Intertrigo

What is intertrigo?

Intertrigo is a common skin rash caused by friction of skin on skin. The friction causes inflammation and irritation. It happens in areas where there’s a lot of contact between skin, like:

• Behind the ears

• In the folds of the neck

• Under the arm, groin, belly or breast

• Between the fingers or toes

These areas easily trap moisture from sweat and have a slightly higher temperature. This creates an environment where bacteria and yeast like to grow, causing intertrigo. 

There are a few different types of intertrigo:

• Acute – if it appeared recently

• Recurrent – if it has happened several times and keeps coming back

• Chronic – if it’s been going on for more than 6 weeks

• Interdigital – between the fingers and toes

• Candidal – happens when the skin becomes infected with the yeast Candida

• Diaper rash – happens in babies, where the rash appears around their nappy area

What are the symptoms of intertrigo?

The main symptoms of intertrigo include:

• Redness and can lead to a rash

• Soreness

• Swelling

• Itchiness

• Cracking, splitting, or crusting of the skin

• Sores that may become infected

• Blisters

• A slight odour

How common is intertrigo?

In the UK, around 1 in 8 people have intertrigo. Intertrigo can affect anyone, but people in hospitals or nursing homes are especially likely to get it. 

What causes intertrigo?

The main cause of intertrigo is skin-on-skin contact that traps moisture and causes inflammation and infection. 

Anyone can get intertrigo, but some people are more prone to getting it. People with lots of skin folds, like obese people or babies, are more prone to having intertrigo.  Toe web intertrigo is common in active people who wear closed-toe and tight-fitting shoes.  Having diabetes can also increase your risk of intertrigo. 

How is intertrigo diagnosed?

When you visit your GP, they will diagnose intertrigo by asking you a few questions and having a look at the sore area.

They may also take a swab and scraping of the skin, which they will send to the lab for analysis. In severe cases where intertrigo does not respond to treatment, they may want to take a skin biopsy.

How is intertrigo treated?

When you’re dealing with intertrigo, one of the best things to do is double down on hygiene and keep the area as dry as you can. 

• Wash the affected areas regularly

• Dry your skin well – use a patting motion rather than rubbing. You might also want to try using a hairdryer on the cool setting for areas like under the breasts

• Wash your towels regularly and avoid sharing them with others to prevent the infection from spreading

• Use an antiperspirant cream or powder wherever you have the rash

• Wear a well fitting bra, ideally made from cotton, and wash it regularly

• Lose weight to reduce the areas where the skin folds rub

If the intertrigo is causing you lots of discomfort, you can also try over-the-counter treatments with the advice from your pharmacist:

• Anti-fungal creams and powders can be applied twice a day – be sure not to apply to areas where the skin has broken

• Barrier cream can be applied once the infection has been cleared to stop it from coming back – these can include zinc or castor oil

• Ketoconazole 1% shampoo is an antifungal shampoo that you can apply over the affected areas while you’re in the shower

If these don’t get rid of intertrigo, talk to your GP about other treatments:

• Creams may be given to treat the bacterial or fungal infection, like topical fusidic acid, clotrimazole or terbinafine

• Tablets may also help treat if the infection is persistent or severe. Some examples include oral flucloxacillin, erythromycin, itraconazole or terbinafine

• If your GP suspects that you have an inflammatory skin disease, they may recommend topical steroid creams like hydrocortisone. More potent steroids are avoided as they cause skin thinning. Calcineurin inhibitors can also help, like tacrolimus or pimecrolimus ointments.

• In worse cases, they may refer you to a dermatologist or consider surgery to remove the bad skin

When should I speak to a doctor?

Book an appointment with a GP if:

• Your symptoms last for more than a couple of months and do not go away without treatment

• The rash spreads to other parts of your body

• The skin blisters and cracks

• Your finger or toenails change colour or shape

• You get smelly discharge from the area

• You develop a fever, feel tired and weak

How can Livi help?

A Livi doctor will ask you questions about your symptoms. They’ll make an individual assessment, recommend a treatment or refer you to a specialist if needed.