What Is It?
A burning, itching, raw rash that occurs in skin folds, such as the skin under the breasts, the belly fold, in the armpits, and in the groin.
What Causes It?
Skin friction, warmth, moisture from sweat, and bacterial and yeast overgrowth all combine to create this uncomfortable problem.
How Is It Treated?
- Completely dry the skin after bathing. This skin is thin and delicate, especially when red and irritated.
- DON’T RUB; gently PAT dry.
- Using a hair dryer on the cool setting is also very helpful.
- Greer’s goo is a prescription, compounded cream consisting of a mild topical steroid, an anti-yeast ingredient, and zinc oxide paste. It’s not for long-term use, because even mild topical steroids can thin the skin in warm, moist, already-thin locations. It will calm it down so that other treatments can be tolerated (but it is messy). Although messy, this product:
- reduces the redness/inflammation,
- decreases yeast counts,
- and the zinc provides a barrier to help heal and soothe.
- You put a THICK COAT on all affected areas at least twice a day.
- Expect it to ruin your undergarments, so don’t wear your best stuff.
- When bathing, wash with normal to light scrubbing.
- Make NO effort to wipe all the zinc oxide off. The zinc is functioning AS your skin until your skin has healed.
- Diflucan® (fluconazole) pills are often helpful as an added boost early on to decrease the yeast counts.
- We frequently use one dose a week for a month (4–5 doses total).
- This medicine has a lot of drug interactions, but because we are just using it once a week, it doesn’t usually require changing anything you’re taking.
- Laying an absorbent cloth in the fold can be helpful if it will stay. Avoid cotton, which holds on to moisture. Very expensive but fabulous InterDry® fabric, which you cut to the size of your fold daily, really helps (must be purchased off the internet).
- After the Greer’s goo has calmed it down (takes about a week):
- Use a mild antiperspirant (the spray variety is perfect) as long as the skin doesn’t have any open wounds; it will STING!!
- Antiperspirants work by forming a crystal in the sweat coil, thus blocking the sweat. If the sweating is too profuse, it’s difficult for the product to stay in the coil long enough to crystallize.
- Apply it at night, when our bodies naturally produce less sweat.
- It takes about 2–3 weeks for a crystal to form, so stick with the spray at night for several weeks before giving up.
- If you tolerate the spray variety, you can slowly work your way up to higher concentrations of antiperspirants (most are between 14–21%). And vigorous washing will dislodge those crystals, so, again, don’t scrub too hard in the shower.
- Zeasorb® antifungal powder is excellent for daytime use. It’s often located with the foot products since it’s really for athlete’s foot, but it contains 2% miconazole (prescription strength!).
- Reduce friction. Weight loss, breast reduction surgery, etc., are very helpful.
Can It Be Cured?
Not frequently. Our goal is usually to control this chronic condition rather than aim for a cure that will keep it from ever coming back.
Have questions about a rash in a skin fold, or want me to take a look? You can book online or call the office at 423-528-8833. This page is for general education, not a substitute for a personal exam.