Intertrigo, which means “rubbed sore” in Latin, is an inflammatory skin condition that particularly affects the skin folds. The infection is also known as “skin sore.” Promoting factors are lesions of the skin, tight clothing, a lack of hygiene, humid climate and diseases such as diabetes.
What is intertrigo?
Intertrigo skin infection can be seen in various skin folds, for example, the feet, armpits, groin, between the toes, inside the thighs, in the anal crease and under the breasts. In common parlance, the red, erosive, itchy and inflammatory skin change is also called “wolf”. Intertrigo is caused by a mechanical friction in the skin folds, which causes skin erosion and maceration. Moisture and heat intensify the mechanism. The opposing surfaces of the skin become red and painful. The loss of integrity promotes the growth of bacteria and fungi. A common fungal pathogen is Candida albicans. Without treatment, the skin usually defends itself against it in vain. Extensive and weeping inflammations develop. These are exacerbated by sweat, urine, feces, vaginal secretions and other fluids. Infants are also already affected by the disease intertrigo, as the bent posture, short neck and roundish body contribute to skin folds.
Causes
Eczema can be either mycotic in origin, but can also be caused by bacteria such as streptococci and staphylococci, candida, or dermatophytes. Promoting factors are mainly transpiration (sweating) and maceration due to heat exposure. Visiting swimming pools and saunas promotes contamination due to the high humidity prevailing here. Tight-fitting clothing and synthetic materials such as nylon also promote the occurrence of the disease. Overweight people and athletes, such as cyclists and hikers, are particularly susceptible to intertrigo because they sweat more and their skin is often exposed to rubbing and chafing. With a fuller body, the skin folds are also particularly pronounced. A warm, moist climate develops in them, which damages the natural acid mantle and makes the skin susceptible to pathogens. However, lack of exercise, for example due to bed confinement or office work, is also one of the risk factors. Diabetic patients are also more likely to develop intertrigo.
Symptoms, complaints and signs
Intertrigo is easily recognized by the demarcated lesions on the skin, which are pinkish to brownish in color. The mild to severe redness develops on both sides of the fold in a roughly mirror image. Purulent crusts may also form at the edges of the skin defects. As bodily fluids leak out, itching or burning sensations are also present. The lesions are usually painful. If the skin infection is caused by fungi, the patches have a white border. Pustules and papules indicate that the infection is secondary to Candida. The pre-damaged skin and the moist and warm environment are an optimal breeding ground for microorganisms, so that a secondary infection with various fungi such as Candida and dermatophytes, bacteria such as streptococci and viruses is favored.
Diagnosis and course of the disease
Intertrigo is diagnosed by history, appearance, and examination. For example, a dermatologist may perform a KOH test to examine the fungal mycelia that are spreading in the skin lesion. Detection of the pathogens is helpful in selecting appropriate therapy. The corresponding skin rash can provide a good indication of the infection. While blisters are indicative of a bacterial infection, scattered papules or pustules around the edges are more likely to be a sign of infection with Candida. Clearly demarcated and strongly reddened, foul-smelling rashes without satellite papules raise the suspicion that an infection with streptococci is present. If the risk factors that lead to the occurrence of intertrigo are not avoided or eliminated, the condition may recur.
Complications
Intertrigo usually causes severe discomfort to the skin of the affected person. Due to this discomfort, it is not uncommon to experience lowered self-esteem or further inferiority complexes and depression.Patients no longer feel comfortable with their appearance and thus often avoid social contacts or events. The skin may also be very red and the patient suffers from severe itching or burning. These unpleasant feelings can also lead to a general irritability of the affected person. Similarly, pustules and papules form on the skin and can continue to negatively affect the aesthetics of the patient. Further treatment of this disease usually depends on the cause. In most cases, however, no particular complications or discomfort occur and the symptoms disappear again. Also with the help of
Medications and ointments or creams, intertrigo can be limited. The life expectancy of the affected person is not reduced with this disease. Furthermore, the patient is dependent on good personal hygiene to prevent the disease from recurring.
When should one go to the doctor?
If the redness on the skin persists for more than a few days, a visit to the doctor is recommended. Intertrigo should be clarified by a doctor in any case, because if left untreated, the skin disease can cause serious complications. If further symptoms occur, a doctor should be consulted immediately. This is especially true if the well-being is affected. Thus, severe itching and bleeding, as well as large skin changes, must be clarified by a doctor in any case. Intertrigo occurs in connection with bacterial infections or obesity. Athletes who wear tight-fitting clothing are also susceptible to the development of sores. A doctor should clarify the symptoms and prescribe an appropriate medication for the patient. Diabetes patients should inform the responsible physician about the skin changes. If the sore spots appear for no apparent reason, there may be a serious underlying condition that needs to be clarified by a medical professional. The right contact point is the family doctor or a dermatologist. With children, it is best to go to the pediatrician in charge.
Treatment and therapy
Treatment of intertrigo can be done with homeopathic remedies, for example, hepar sulfuris C5. In the case of a disease of the toes or athlete’s foot with a red, moist and itchy skin, Hydrocotyle C5 is used. If the skin lesions are caused by sweating, Dulcamara C5 and Natrium sulfuricum C5 are helpful. If the disease is of mycotic origin, Mercurius C5 is taken. For weeping lesions, the homeopathic remedy Graphites is the optimal choice, and for intertrigo of infectious origin with a progressive extension, Hepar sulfuris calcareum C5. Lycopodium clavatum C5 is good for reducing intertrigo if the condition was caused by a rash with superinfection. If intertrigo was caused by Candida albicans, the remedy Monilia albicans C5 is used. Glucocorticoids are anti-inflammatory, so they are suitable for treating inflammatory processes. Drying skin care products such as zinc ointment are also helpful. Antifungals and antibiotics can also be used against superinfections. Without treatment, the skin infection spreads to the whole body at a rapid rate. Therefore, a doctor should be consulted when the first symptoms such as reddish and moist patches appear on the skin folds. The same applies to cracked skin and itching, because these symptoms also indicate intertrigo. Skin care products can be of help. Oil-in-water emulsions, for example, stabilize the damaged skin barrier and prevent the recurrence of intertrigo.
Outlook and prognosis
For a large number of patients, the prognosis of the disease is favorable. This depends on a number of factors. They include the cooperation of the affected person, the general state of health, and the use of medical care. A physician is not always needed. If intertrigo is triggered due to poor hygiene, freedom from symptoms can be achieved by daily washing or showering and a regular change of clothing. Wearing tight clothing should also be avoided and may help alleviate the skin lesions. If obesity is the cause of the disease, the affected person can achieve relief from the existing symptoms by changing his diet and optimizing his food consumption on his own responsibility.Weight loss often minimizes the skin irregularities in these sufferers. If a diabetic disease is the trigger for intertrigo, a doctor should be consulted so that a treatment plan can be drawn up in cooperation with him. Existing symptoms are alleviated through the administration of medications. Long-term therapy is necessary for these patients, since in most cases a relapse occurs when the medication is discontinued. The skin disease is triggered by a chronic underlying disease and can therefore usually only be alleviated with adequate therapy.
Prevention
The best solution to avoid intertrigo is called prevention. This is possible by reducing weight, avoiding sweaty drinks, such as coffee, and avoiding clothing made of synthetic fibers, as cotton is more suitable. Women should also avoid wearing a bra that is too tight. Secondary infections can be prevented with a disinfectant.
Aftercare
With intertrigo, prevention, treatment, and follow-up care all go hand in hand. Patients can reduce the risk of developing the disease by losing weight. To avoid excessive sweat production, it also helps to avoid hot drinks and spicy foods. Wearing natural fibers such as cotton ensures good breathability. At the same time, clothing should not be too tight to prevent possible irritation. Special disinfectant products are available to those affected against secondary infections. The doctor informs the patients about the usual treatment with homeopathic medicines. Patients should be careful to take them correctly and consider additional relief measures if necessary. Vaseline, talcum powder or ointment helps to target and relieve the skin condition. There are also special wound ointments for this purpose, some of which contain cortisone. In accordance with the doctor’s recommendation, patients use skin-friendly, gentle agents to clean and care for the affected skin area. Fresh air is very helpful. To kill the germs, a bath with antiseptic ingredients is suitable. If it comes to the open wound, a bandage or plaster is recommended. If infection occurs, it is necessary to properly apply the antibiotic prescribed by the doctor. This complements the home remedies already mentioned.
This is what you can do yourself
With the help of some household and natural remedies, intertrigo can be cured by yourself in many cases. For example, the “skin wolf” can be treated with petroleum jelly or talc, either as a powder or as an ointment. Wound ointments (e.g. Hametum ointment or burn and wound gel) and cortisone-containing agents also help with acute symptoms. Accompanying this, the affected skin area must be regularly cleaned with a skin-friendly disinfectant and, if possible, provided with fresh air. An antiseptic bath with Bepanthen or Betaisodona kills the germs. A plaster or bandage should be applied to open wounds. In case of infection, the doctor must prescribe a suitable antibiotic, which is best used in addition to home remedies mentioned. Various globules are available from homeopathy. For example, the anti-inflammatory preparation Hepar sulfuris C5 has proven itself. If the toes are affected or if there is athlete’s foot, Hydrocotyle C5 can be used. Dulcamara C5 and Natrium sulfuricum C5 help with skin lesions caused by excessive sweating. If, despite everything, the infection spreads, a doctor must provide treatment.