How Does it Look?

Erythrasma usually appears as:

• Reddish-brown or pink patches with well-defined edges
• Slightly scaly, wrinkled, or dry skin
• Mild itchiness or burning (especially in the groin)
• Cracks or softening of the skin in between the toes (can look like athlete’s foot)
• On darker skin, it may appear as lighter patches with darker edges

Common areas affected:

• Armpits
• Groin
• Under the breasts
• Between the buttocks
• Belly button
• Inner thighs
• In between toes
• Folds of excess skin (stomach, legs)

It is more common in men (groin involvement) and in women (between the toes).

Warning Signs and Symptoms

• Red, pink, or brown patches of skin
• Mild itching or burning
• Scaly or wrinkled skin
• Macerated (softened) skin between toes
• Small cracks on the feet
• Rash that resembles ringworm or fungal infection
• In many people: no symptoms at all

Self-Care and Treatment

Most cases can be treated successfully with good hygiene and topical or oral antibiotics.

At home care:

• Wash affected areas daily with antibacterial soap
• Keep skin clean and dry, especially in folds
• Wear loose, light, cotton clothing to reduce sweating
• Use baby powder to keep skin folds dry
• Eat a healthy diet and maintain a healthy weight

Medicines that may be used (prescribed by a healthcare worker):

• Topical antibiotics: Clindamycin cream, Erythromycin cream, Fusidic acid cream, Mupirocin cream, Whitfield’s ointment
• Oral antibiotics (for widespread or resistant cases): This should be prescribed by a doctor to limit the growing antibiotic resistance
• Benzoyl peroxide wash to reduce bacteria
• Mild steroid or antifungal creams (e.g. hydrocortisone, miconazole) for itching or irritation

When to Seek Medical Attention

See a healthcare worker if:

• You notice reddish-brown patches in moist areas that do not improve with self-care
• The rash spreads, worsens, or looks like ringworm
• You have diabetes or a weak immune system and notice new patches
• You develop fever, pain, or spreading infection
• The skin blisters, peels, or becomes severely irritated
• You have severe symptoms like breathing problems, swelling of the mouth or face, or widespread rash

Prevention

• Bath or shower daily, especially in hot weather
• Keep skin dry and clean, especially folds
• Wear loose cotton clothing that absorbs sweat
• Avoid staying in very hot, damp conditions for long periods
• Manage weight to prevent obesity
• Control blood sugar if you have diabetes
• Do not share towels or clothing in crowded settings

Key Points

• Erythrasma is common but often overlooked in sub-Saharan Africa.
• It is caused by bacteria, not fungi, though it may look like fungal infections.
• Good hygiene, early treatment, and prevention strategies can help control the disease and reduce recurrence.