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Rash under the chin and in other skin folds in babies - intertrigo

Intertrigo; eczema; dermatitis; thrush; candida; seborrhoeic; skin; rash; heat; candidiasis; heat rash; baby; infant; impetigo; nappy; corn; flour; powder; ;

Intertrigo is a rash which occurs inside skin folds, where two surfaces of the skin press on or rub on each other, such as under the chin of a baby, under the armpit or in the nappy area. The skin in these areas may be damp much of the time, and can develop a rash. This rash is called intertrigo.

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Alert!
If a child's rash suddenly gets worse, it may be due to an infection. See your doctor as different treatment may be needed.

What does intertrigo look like?

  • Babies and children with intertrigo have red, 'raw', weeping skin in a skin fold such as in the folds of skin under the neck, under the arm, in the nappy area.
  • Unlike nappy rash, the rash is worst inside the fold of skin. In nappy rash, the skin inside a fold is often protected, with the rash worst on the areas touched by the nappy.

What causes intertrigo?

  • Intertrigo occurs when skin stays moist, when the temperature of the skin rises and when there is rubbing on the skin (eg from movement).
  • The moistness can be because of not drying the skin well enough after washing, from sweat or, especially under the chin, from dribbling or frequent spilling.
  • Because the skin has lost its top layer, it is very prone to getting infected with thrush or bacteria (causing an infection like impetigo).

What you can do

  • The surface of the affected skin is very delicate and painful. It needs to be treated very gently. Even washing it with water can be painful. Using sorbolene to clean the skin may be gentler.
  • Be careful not to rub the skin. Pat it dry carefully, and often.
  • Creams or ointments which protect the skin from moisture, such as those which are used for nappy rash may be helpful. Zinc creams, zinc and cod-liver oil creams and similar can be useful. Check with your chemist (pharmacist) for other useful creams or ointments.
  • If the rash is not getting better, or it is spreading, see your doctor as the infection may need treatment. Thrush infections are common.
  • Some people recommend using corn flour or other powders to dry the surface of the skin. These could hold moisture on the skin and make the rash worse. Some bacteria which cause skin infections feed on cornflour, so it is best not to use it.
  • If the intertrigo is under the chin of a baby who is dribbling, using a bib to catch the dribble might be helpful.
  • If the baby is irritable, it may be due to pain from the rash. Paracetamol may be helpful if the baby is not sleeping or feeding well. Do not use ibuprofen for babies under 3 months old. See the topic 'Using paracetamol or ibuprofen'.

Preventing intertrigo

If a baby has had intertrigo, it will be worth trying to prevent it coming back even when the skin looks healthy by:

  • keeping the skin fold as dry as possible - have a bib on much of the time if the baby is dribbling (though this does not always collect all the moisture). Take the bib off when your baby is sleeping. 
  • using a protective cream like the ones used to prevent nappy rash.
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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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