Intertrigo: How to Recognize and Manage This Common Dermatosis

Welcome back, DERM Community!

Last week, we explored the complex interplay of Lymphedema and lymphatic dysfunction, highlighting how impaired drainage shapes skin outcomes.

This week, we turn our focus to another common yet often underestimated condition in dermatology and primary care:

Intertrigo

Though frequently dismissed as a simple “rash,” intertrigo reflects deeper issues of skin barrier compromise, friction, and moisture accumulation. Early recognition and targeted management are essential to prevent secondary infection and chronic skin changes.

Featured on This Week’s Chapter:

Understanding and Managing Intertrigo

• Recognizing clinical features that distinguish intertrigo from fungal, bacterial, or inflammatory dermatoses

• The pathophysiology of skin friction, moisture, and maceration in skin folds

• Diagnostic approaches: when to perform cultures, KOH prep, or biopsy

• Multimodal management strategies beyond topical antifungals

What is Intertrigo?

Intertrigo is an inflammatory condition that occurs in intertriginous areas, where two skin surfaces rub together, such as:

• Axillae (underarms)

• Inframammary folds (under breasts)

• Inguinal folds (groin)

• Abdominal folds

• Between fingers or toes

It is characterized by:

• Erythema, maceration, and fissuring in intertriginous areas

• Burning, itching, or tenderness

• Secondary infections with Candida, bacteria, or dermatophytes

• Chronic lichenification and hyperpigmentation if untreated

It is caused by a combination of friction, moisture, heat, and maceration, which disrupt the skin barrier and trigger inflammation. The compromised skin can then become susceptible to secondary infections, most commonly:

• Fungal infections, especially Candida albicans

• Bacterial infections, often Staphylococcus aureus or Streptococcus species

• Occasionally dermatophytes

Risk factors include:

• Obesity or overweight

• Hyperhidrosis (excessive sweating)

• Diabetes or immunosuppression

• Poor hygiene or occlusive clothing

• Prolonged bed rest or mobility limitations

Treatment of Intertrigo

Effective management of intertrigo requires both treating the inflammation/infection and addressing the underlying environmental factors.

1. General Measures

• Keep the area dry: Use absorbent powders, barrier creams, or non-occlusive dressings.

• Reduce friction: Wear loose, breathable clothing; consider soft cotton or moisture-wicking fabrics.

• Weight management: In obese patients, reducing skin folds can significantly decrease recurrence.

• Hygiene: Gentle cleansing with mild soap and thorough drying. Avoid harsh scrubbing.

2. Topical Therapies

• Antifungal agents: For Candida infections, use clotrimazole, miconazole, or nystatin creams.

• Topical corticosteroids: Low-potency corticosteroids can reduce inflammation but should be used carefully to avoid further skin atrophy.

• Combination therapies: Products combining antifungal and low-potency corticosteroid are often preferred for inflamed fungal intertrigo.

• Barrier ointments: Zinc oxide or petrolatum to protect against moisture and friction.

3. Systemic Therapy

• Oral antifungals may be necessary in severe, widespread, or refractory cases.

• Oral antibiotics if bacterial superinfection is suspected (based on purulence, odor, or culture).

4. Adjunctive and Preventive Strategies

• Powders to reduce moisture

• Frequent monitoring in patients with chronic illness or immobility.

• Education: Teaching patients to dry folds carefully and monitor for early signs of recurrence.

Want to see real cases with real outcomes?

Our dedicated Impetrigo Module offers case-based learning to support diagnosis and long-term management of patients with venous-related dermatoses.

Everything you need in one place!

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Whether you’re actively exploring new opportunities or just curious about what’s available, now is the perfect time to discover dermatology roles focusing on lymphatic and vascular skin conditions.

Why browse now?

• Find positions with specialized wound and lymphatic care focus

• Discover roles offering leadership and innovation in multidisciplinary teams

• Explore telemedicine and research opportunities advancing lymphatic medicine
  

Explore new locations, new teams, or new modalities (hello, AI-driven diagnostics!)

👋🏻 See you next Thursday, DERM community!

Intertrigo may seem minor, but its impact on patients is uncomfortable, persistent, and often preventable.
Our mission? Identify it early, manage contributing factors, and treat beyond the rash.

If today’s insights brought clarity on intertrigo, share them widely with colleagues, trainees, or wound care teams.

— The Derm for Primary Care Team