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Definition
Tinea versicolor (TIN-ee-uh vur-si-KUL-ur), also called pityriasis versicolor, is a common fungal infection of the skin. The fungus interferes with the normal pigmentation of the skin, resulting in small, discolored patches.
Tinea versicolor is most common in teens and young adults. Sun exposure may make tinea versicolor more apparent.
Antifungal creams, lotions or shampoos can help treat tinea versicolor. But even after successful treatment, skin color may remain uneven for several weeks until repigmentation occurs, and tinea versicolor may return, especially in warm, humid weather.
Symptoms
Tinea versicolor is a type of infection that appears as a tissue-thin coating of fungus on your skin. The signs and symptoms of tinea versicolor are:
- Small scaly patches of discolored skin
- Patches that grow slowly
- Patches that tend to become more noticeable after sun exposure
- Possible mild itching
The patches can be various colors, including:
- White
- Pink
- Tan
- Dark brown
Although the discoloration may be more apparent on dark skin, the infection can affect anyone, regardless of skin color.
The infection, which is most common in warm, humid temperatures, usually affects the:
- Back
- Chest
- Neck
- Upper arms
When to see a doctor
See your doctor if:
- Your skin doesn't improve with self-care measures
- The fungal infection returns
- The patches cover large areas of your body
Causes
Healthy skin may normally have the fungus that causes this disorder growing in the area where hair follicles open onto the skin surface. Tinea versicolor occurs when the fungus becomes overgrown. A number of factors may trigger this growth, including:
- Hot, humid weather
- Excessive sweating
- Oily skin
- Hormonal changes
- Immunosuppression — when your immune system is unable to protect your body from the growth of yeast or fungus on your skin or elsewhere
Preparing for your appointment
You're likely to start by first seeing your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes in skin disorders (dermatologist).
Because appointments can be brief, it's a good idea to arrive well prepared. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, as well as any vitamins or supplements, that you're taking.
- Write down questions to ask your doctor.
Preparing a list of questions can help you make the most of your time with your doctor. For tinea versicolor, some basic questions to ask your doctor include:
- How did I get tinea versicolor?
- Are there other possible causes for these symptoms?
- Do I need any tests?
- Is tinea versicolor temporary or long lasting?
- What treatments are available, and which do you recommend?
- What types of side effects can I expect from treatment?
- How long will it take for my skin to return to normal?
- I have other health conditions. How can I best manage them together?
- Is there a generic alternative to the medicine you're prescribing me?
- Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- How long have you had these discolored areas on your skin?
- Have your symptoms been continuous or occasional?
- Have you had this or a similar condition in the past?
- Do the affected areas itch?
- Does anything seem to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
What you can do in the meantime
Over-the-counter fungal creams or shampoos can often clear up tinea versicolor. If you don't notice any improvement after about a month of treatment, be sure to see your doctor.
Tests and diagnosis
Your doctor can diagnose tinea versicolor with a skin exam. If there's any doubt, he or she may take skin scrapings from the infected area and view them under a microscope.
Treatments and drugs
If tinea versicolor is severe or doesn't respond to over-the-counter antifungal medicine, you may need a prescription-strength topical or oral medication. Such medications for tinea versicolor treatment include:
Topical
- Selenium sulfide 2.5 percent lotion
- Ciclopirox (Loprox) cream, gel or lotion
- Ketoconazole (Nizoral) cream or shampoo
Oral
- Ketoconazole (Nizoral) tablets
- Itraconazole (Sporanox) capsules
- Fluconazole (Diflucan) tablets
Even after successful treatment, your skin color may remain uneven for several weeks, or even months. Also, the infection may return in warm, humid weather. In persistent cases, you may need to take a medication once or twice a month to prevent the infection from recurring.
Lifestyle and home remedies
For a mild case of tinea versicolor, you can apply an over-the-counter antifungal lotion, cream, ointment or shampoo. Most fungal infections respond well to these topical agents, which include:
- Selenium sulfide shampoo (Selsun Blue)
- Miconazole (Monistat-Derm)
- Clotrimazole (Lotrimin)
- Terbinafine (Lamisil)
Wash and dry the affected area. Then, apply a thin layer of the topical agent once or twice a day for at least two weeks. If you're using shampoo, rinse it off after waiting five to 10 minutes. If you don't see an improvement after four weeks, see your doctor. You may need a stronger medication.
Prevention
Avoid applying oil or oily products to your skin or wearing tight, restrictive or nonventilated clothing. Sun exposure makes the fungal infection more apparent.
To help prevent tinea versicolor from returning, your doctor can prescribe a topical or oral treatment that you take once or twice a month. Preventive treatments include:
- Selenium sulfide (Selsun) lotion applied to the affected areas every two to three weeks
- Ketoconazole (Nizoral) tablets once a month
- Itraconazole (Sporanox) capsules once a month
Last Updated: 2010-02-23
