INTERTRIGO

Intertrigo is an inflammatory skin condition that is caused by skin-to-skin friction (rubbing) that is intensified by heat and moisture. It usually looks like a reddish rash. Trapped moisture, which is usually due to sweating, causes the surfaces of your skin to stick together in skin folds. The moisture increases the friction, which leads to skin damage and inflammation.

In many cases of intertrigo, damage to the skin allows bacteria and/or fungus normally present on the surface of skin to overgrow. The warmth, trapped moisture and friction-induced skin damage create an ideal environment for bacteria and fungi to grow and multiply. This overgrowth of bacteria and/or fungi triggers your immune system to respond, which results in secondary inflammation and a visible rash. In more severe cases, the bacterial and/or fungal overgrowth is significant enough to cause a secondary infection.

PARTS OF THE BODY GET AFFECTED BY INTERTRIGO

Intertrigo can appear in between any skin areas that are in close contact with each other, such as skin folds, and that are often moist.

The most common places that intertrigo occurs include:

• In the crease(s) of your neck.
• In your armpits.
• Beneath or between your breasts.
• Between your belly folds.
• Between your buttocks.
• In your groin at your scrotum.
• In your inner thighs.
• Between your toes and fingers.

Babies are especially at risk for intertrigo because their skin is delicate and they’re more likely to have moist skin from drooling or from wearing diapers. The most common places for babies to have intertrigo include:

• On their buttocks or in their groin area (often referred to simply as diaper rash).
• In between their neck folds.
• In the creases of their skin rolls or folds on their arms and legs.

DIFFERENT KINDS OF INTERTRIGO

There are a few names for intertrigo (also known as intertriginous dermatitis) depending on certain factors such as where it appears and if it’s caused an infection or not. Your healthcare provider may use one or more of these terms to describe your intertrigo:

• Acute intertrigo: If your intertrigo just recently appeared, it’s called acute intertrigo.
• Recurrent intertrigo: If you’ve had multiple cases of intertrigo over time, it’s called recurrent (relapsing) intertrigo.
• Chronic intertrigo: If your case of intertrigo has lasted six weeks or more, it’s called chronic intertrigo.
• Uncomplicated intertrigo: Uncomplicated intertrigo means your intertrigo has not caused an infection.
• Interdigital intertrigo: Intertrigo between your fingers or toes is called interdigital intertrigo.
• Candidal intertrigo: Candidal intertrigo happens when your intertrigo becomes infected by the yeast (fungus) Candida. Candida is the most common cause of intertrigo infections.
• Diaper rash: Also known as diaper dermatitis, diaper rash is a form of intertrigo.

CAUSES INTERTRIGO

Intertrigo is caused by skin-to-skin friction that is made worse by heat and moisture. This most commonly happens between skin folds or creases and between your toes or fingers.

The trapped moisture — often due to sweating — causes your skin surfaces to stick together. This increases the friction between your skin surfaces, which causes skin damage, bacterial and/or fungal overgrowth and inflammation. In many cases of intertrigo, the skin breaks open from the friction, which allows bacteria and/or fungus to get into your skin, causing an infection. The moisture and warmth make a perfect environment for bacteria and fungi to multiply. If the affected area comes in contact with sweat, pee or poop, it can make your intertrigo worse.

Different kinds of fungi and bacteria that can cause secondary infections include:

• Candida: Candida, a type of yeast and fungus, is the most common cause of secondary infections in intertrigo cases.
• Dermatophytes: Dermatophytes are fungi that require keratin (a type of protein) for growth. These fungi can cause infections in your skin and nails. Dermatophyte fungi often cause secondary infections from intertrigo in between your fingers or toes.
• Staphylococcus aureus: This bacteria — often called staph — is a common cause of intertrigo bacterial infections.

THE SIGNS AND SYMPTOMS OF INTERTRIGO

Signs and symptoms of intertrigo depend on how severe it is and if there is an infection or not.

Early symptoms of intertrigo without infection can include:

• Having a somewhat symmetrical red or reddish-brown rash with small bumps in an area where your skin rubs against itself.
• Having itching, stinging and/or burning in the affected area.
• Feeling uncomfortable or experiencing pain in the affected area.

If intertrigo is not treated in its early phase, you can develop the following symptoms:

• Feeling like your affected skin is raw.
• Having cracks in your affected skin.
• Experiencing bleeding or oozing from your affected skin.
• Having skin that is crusted over and/or scaly in the affected area.

Symptoms of intertrigo with an infection can include:

• Having a foul smell in the affected area.
• Having bumps on your affected skin that contain pus.
• Having raised, tender bumps on your affected skin.

If you have signs of an infection, it’s important to see your healthcare provider or go to the nearest hospital as soon as possible. Infections need proper medical treatment and can lead to serious complications if they’re left untreated.

THE RISK FACTORS FOR GETTING INTERTRIGO

Risk factors for getting intertrigo include:

• Obesity: Intertrigo is strongly associated with having obesity. People who have obesity usually have more pronounced skin folds and increased sweating. It can also be more difficult for people with obesity to properly clean and care for their skin folds.
• Diabetes: Having diabetes can cause increased sweating, which helps contribute to intertrigo. In addition, having diabetes and chronic high blood sugar can increase your skin surface pH, which makes it more ideal for bacteria and fungi to grow and multiply. This can put people with diabetes at a higher risk of getting an infection from intertrigo.
• Incontinence: People who have urinary incontinence (not being able to control their bladder) and/or fecal incontinence (not being able to regulate their bowel movements) are at higher risk for intertrigo because pee and/or poop in an absorbent undergarment creates a warm and moist environment. If you already have intertrigo, contact with sweat, pee or poop can make your intertrigo worse.
• Excessive sweating: Excessive sweating (known as hyperhidrosis) can put you at a higher risk of intertrigo.
• Excess skin from significant weight loss: People who have excess skin from significant weight loss are more likely to get intertrigo due to the skin folds rubbing together.
• Living in a hot and humid environment: Intertrigo is caused by skin friction due to trapped moisture, so living in a hot and humid environment, where you are more likely to sweat, puts you at a higher risk of getting intertrigo.
• Your age: Intertrigo is more common in babies and older people. Babies are at a higher risk for intertrigo because their skin is sensitive and they often have moist skin from drooling or from wearing diapers. It can be more difficult for older people to bathe and care for their skin routinely, so they’re at a higher risk for intertrigo.

MANAGEMENT

The main way to treat intertrigo that hasn’t caused an infection is by keeping the affected area dry, clean and cool. Ways you can keep your intertrigo dry, clean and cool at home include:

• Dry yourself thoroughly with a clean towel after you take a shower. Dry the affected area by patting it with a towel, not rubbing it.
• Use a fan or a hairdryer on the “cool” setting over the affected area multiple times a day.
• Wear loose clothing and breathable fabrics, such as cotton.
• Use a mild antiperspirant (deodorant) in your armpits or under your breasts to minimize sweating.

PREVENT INTERTRIGO      

There are several things you can do to try to prevent getting intertrigo, including:

• Keep your skin cool, dry and clean, especially areas where your skin rubs together.
• Shower and dry off completely every day and especially after you exercise or sweat.
• Avoid wearing tight clothes or shoes.
• Wear clothes that are made of breathable and absorbent fabrics, such as cotton, and avoiding clothes made of synthetic materials.
• Use a skin barrier protectant cream if you have incontinence.
• Change your child’s diaper frequently to prevent diaper rash.

COMPLICATIONS

If intertrigo is not treated properly, it can cause complications, including:

• Nail fungal infections: If a fungal infection from intertrigo that is between your toes or fingers is not treated properly, it can cause a fungal infection in your toenails or fingernails.
• Cellulitis: Cellulitis is a deep infection of the skin and soft tissue caused by bacteria. If cellulitis is not treated properly, it can be life-threatening. This complication is more common in people who have diabetes and intertrigo.
• Sepsis: If you have an infection caused by intertrigo that is not treated, it could lead to sepsis. Sepsis is a medical emergency caused by the body's response to systemic infection. It can be life-threatening.

HOMOEOPATHIC TREATMENT

ARS-ALB. Skin popular dry, rough, dirty looking, scaly< cold and scratching. Hot, itching and violent burning in skin, itching increased by scratching followed by bleeding. Icy coldness of body. Parts painful after scratching. Disease begins as red spot spread like ringworm covered with silvery scales.Great Prostration, with rapid sinking of the vital forces; fainting.The greater the suffering the greater the anguish, restlessness and fear of death. Mentally restless, but physically too weak to move. Indicated by its periodicity and time aggravation: after mid-night, and from 1-2 a.m. And by its intense restlessness, mental and physical: its anxiety and prostration.

GRAPHITES: Skin rough, hard, persistent dryness of portions of skin unaffected by eczema. Eruptions, oozing out a sticky exudation. Rawness in bends of limbs, groins, neck, behind ears. Unhealthy skin; every little injury suppurates. Ulcers discharging a glutinous fluid, thin and sticky. Swelling and induration of glands.  Cracks in nipples, mouth, between toes, anus. Phlegmonous erysipelas of face; burning and stinging pain.
Suited to – Excessive cautiousness; timid, hesitates; unable to decide about anything. Fidgety while sitting at work. Sad, despondent; music makes her weep; thinks of nothing but death.

SOL.: Itching so intolerable almost makes him crazy. Better cold air and when bed is cold. Worse warmth of bed. Almost constantly moist, free perspiration which gives no relief. Skin almost constantly moist. Persistent dryness of the skin contra indicates mercurius. Excessive odorous viscid perspiration; worse, night. General tendency to free perspiration, but patient is not relieved thereby. Vesicular and pustular eruptions. Ulcers, irregular in shape, edges undefined. Pimples around the main eruption. Itching, worse from warmth of bed. Crusta lactea; yellowish-brown crusts, considerable suppuration. Glands swell every time patient takes cold.

MEZERIUM: Violet itching worse bed, from touch compelling to scratching until epidermis is removed and denuded part is covered with a scab or there is repeated exfoliation.
For light-haired, irresolute persons of a phlegmatic temperament. Eczema and itching eruptions after vaccination. Hypochondriacal and despondent; indifferent to everything and everyone; angry at trifles and perfectly harmless things, but is soon sorry for it.

PETROLEUM: Itching at night. Skin dry, constricted, very sensitive, rough and cracked, leathery. Itching sore, moist surfaces with redness and rawness. External hard pressure not painful but a soft touch is unbearable. Cracks bleed easily.
Adapted to persons with light hair and skin; irritable, quarrelsome disposition; easily offended at trifles; vexed at everything. Ailments: from riding in a carriage, railroad car, or in a ship. Ailments which are worse before and during a thunderstorm. Symptoms appear and disappear rapidly. During sleep or delirium: imagines that one leg is double; that another person lies along side of him in same bed; that there are two babies in the bed. Vertigo on rising; in occiput as if intoxicated; like seasickness.

PSORINUM: Dirty dingy look. Itching when body becomes warm. Agg. In bed and from warmth. Scratches until it bleeds. Scratching gives temporary relief. Dry, lusterless, rough hair. Intolerable itching. Herpetic eruptions, especially on scalp and bends of joints with itching.
Especially adapted to the psoric constitution. In chronic cases when well selected remedies fail to relieve or permanently improve; when Sulphur seems indicated but fails to act. Lack of reaction after severe acute diseases. Appetite will not return.

SULPHUR: Dry, scaly, unhealthy skin. Itching, spots painful red and hot after scratching. Bleeds after scratching, recurring every night in bed. Violent on thighs and legs. Skin painful for a long time after rubbing as if denuded and sore. Itching, burning worse scratching and washing. Excoriation on folds.
Adapted to persons of a scrofulous diathesis, subject to venous congestion; especially of portal system. Persons of nervous temperament, quick motioned, quick tempered, plethoric, skin excessively sensitive to atmospheric changes. For lean, stoop-shouldered persons who walk and sit stooping like old men. Standing is the worst position for sulphur patients; they cannot stand; every standing position is uncomfortable. Dirty, filthy people, prone to skin affections. Aversion to being washed; always <. after a bath.