Intertrigo: Under-Skin Seeping

For those of us who have a lot of flesh that hangs, we know all about Intertrigo (in-tur-tree-go), even if we don’t know that exact name. Intertrigo is when the skin under our folds gets wet, seeps, smells, and sometimes bleeds or gets sores.

I’ve fought the wetness under my belly since I was in 12-years old in junior high and in the marching band, practicing in the Florida summer sun for weeks on end. Talk about your sweating!

Mind you, I did not learn the term intertrigo, what it was, and how to treat it until I was 60 years old. I am now 62.

Through the decades, I tried everything I could to keep it dry.

• Cornstarch
• Baby powder
• Tucking bandanas underneath
• Putting pads under there (and hoped they didn’t fall out)
• Desitin Baby Ointment (zinc oxide)
• Vaseline
• And anything else I could find that might lessen the goopy wet.

When I was diagnosed with diabetes in 1996, the intertrigo doubled in wetness and pain. I could cry now knowing there were ways to stop that experience and subsequent yeast infections.

Yeasties Attack

Again, those of us who know this experience, can smell when the yeast infection sets in. This can happen when we have Insulin Resistance, PCOS, and/or Diabetes. Even just a night of pizza and chocolate can be enough to set the underbelly aflame with the smell of baking bread. Putrid baking bread.

Again, it was many, many years before I knew that change in scent meant I had a yeast infection under my hanging belly (called “pannus“<<—- a great article by American Nurse) or under my breasts. As I got fatter, I also had the yeasties behind my knees and in the creases in my thighs.

My Beloved Dermatologist

When I was diagnosed with Malignant Melanoma in 2019, I was finally put into the right medical arena that could help me with those under-belly infections. Once the three main sections of the cancer were excised (by a general surgeon, not the Derm surgeon), I was able to ask what was going on underneath my pannus. This is when I learned the term Intertrigo.

Without hesitation, she gave me a sheet of treatments to use in order to stop the irritation and infections. I ordered the items immediately and began following the instructions. After the first swipe of treatments, I was 90% better. After the second week of following the directions, I went for a year without so much as dew under my belly. It took taking cortisone and two Z-packs in a row for the intertrigo to return and my needing two weeks of Diflucan to help balance things out again. Since then, I have had no issues with wetness, seeping, yeasties, sores, bleeding, or pain, all because of following this plan.

The Path to Avoiding Seeping, Pain, & Infection

The usual disclaimer:

Share this with your care provider to make sure these are cool
for you to use on your body. 

1. During two showers each week, wash the areas that get the intertrigo (under-belly, under breasts, in creases, etc.) with the Nizoral Anti-Dandruff shampoo. Let the shampoo sit on those areas for at least 2-3 minutes before washing it off. The antifungal properties do a kick-ass job in removing the nasties from our bodies.
2. After drying off, use a blow dryer on cool to dry the area completely. Lift your pannus and breasts to get the entire area dry. I lie back on the bed to be able to lift my ample pannus, one side at a time. I cannot do my belly sitting or standing. Blow-dry any creases you might have in your thighs, behind your knees, your upper arms, or your bum. It’s tempting to just use a towel to dry these areas, but I promise, the blow dryer is required. That cool air is so good to get every last drop of moisture out of those creases.
3. When everything is dry, put the Zeasorb AF (Antifungal Powder) on the areas that get infected. I use gloves and turn off fans so it doesn’t get all over me or the room. Women, be careful not to get the powder in the genital area. I use a dry washcloth or towel to cover my genitals, then toss them in the hamper afterwards. If you get the infection in the creases between your pubic area and thighs, use a finger to put the powder there while keeping it away from mucus membranes.
4. Take at least two showers a week. I know how hard that can be if you are really big, are in pain, or cannot get into or out of the shower easily. At 400 pounds, I sometimes went three weeks without one because it was a day-long process to take a shower, including walking, resting, and then napping afterwards. But the two showers a week go a long way to keeping the intertrigo in check. It’s even better when you are able to use the Nizoral shampoo on those tender areas, leaving it on for 2-3 minutes.

This part alone has helped me avoid the infections almost 100%.

Intertrigo Treatment for Yeast

Important Note:

This next mixture is for external use only! Do NOT use this for vaginal or anal yeast infections! Your care provider can help you with ideas about what to use for internal use.

But if I happened to get a yeast infection in my skin folds and underbelly (the #1 place I got intertrigo), the Dermatologist prescribed three over-the-counter medications. These three, Clotrimazole (an “azole” which are used to fight fungal infections. Nizoral and Zeasorb are also azoles), 1% or 2% Hydrocortisone Cream, and a Triple Antibiotic Ointment, are mixed together to make one cream and then used that way.

In the photo, I have Mupirocin, a prescribed, kick ass, antibiotic ointment. The Derm prescribes it for me because I have Diabetes and it is crucial to get rid of infections as fast as possible in diabetics. But most people do fine on triple antibiotic ointments. Note that antibiotic ointments are to be used on the body sparingly because you can become antibiotic resistant to that specific kind and need to move to different, and often, stronger ones.

With three equal parts, mix the creams… I use a glass bowl with a secure, airtight, lid… and use it that way. The container stays in a dark wicker box I have here in my room, but some people keep it in the fridge because it can feel great when you need it on your body. Soothing, they say. I use gloves to put it on, mostly because it can be a pain to wash off your hands afterwards. If you use your hands to apply it, wash your hands really, really, really well and dry them completely before dipping into the cream. For me, nitrile gloves are easier.

Then apply the cream. Do not cover the creams on your body with anything! No pads, no cloths, nothing. Just let the cream slosh around on the infection. If you wear undies, make sure they are cotton. I was too big to wear any for two decades. Do not wear a bra if at all possible. I was also too fat to find bras that fit so went braless for decades as well. If you have to wear a bra, make sure it is cotton if at all possible and take it off and reapply cream as soon as you can. If you were like me, naked underneath and might get the cream on your clothes, just wear a muumuu or gym shorts and let them get the cream on them without concern. It washes out easily in the washer. Hot water. That will kill the yeast on the clothes, too. Any strategy used to heal is a great one!

Additional Note from March 5, 2024: I hadn’t had an infection in so long, the cream I stored in the sealed bowl turned pink. It didn’t smell like anything bad, but I dumped it anyway and started anew. I am going to keep it in the fridge now and hope that helps keep it longer. If yours turns any color but pure white, toss it and start over again. Be safe with your bodies!

Tutorial on Intertrigo Has Ended

I really hope this helps. Know that even though I am down 170+ pounds, my pannus has barely changed in size. I don’t know if I will ever have surgery to have it removed. I adhere to this regimen even though my HbA1c is 5.1 and my blood glucoses in great control. I spent enough decades not knowing what to do. Now that I do, it is part of my shower experience. Know that I feel for you all still struggling with showers. They do get easier as you lose weight with the GLP-1s. When I take a shower now, I marvel at how easy they are and how thinner people take them for granted. A daily shower two years ago was impossible.

If you have questions, feel free to ask in the comments (others surely have the same question) or email me at HealthAtAnyCost@Gmail.com.

Hope this helps!