Intertrigo: The Under-Breast Infection Connection

Tina Williams, the 62-year-old in Sheffield, England, who was interviewed in the Mail article, talked about her D-cup breast size.

"They never used to cause me problems," she told the Mail, "but about 20 years ago I noticed a red rash under my chest. It could be extremely sore and sometimes it would bleed. At night I'd want to hold my bust up because it was so painful."

"The smell was the worst thing," Tina added in the Mail interview. "and no amount of showering or using cream seemed to get rid of it." Her underwire bra worsened the problem, and she even considered breast reduction surgery at one point.

For women like Tina, I’d like to add my two cents and some words of hope.

What Causes Intertrigo in the Folds of Skin?

Essentially, intertrigo is an inflammation of body folds, a red, scaly chafing where the skin-on-skin area prevents perspiration from evaporating and results in a fungal, bacterial or viral infection. As a consequence, this perpetually dark, damp, warm area becomes a breeding ground for the proliferation of yeasts or bacteria already on the skin. These multiply, become infected, the skin breaks and the rash spreads.

Because it involves skin folds, intertrigo is a common side effect of obesity and can occur under the arms, on the belly, between the thighs, in the groin and even behind the ears. Diabetics are particularly vulnerable as their immune systems are already compromised. As unattractive as the rash is, what disconcerts people even more is the foul, oozing smell that is so stubborn that it won’t abate until the infection is completely cleared.

In the breasts – whether in the slender or the overweight – the issue is as much about sag as it is about volume, though bigger breasted women tend to have it worse . . . because it’s all about skin on skin. What makes the underbust area particularly painful though is its constant rubbing against the bra.

Treatment for Under-Breast Infections Can Be Trial and Error

Intertrigo is notoriously difficult to treat, but that doesn’t mean it’s impossible. Though it may take some trial and error to find the most effective approaches, here’s what I suggest (and the last one may shock you).

  • Wash carefully with an emollient cleanser. The skin here is tender so stay away from harsh or fragranced washes and do not scrub.
  • Keep your underbust dry. This may be easier said than done but is absolutely essential. This could mean hitting the area with the hairdryer on a cool setting before putting on your bra. This could mean changing your bra in the middle of the day. Whatever keeps that area dry.
  • Wear the right bras and change them often. When was the last time you were professionally fitted? Make sure you actually are wearing the correct band size and a properly fitted cup . Contrary to what you may think, an underwire isn’t necessarily a problem if it fits well and keeps the breast off of the chest. You may find all-cotton bras to be preferable to synthetic fabrics. Or, consider quick-drying sports bras designed to wick away and evaporate moisture quickly and efficiently.
  • Consider wearing an all-cotton bra while you sleep. In order to heal, it’s necessary to keep the skin away from the skin. So if you are someone who perspires at night, a cotton bra to keep your breasts off and away from your chest will be beneficial.
  • See a dermatologist if it doesn’t clear in 6 months. If you try the above and the condition hasn’t cleared, it’s time to visit a dermatologist. Since the infection could be a yeast (fungus), bacteria or virus, it may elude a DIY approach and require professional help.
  • Consider Botox injections to get sweat-free. If your perspiration is unrelenting, a doctor can inject Botox and free the area of dampness and sweat. As a treatment for hyperhidrosis (the technical term for excessive perspiration), Botox blocks the chemical signals from the nerves that stimulate the sweat glands for up to 6 months. It may be expensive, but if this last resort could help relieve the indignity and pain of intertrigo and allow it to heal in dryness, it may well be worth the investment.

Sometimes intertrigo happens, but it doesn’t have to grow on your skin.

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