What are the common symptoms of intertrigo. How is intertrigo diagnosed and treated. What steps can be taken to prevent intertrigo from occurring or recurring. Who is most at risk for developing intertrigo.

Understanding Intertrigo: A Common Skin Fold Condition

Intertrigo is an inflammatory skin condition that primarily affects areas where skin folds rub together, creating a warm and moist environment. This friction and moisture can lead to skin breakdown, inflammation, and increased susceptibility to bacterial or fungal infections. While intertrigo can affect people of all ages, it’s particularly common in individuals who are overweight, have diabetes, or use medical devices like splints or prosthetics.

Recognizing the Symptoms of Intertrigo

Identifying intertrigo early is crucial for effective management. The condition typically presents as a red or reddish-brown rash in areas where skin touches skin. Common symptoms include:

• Redness and inflammation in skin folds
• Itching or burning sensation
• Raw or oozing skin
• Unpleasant odor in severe cases
• Cracked or bleeding skin in advanced stages

Are certain body areas more prone to intertrigo? Yes, the condition commonly affects:

• Armpits
• Under the breasts
• Groin area
• Abdominal folds
• Between toes and fingers
• Neck creases
• Buttock area

Unraveling the Causes of Intertrigo

Intertrigo develops due to a combination of factors that create an ideal environment for skin irritation and microbial growth. The primary causes include:

1. Skin-on-skin friction in folded areas
2. Excessive moisture trapped in skin folds
3. Warm temperatures promoting microbial growth
4. Poor air circulation in affected areas
5. Presence of irritants like sweat, urine, or feces

Can intertrigo lead to secondary infections? Indeed, the compromised skin barrier in intertrigo-affected areas can facilitate overgrowth of:

• Yeast (particularly Candida species)
• Various fungal organisms
• Bacteria, including Staphylococcus and Streptococcus

Identifying Risk Factors for Intertrigo

While anyone can develop intertrigo, certain factors increase the likelihood of occurrence. These include:

• Obesity or overweight status
• Diabetes mellitus
• Use of corticosteroids or antibiotics
• Wearing tight-fitting clothing or non-breathable fabrics
• Living in hot, humid climates
• Poor personal hygiene
• Excessive sweating (hyperhidrosis)
• Weakened immune system

Diagnosing Intertrigo: When to Seek Medical Attention

Proper diagnosis of intertrigo is essential for effective treatment. While mild cases may be self-diagnosed, it’s advisable to consult a healthcare professional if symptoms persist or worsen. The diagnostic process typically involves:

1. Physical examination of affected skin areas
2. Review of medical history and risk factors
3. Skin scraping or swab for microscopic examination or culture (in cases of suspected infection)

Is a biopsy necessary for diagnosing intertrigo? In most cases, a biopsy is not required. However, if the rash is atypical or doesn’t respond to initial treatment, a skin biopsy may be performed to rule out other skin conditions.

Effective Treatment Strategies for Intertrigo

The management of intertrigo focuses on addressing the underlying causes, relieving symptoms, and preventing complications. Treatment approaches may include:

1. Topical Treatments

• Antifungal creams or powders (e.g., miconazole, clotrimazole)
• Antibacterial ointments for bacterial infections
• Mild corticosteroid creams to reduce inflammation
• Barrier creams or ointments to protect the skin

2. Systemic Medications

• Oral antifungal drugs for severe fungal infections
• Antibiotics for widespread bacterial infections

3. Lifestyle Modifications

• Keeping affected areas clean and dry
• Using absorbent powders to reduce moisture
• Wearing loose-fitting, breathable clothing
• Maintaining a healthy weight

How long does it take for intertrigo to heal with proper treatment? With appropriate care, mild cases of intertrigo may improve within a few days to a week. However, more severe or recurrent cases may require longer treatment and ongoing management.

Preventing Intertrigo: Proactive Measures for Skin Health

Taking preventive steps can significantly reduce the risk of developing intertrigo or experiencing recurrences. Key prevention strategies include:

• Maintaining good personal hygiene
• Drying skin folds thoroughly after bathing or sweating
• Using moisture-wicking fabrics for clothing
• Applying protective barriers like zinc oxide to prone areas
• Managing underlying health conditions like diabetes
• Losing weight if overweight or obese
• Using antiperspirants to control excessive sweating

Can dietary changes help prevent intertrigo? While not directly linked, a balanced diet rich in nutrients that support skin health (such as vitamins A, C, and E) may contribute to overall skin resilience and faster healing.

Living with Intertrigo: Long-term Management and Outlook

For individuals prone to intertrigo, adopting a proactive approach to skin care is crucial for long-term management. This may involve:

1. Regular skin inspections to catch early signs of irritation
2. Promptly addressing any skin fold irritation or rashes
3. Maintaining a consistent skincare routine
4. Working with healthcare providers to manage underlying risk factors
5. Being mindful of environmental factors that may exacerbate symptoms

Is intertrigo a chronic condition? While not inherently chronic, some individuals may experience recurrent episodes of intertrigo, especially if risk factors persist. However, with proper management and preventive measures, the frequency and severity of outbreaks can be significantly reduced.

Intertrigo in Special Populations: Considerations and Approaches

Certain groups may require special attention when it comes to intertrigo management:

Infants and Young Children

In infants, intertrigo often manifests as diaper rash. Prevention and treatment focus on:

• Frequent diaper changes
• Use of barrier creams
• Allowing diaper-free time for air exposure

Elderly Individuals

Older adults may be more susceptible due to decreased skin elasticity and mobility issues. Care strategies include:

• Regular repositioning for bedridden patients
• Careful attention to skin folds during bathing
• Use of moisture-absorbing pads in skin fold areas

Athletes and Active Individuals

Those engaged in frequent physical activity may face increased risk. Preventive measures include:

• Wearing moisture-wicking athletic wear
• Showering promptly after exercise
• Using anti-chafing products for high-friction areas

How does the approach to intertrigo differ in these populations? While the basic principles of treatment remain similar, the specific interventions and preventive measures may be tailored to address the unique needs and circumstances of each group.

Emerging Research and Future Directions in Intertrigo Management

As our understanding of skin health and microbial interactions evolves, new approaches to intertrigo prevention and treatment are emerging. Some areas of ongoing research include:

• Development of advanced moisture-wicking fabrics
• Novel antimicrobial compounds with reduced resistance potential
• Probiotic-based interventions to promote healthy skin flora
• Personalized treatment approaches based on individual microbiome profiles

What potential breakthroughs might we see in intertrigo management in the coming years? While it’s difficult to predict specific advances, continued research into skin barrier function, microbial ecology, and innovative topical formulations may lead to more effective and targeted treatments for intertrigo.

The Role of Patient Education in Intertrigo Management

Empowering patients with knowledge about intertrigo is crucial for effective prevention and management. Key aspects of patient education include:

1. Understanding the causes and risk factors of intertrigo
2. Recognizing early signs and symptoms
3. Learning proper skin care techniques for prone areas
4. Understanding the importance of weight management and overall health
5. Knowing when to seek medical attention

How can healthcare providers effectively educate patients about intertrigo? Utilizing a combination of verbal instruction, written materials, and visual aids can help reinforce key messages. Additionally, follow-up appointments and support groups can provide ongoing education and encouragement.

Intertrigo and Quality of Life: Addressing the Psychosocial Impact

While often viewed primarily as a physical condition, intertrigo can have significant psychological and social effects on those affected. These may include:

• Embarrassment or self-consciousness about appearance or odor
• Discomfort or pain affecting daily activities
• Anxiety about recurrence or worsening of symptoms
• Impact on intimate relationships

How can healthcare providers address the psychosocial aspects of intertrigo? A holistic approach that considers both physical and emotional well-being is essential. This may involve:

• Providing reassurance and emotional support
• Offering resources for coping strategies
• Referring to mental health professionals when necessary
• Encouraging participation in support groups or online communities

By addressing both the physical and emotional aspects of intertrigo, healthcare providers can help patients achieve better overall outcomes and improved quality of life.

Symptoms, Causes, Diagnosis, Treatment & Prevention

What is intertrigo?

Intertrigo is a rash that usually affects the folds of the skin, where the skin rubs together or where it is often moist. This rubbing can cause a breakdown in the top layers of the skin, causing inflammation and a rash. The breakdown of skin makes it easier for bacteria or fungus to develop in this area. It can make the rash worse.

Intertrigo is most common in people who are overweight or who have diabetes. People who have splints, braces, or artificial limbs are also more likely to develop this rash.

Symptoms of intertrigo

Symptoms include a red or reddish-brown rash that can appear anywhere skin rubs together or traps wetness. This rash may burn or itch. The most common areas include:

• Between toes
• In the armpits
• In the groin area
• On the underside of the belly or breasts
• In the crease of the neck

Intertrigo can also affect the skin between the buttocks. The affected skin will often be very raw and may itch or ooze. In severe cases, intertrigo may cause a foul odor, and the skin may crack and bleed.

What causes intertrigo?

Skin folds sitting together and rubbing together causes intertrigo. This skin-on-skin friction creates a warm, moist environment. This environment invites an overgrowth of yeast, fungus, and bacteria. Intertrigo is not contagious. You cannot catch it from or pass it to another person.

How is intertrigo diagnosed?

The best way to know for sure is to ask your doctor. Your doctor will be able to tell if you have the rash by looking at your skin. No special tests are needed but your doctor may take a sample to determine what type of bacteria or fungus may be present.

Can intertrigo be prevented or avoided?

You can help prevent intertrigo by doing these things:

• Keep skin cool and dry.
• Do not wear tight shoes or clothing. Wear a bra that has good support.
• Wear clothes made with absorbent fabrics, such as cotton. Avoid nylon or other synthetic (manmade) fibers.
• If you are overweight, try to lose weight.
• After exercising, shower and dry off completely. Use a hair dryer with a cool setting to dry areas that can trap wetness, such as under your arms or breasts.

Intertrigo treatment

For mild cases, your doctor will tell you to keep the affected area of your skin dry and exposed to air. Your doctor may also want to prescribe a topical steroid cream. For certain cases, your doctor may prescribe an antibiotic or antifungal cream. There are also antifungal powders that may help dry the skin. Talk to your doctor about which treatment is right for you.

Living with intertrigo

Intertrigo may come and go. If you know that you are predisposed to getting this type of rash, take precautions. Before physical activity, treat the area with deodorant or with petroleum jelly. Do what you can to keep skin folds dry.

Questions to ask your doctor

• What is the best way to keep from getting intertrigo again?
• Do I need to make any changes to my lifestyle?
• Do I need to use a cream or ointment?
• What side effects could I have from my medicine?
• Do I need to take an antibiotic?
• Is there anything I can do on my own to help myself get better?

Resources

U.S. National Institutes of Health, MedlinePlus: Intertrigo

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Risk Factors, Causes, Symptoms, and Treatment

Written by Annie Stuart

• Symptoms of Intertrigo
• Causes of Intertrigo
• Risk Factors for Intertrigo
• Prevention and Treatment of Intertrigo

Intertrigo is a fancy name for a rash that shows up between the folds of skin. It is a very common skin rash that can crop up throughout life.

The most common areas affected include larger skin-fold areas such as:

• Armpits
• Beneath the breasts
• Genital area
• Abdomen

What does intertrigo look like? It may cause:

• Red or reddish-brown rash
• Raw, itchy, or oozing skin
• Foul odor
• Cracked or crusty skin

Intertrigo may appear in any skin folds that rub together and trap moisture. In infants, intertrigo often shows up as diaper rash.

Intertrigo can occur:

• Between toes and fingers
• In armpits
• In the inner thighs
• In the groin and at the scrotum
• On the underside of your breasts or belly
• In the crease of your neck
• Between the buttocks

If you have any symptoms of intertrigo, be sure to see your doctor. Your doctor can check for the presence of infection as well.

Intertrigo is an inflammatory skin condition that can be caused and worsened by many factors. These include:

• Moisture
• Heat
• Lack of air circulation
• Friction between skin folds

Sweat, urine, and feces can contribute to the skin problem.

Intertrigo is often accompanied by an infection caused by:

• Yeast
• Other types of fungus
• Bacteria

You are more likely to get these infections in skin folds because these are areas that are warm and tend to stay moist. This creates a welcome environment for the growth of germs.

You are more likely to develop intertrigo if you:

• Are obese
• Have diabetes
• Have a splint, brace, or artificial limb
• Are exposed to high heat and humidity

Other possible risk factors include:

• Incontinence
• Excessive sweating
• Poor hygiene
• Malnutrition
• A suppressed immune system due to chemotherapy or HIV

Infants — with their chubbiness, shorter necks, and flexed posture — are also at greater risk for intertrigo.

Certain skin diseases such as psoriasis may also prompt the development of intertrigo. So it’s a good idea to have a dermatologist check it out.

If you or your child has intertrigo, your doctor may suggest simply keeping the affected area dry and exposed to the air. You may control oozing with moist compresses of an astringent called Burow’s solution. Then air-dry with a hair dryer set on “cool.”

A barrier cream may be recommended to help protect skin from irritants.

To treat intertrigo, your doctor may recommend short-term use of a topical steroid to reduce inflammation in the area. If the area is also infected, your doctor may prescribe an antifungal or antibiotic cream or ointment. Sometimes you need an oral medication.

Some simple steps may help lower your risk in the future, such as:

• Shower and dry off thoroughly each day. Keep your skin as dry and cool as you can.
• Avoid wearing tight shoes or clothing.
• Wear a bra with good support.
• If the areas between the toes are affected, consider wearing open-toed shoes.
• For infants with diaper rash, change diapers more frequently.
• If you are overweight, do what you can to lose weight.

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Atopic dermatitis or skin inflammation

What is atopic dermatitis or skin inflammation?

Atopic dermatitis is a chronic skin disease with exacerbations and improvements, the main symptom of which is itching.

In atopic dermatitis, the formation of the natural protective layer of the skin is disrupted. Characterized by dry and flaky skin. During an exacerbation, inflamed red and scaly (scaly) or weeping patches appear.

Where is the atopic dermatitis rash located?

The location of the rash on the body depends on age. In infants, young children, adolescents, and adults, the location of the rash varies.

Baby (infant):

• The face and cheeks are red and rough.
• Inflammation covers the chest, back and folds of the limbs.
• The rash is symmetrical.
• Under eyes, area around mouth and nose mostly without rash.

Small child:

• The rash is located on the folds of the elbow and knee joints.
• Often rash on the neck, wrists, back of the hand, ankle.
• The skin pattern is strongly pronounced, the skin is often thickened.
• Skin shows scratch marks.

Adolescents and adults:

• The rash is localized on the elbows and knees, wrists and palms.
• The skin pattern is strongly pronounced, the skin is thickened.
• Characteristic skin fold under the eyes.

What are the complaints caused by atopic dermatitis

• Symptoms range from short and mild to severe itching and rash causing sleep disturbance.
• Due to sleep disturbances, children are tired during the day, their attention is distracted, their academic performance and ability to work are reduced.
• One of the main risk factors for exacerbation of atopic dermatitis is stress. At the same time, a visible rash and excruciating itching, in turn, lead to psychological stress, which makes it difficult to control the disease.

What is the cause of atopic dermatitis and its exacerbation

The cause of the disease is still unclear, although heredity and human environment play an important role. Exacerbation of dermatitis can cause physical and chemical irritants that get on the skin. For example, rough clothes (wool and synthetics), smelly detergents, hot water, wiping with a hard towel, cold and hot weather.

Exacerbation of atopic dermatitis can cause a general illness, which can be caused by severe respiratory tract infections or severe purulent inflammation of the skin.

Exacerbation of the rash of atopic dermatitis can cause a state of mental irritation or an allergen contained in food or air. About a third of children with atopic dermatitis are allergic to food or air allergens.

What to use for atopic dermatitis

Atopic dermatitis cannot yet be cured, but the disease can be controlled with daily skin care. To improve the elasticity of the skin, to avoid cracks, reduce itching and flaking of the skin, increase the protective function of the skin, you can smear softening base creams on dry areas of the skin several times a day. When choosing a base cream, it is very important that it is suitable for the patient and does not cause burning and redness. Zinc-containing creams reduce inflammation and soothe, but at the same time dry the skin. Zinc-containing creams can be alternated with base creams.

Creams with a high fat base generally need to be applied less frequently than water-based creams.

Considerations for atopic dermatitis

• For especially sensitive skin, use a base cream.
• Short periods of time may be spent in the shower, bath or pool
• Oils may be added to the water while taking a bath.
• Skin irritation can be avoided by using fragrance-free and color-free detergents.
• Wipe the skin with a soft towel, blotting lightly and then immediately apply the cream.
• Avoid sweating as much as possible, as this can irritate the skin.
• Choose a cool room for sleeping, as coolness reduces itching.

Compiled by: sister of the children’s clinic Tiija Kõivist

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What is atopic dermatitis?

“Dermatitis” means inflammation of the skin. And the term “atopic” is understood as a hereditary predisposition to allergies.

Most often, this disease first manifests itself in childhood. In most patients, by the age of five, atopic dermatitis goes into stable remission, but often the disease can continue in adults. The exact causes of the disease have not been established, but modern medicine believes that atopic dermatitis is a multifactorial disease, which is based on a genetic predisposition to atopic diseases.

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-treatment! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan for a consultation!

A tendency to atopic dermatitis can be realized when there are provoking factors in your life:

• psycho-emotional stress;
• disturbance in the functioning of internal organs;
• unfavorable environment.

It has been noticed that atopic dermatitis worsens more often in the cold season, so if skin problems arise with the onset of cold weather, there is reason to think about visiting a dermatologist.

The main symptom of atopic dermatitis is itching of varying intensity. Sometimes so strong that it can disturb the sleep of the patient. Inflammation and dryness of the skin, a variety of rashes that often accompany the disease, cause very unpleasant sensations.

There are several stages of the disease:

• Infantile (up to two years of age).

During this period, rashes, as a rule, are edematous redness, peeling on the skin of the face, on the extensor surfaces of the arms and legs. In more severe cases, blisters, weeping, and crusts may appear. In this stage, as a rule, there is a clear connection with food irritants.

• Children (from two to 12 years).

At the age of two years, atopic dermatitis in children manifests itself in the form of rashes on the skin of the elbows, popliteal fossae, and the back of the neck. The tendency to get wet decreases, nodular inflammatory elements are more often present, increased dryness of the skin, its peeling and irritation persists.

• Adult (over 12 years old).

In most patients, by this age, the disease goes into stable remission (no manifestations of the disease). With the continuation of the disease in adulthood, intense pruritus comes to the fore. Severe dryness of the skin, peeling persists. Rashes on the skin can be varied (bubbles, nodules, foci of redness). Most patients have a clear connection between exacerbations and psycho-emotional factors.

The above symptoms refer to periods of exacerbation of atopic dermatitis. During the “lull” the disease can manifest itself only as increased dryness of the skin.

Advice for people with atopic dermatitis

• People with atopic dermatitis have very sensitive skin. Such people do not want frequent water procedures, and they need to wash themselves with the use of special emollients and moisturizers, do not use a washcloth. After washing, it is better to remove water from the surface of the skin with blotting movements, and not with the usual wiping.
• Emollient and moisturizing cream for atopic dermatitis must be used daily. In clothes, preference should be given to cotton and skin contact with wool, synthetic and coarse fabrics should be avoided.
• For those suffering from atopic dermatitis, it is better to keep carpets, as well as items and furniture that contribute to the accumulation of dust, in the house. Books and clothes are best kept in lockable cabinets and vacuumed regularly. Pillows and blankets are better to use not down, but from synthetic materials.
• This disease imposes some dietary restrictions. Especially in infancy. It is very important that parents keep a food diary for their baby. It will help to clearly trace the connection between the use of a particular product and the exacerbation of atopic dermatitis.
• Many children have an increased sensitivity to milk and egg whites, which disappears with age. In the future, the significance of food allergies decreases. In adults, true food allergies are extremely rare.

However, adults with atopic dermatitis should also avoid foods that are rich in histamine or increase its release in the body:

• fermented cheeses cheeses
• cheeses
• marinades
• brewer’s yeast
• alcohol, etc.

In addition, if the patient notices a deterioration in the skin condition after consuming a particular product, then this product should also be excluded from the diet. During an exacerbation of the disease, a more stringent diet is required, excluding all irritating foods: spicy, smoked, spicy, marinades, fatty, sweet, muffin, fried, citrus fruits, honey, nuts, chocolate, alcohol. The sun is a powerful factor influencing the condition of the skin.

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Is it possible sunbathing with atopic dermatitis?

Yes, but the skin should still be protected from excess UV radiation. For example, using creams with a high degree of protection (SPF30+ and above). Apply the cream to the skin every two hours. In addition, it is better not to spend the “hottest” hours in the open sun. Even people without skin problems are advised to sunbathe either before 11 am or after 4 pm.

How to treat atopic dermatitis?

• The first step in the treatment of atopic dermatitis is the identification and elimination of triggers. At the same time, antihistamines are prescribed to eliminate the itching that bothers the patient. When choosing a drug, it is strongly recommended to consult a doctor so that he can help not only choose a medicine, but also calculate the dose corresponding to the age of the patient and the nature of the course of the disease.
• In addition, local anti-inflammatory drugs (creams, ointments), including hormonal ones, are used in the treatment of atopic dermatitis. The choice of drug should be approached very carefully, especially for infants.