though intertrigo is an inflammatory rash, sometimes, it may lead to secondary infections caused by bacteria, viruses, or fungi. The suitable conditions for the growth of infection-causing microbes around intertrigo are increased warmth and moist skin surfaces.
When the region comes in touch with bodily secretions, such as sweat, urine, or feces, the symptoms of intertrigo worsen.
One may develop small lesions in different parts of the body, such as behind the ear. Satellite lesions are small patches of the same rash that are close to but not related to the main one are features of intertrigo.
What are the causes of intertrigo?
Intertrigo is essentially a fungal infection.
- The fungal antigens (proteins) cause inflammation in the body folds, red, scaly chafing, and skin edema.
- As a result, this persistently dark, damp, heated environment becomes a breeding ground for the multiplication of yeasts or bacteria already present on the skin.
- These multiply and cause the skin to break and the rash to spread.
Intertrigo is a typical side effect of obesity that involves skin folds and can develop beneath the arms, on the abdomen, between the thighs, in the crotch, and behind the ears. Patients with diabetes are especially vulnerable because their immune systems are already impaired.
It does not matter whether the breasts are skinny or overweight. However, women with bigger breasts have it worse because it results in more skin folds and rubs. The constant pressing of skin against the bra is what makes the under-bust area so unpleasant.
9 infections that can cause intertrigo
8 inflammatory conditions that can cause intertrigo
14 risk factors of intertrigo
- Having diabetes
- Obesity or having many skin folds as a result of obesity
- Small children with shorter or chubby necks are at a higher risk
- Using tobacco
- Alcohol intake
- Staying in an excessively humid or hot environment
- Sweating excessively
- Poor personal hygiene
- Tight-fitting gowns
- Using diapers
- Suppressed immune system due to human immunodeficiency virus-like infections or use of immunosuppressants
- Excessive sweating as a result of one's job (this is the main cause of groin and toe intertrigo)
How is intertrigo diagnosed?
A dermatologist can readily identify it by looking at the rashes, followed by a series of inquiries about any preexisting medical conditions, the temperature in the area where the individual resides, and many more.
- Skin examination: The skin is carefully scraped for a sample of dead cells to study. The dead cells are mixed with potassium hydroxide solution and are studied under a microscope.
- Wood's light: A special light is used to detect a bacterial infection, such as erythrasma. This examination is done in a dark room.
- Biopsy of the skin: In rare circumstances, a tissue sample may be taken to confirm intertrigo or rule out other issues.
- Bacterial culture: A sample from the skin is collected and is subjected to cultures to diagnose bacterial infections.
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What are the treatment options for intertrigo?
In mild cases, the doctor may advise keeping the affected area of the skin dry and open to the air. This is the most common approach to treat intertrigo. Reducing moisture and friction with the use of absorptive powders, such as talc or barrier creams, is advised. The doctor may recommend a topical steroid cream.
- Simple, uninfected intertrigo can be treated with protective ointments, such as petroleum jelly and Desitin (zinc oxide). Applying cotton compresses drenched with a drying solution, such as Burow's solution (aqueous solution of aluminum triacetate), to the skin folds for 20 to 30 minutes many times each day to help heal rashes.
- In more severe situations, the doctor may advise using an antibiotic or antifungal lotion. There are antifungal powders that may help dry the skin.
If a person is obese, they should try to shed weight if possible, dress in light, non-constrictive and absorbent clothing, avoid nylon, and other synthetic fibers. Bio-textiles, such as cotton or polyester gauze with antimicrobial molecules integrated into, may be beneficial.
Consult the doctor to determine the best treatment.
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Janniger CK, Schwartz RA, Szepietowski JC, Reich A. Intertrigo and common secondary skin infections. Am Fam Physician. 2005 Sep 1;72(5):833-8. https://www.aafp.org/afp/2005/0901/p833.html
American Academy of Family Physicians. What is intertrigo? https://familydoctor.org/condition/intertrigo/
Stuart A. Intertrigo. WebMD. https://www.webmd.com/skin-problems-and-treatments/guide/intertrigo-symptoms-causes-treatment-risk_factors_
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