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Last updated: Mar 07, 2022
6 min read

Intertrigo: what is it, symptoms, causes, treatment

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Intertrigo is a common type of skin rash that affects the skin folds—areas of the body where your skin rubs together and traps moisture (Nobles, 2021). Babies and the elderly are at a higher risk of developing intertrigo. Fortunately, it’s usually treated easily with home remedies. Sometimes stronger topical medications or antibiotics are needed.  

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What is intertrigo?

Intertrigo, or intertriginous dermatitis, is the medical term for a skin condition that presents as a rash in the skin folds. 

It most commonly affects the armpits, abdomen, genital area, and the area under the breasts, but it can appear in any area where your skin rubs together, even between the toes. 

In some cases, intertrigo is caused by an infection, most commonly by a yeast infection known as candidal intertrigo. The rash associated with candidal intertrigo may appear scaly, with pustules that ooze or crust over (Metin, 2018). 

In infants, intertrigo commonly manifests as diaper dermatitis, or “diaper rash,” on a baby’s bottom (Tuzun, 2015). 

What causes intertrigo?

In short, intertrigo is caused by skin-to-skin friction and trapped moisture. That’s why this rash affects the skin folds. By their nature, skin folds can trap moisture and heat, which causes your skin to stick together and create friction. Add in bodily fluids like sweat, urine, and feces—and you have the potential for intertrigo to develop (Voegeli, 2020). 

Continued friction in these areas also damages your skin’s barrier, which, along with the moisture and poor air circulation, makes it easy for fungi or bacteria to grow. As the fungus or bacteria grows, your immune system kicks in, resulting in inflammation and a rash that can get worse over time. 

Skin areas with intertrigo may develop an infection, especially if you scratch the rash. It is also possible that an underlying infection, commonly a Candida yeast infection, causes the intertrigo (Kalra, 2014; Metin, 2018).

Types of intertrigo 

Intertrigo goes by many names, depending on where and how it appears. Different types of intertrigo include (Kalra, 2014; Metin, 2018; Nobles, 2021): 

  • Acute intertrigo: intertrigo that has just appeared
  • Recurrent intertrigo: multiple, recurring cases of intertrigo
  • Chronic intertrigo: intertrigo that lasts six weeks or longer
  • Interdigital intertrigo: intertrigo between the fingers or toes.
  • Diaper rash or diaper dermatitis: intertrigo that appears on the buttocks or groins of babies or adults who wear diapers
  • Candidal intertrigo: intertrigo that develops into or is caused by a yeast infection caused by a type of fungus called Candida. Candidal intertrigo is the most common cause of intertrigo infections (Ndiaye, 2017). 
  • Uncomplicated intertrigo: intertrigo that doesn’t cause a secondary infection

Signs of intertrigo

Intertrigo rash appears within the skin folds and is usually moist and red or reddish-brown. The skin may appear bumpy, and it may burn, feel itchy, or feel raw. When intertrigo causes an infection, the rash may give off a foul smell, and the bumps may ooze or fill with pus.

Some of the areas where intertrigo can develop include (Metin, 2018):

  • Armpits
  • Buttocks
  • Groin
  • Genital area
  • Between the toes
  • Between the fingers
  • Inner thighs
  • Neck creases
  • Scrotum
  • Stomach or belly button
  • Under the breasts

In infants, signs of intertrigo may appear in their (Tuzun, 2015; Metin, 2018):

  • Buttocks
  • Groin area
  • Lower belly
  • Neck folds
  • Thighs

Is intertrigo contagious?

You may find intertrigo in different skin folds on your body, but it does not spread. It is also not contagious. If your intertrigo develops an infection, however, that can spread, which is why it’s a good idea to see a healthcare professional or dermatologist if your rash doesn’t go away and starts to smell or ooze.

Risk factors for intertrigo rash

Intertrigo can affect anyone at any age, although it is more common in infants and older adults. 

In fact, up to one in three infants may experience diaper rash. They are at greater risk because they have more skin folds, don’t move much, and wear diapers, which trap moisture and bodily fluids (Metin, 2018; Kalra, 2014). 

Similarly, older adults are at greater risk of intertrigo because they have weakened immune systems and may be bedridden or incontinent (Kottner, 2020).

People with obesity are also more likely to have intertrigo, as they sweat more (creating more moisture) and have larger skin folds (creating more opportunities for friction) (Kalra, 2014). Other conditions that increase one’s risk of intertrigo include (Nobles, 2021):

  • Diabetes
  • HIV infection
  • Incontinence
  • Poor hygiene
  • Excessive sweating
  • Weakened immune system
  • Living in a hot or humid climate

Treatment of intertrigo

Treating intertrigo depends on its type and how severe it is. 

In some cases, treatment can be as simple as keeping the affected area dry and exposed to air. Your healthcare provider may recommend wearing loose, breathable clothing. 

You can keep the skin dry and cool throughout the day by periodically using a fan or a hairdryer on the cool setting. Avoid scratching your rash, and when you bathe, dry the rash by patting, not rubbing.

Your healthcare provider may also recommend a topical treatment. Some topical treatments of intertrigo include (Kalra, 2014):

  • Zinc oxide ointment
  • Petroleum jelly
  • Talcum powder
  • Aluminum sulfate
  • Calcium acetate solution

These topicals help relieve itchiness and pain and protect your skin barrier from further damage. If your healthcare provider prescribes a topical ointment, be sure to follow the directions. For example, you should not apply talcum powders at the same time as an antifungal cream because they can create a sticky paste. 

You can also place gauze or cotton between the affected skin fold to further reduce friction. In cases where intertrigo has developed an infection, your health professional may prescribe oral antibiotics and recommend various topical antifungal creams or topical steroid creams like hydrocortisone (Kalra, 2014).

Tips for avoiding intertrigo in the future

Thankfully, intertrigo is treatable. However, those who have had it can attest it is not a pleasant experience. To prevent intertrigo in the future, try these lifestyle changes (Nobles, 2021; Tuzun, 2015; Ndiaye, 2017):

  • Shower or bathe every day. Then, dry yourself off completely with a clean towel.
  • Wear breathable, loose-fitting clothing. Avoid synthetic fabrics.
  • Remove clothes when they’re wet, or you’ve been sweating.
  • Wear open-toed shoes.
  • Maintain a healthy weight.
  • Use antiperspirants.
  • Change infant diapers frequently and keep your baby’s bottom clean and dry.

When to see a healthcare provider about intertrigo

If you notice a rash that resembles intertrigo, make an appointment with your healthcare provider, especially if it starts to smell or ooze pus, as those could be signs of an infection (Nobles, 2021). 

To determine whether you have intertrigo, another skin condition, or a secondary skin infection caused by intertrigo, your healthcare provider will review your personal medical history, including any medications you are taking (Nobles, 2021). 

They will perform a visual examination of your skin to help rule out other skin diseases or infections like seborrheic dermatitis, psoriasis, atopic dermatitis, or tinea (ringworm). If they think you have an infection, they may perform a test, such as (Metin, 2018):

  • Wood’s lamp examination: Observing the skin under black light can reveal certain types of bacteria or fungi. For example, an erythrasma infection shows up as a fluorescent coral color.
  • Skin scraping: The dermatologist may scrape off some of the affected skin for review under a microscope.
  • Skin biopsy: If the dermatologist needs to analyze more skin, they will numb your skin with local anesthesia before removing a small piece for review under a microscope.

Fortunately, intertrigo is a treatable, common skin rash (Metin, 2018). If you have concerns about your skin, be it an intertrigo rash or something else, talk to a health professional.

References

  1. Kalra, M. G., Higgins, K. E., & Kinney, B. S. (2014). Intertrigo and secondary skin infections. American Family Physician, 89(7), 569–573. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24695603/
  2. ​​Kottner, J., Everink, I., van Haastregt, J., Blume-Peytavi, U., & Schols, J. (2020). Prevalence of intertrigo and associated factors: A secondary data analysis of four annual multicentre prevalence studies in the Netherlands. International Journal of Nursing Studies, 104, 103437. doi: 10.1016/j.ijnurstu.2019.103437. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32105975/
  3. Metin, A., Dilek, N., & Bilgili, S. G. (2018). Recurrent candidal intertrigo: challenges and solutions. Clinical, Cosmetic and Investigational Dermatology, 11, 175–185. doi: 10.2147/CCID.S127841. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29713190/
  4. Ndiaye, M., Taleb, M., Diatta, B. A., Diop, A., Diallo, M., Diadie, S., et al. (2017). Les étiologies des intertrigos chez l’adulte : étude prospective de 103 cas [Etiology of intertrigo in adults: A prospective study of 103 cases]. Journal de Mycologie Medicale, 27(1), 28–32. doi: 10.1016/j.mycmed.2016.06.001. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27554869/
  5. Nobles, T. & Miller, R. A. (2021). Intertrigo. [Updated Sep. 25, 2021].  In: StatPearls [Internet]. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30285384/
  6. Tüzün, Y., Wolf, R., Bağlam, S., & Engin, B. (2015). Diaper (napkin) dermatitis: A fold (intertriginous) dermatosis. Clinics in Dermatology, 33(4), 477–482. doi: 10.1016/j.clindermatol.2015.04.012. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26051065/ 
  7. Voegeli, D. (2020). Intertrigo: causes, prevention and management. British Journal of Nursing (Mark Allen Publishing), 29(12), S16–S22. doi: 10.12968/bjon.2020.29.12.S16. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32579453/