Tinea versicolor also called pityriasis versicolor

Tinea versicolor, 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.

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.

Causes

Healthy skin may normally have the fungus that causes this disorder growing in its pores (the opening of the hair follicles). 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

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

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

You may need a stronger medication to treat your infection. Also, sometimes other skin disorders may mimic tinea versicolor and interfere with pigmentation.

Your doctor may need only to examine your skin to make the diagnosis of tinea versicolor. If there’s any doubt, he or she may take skin scrapings from the infected area and view them under a microscope.

Treatment

If tinea versicolor is severe or doesn’t respond to over-the-counter medicine, you may need a prescription-strength topical or oral medication. These medications for tinea versicolor treatment include:

Topical

  • Selenium sulfide (Selsun) 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. Also, the infection may return in warm, humid weather. In rare cases, you may need to take a medication once or twice a month to prevent the infection from recurring.

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 twice daily for one day a month

For a mild case of tinea versicolor, you can apply an over-the-counter antifungal lotion, cream or ointment. Most fungal infections respond well to these topical agents, which include:

  • Selenium sulfide shampoo (Selsun Blue)
  • Miconazole (Micatin)
  • 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 don’t see an improvement after four weeks, see your doctor. You may need a stronger medication.