Tinea versicolor

Description

Tinea versicolor is a common fungal infection of the skin. The fungus interferes with the normal pigmentation of the skin, resulting in small, discolored patches. These patches may be lighter or darker in color than the surrounding skin and most commonly affect the trunk and shoulders.

Tinea versicolor (TIN-ee-uh vur-si-KUL-ur) occurs most frequently in adolescents and young adults. Sun exposure may make tinea versicolor more apparent. Tinea versicolor, also called pityriasis versicolor, is not painful or contagious. But it can lead to emotional distress or self-consciousness.

Antifungal creams, lotions, or shampoos can help treat tinea versicolor. But even after a successful treatment, the color of the skin may remain uneven for several weeks or months. Tinea versicolor is often repeated, especially in hot and humid weather.

Symptoms

Tinea versicolor signs and symptoms include:

  • Spots of discoloration of the skin, usually on the back, chest, neck, and upper arms, which may appear lighter or darker than usual
  • Mild itching
  • Scale

When to see a doctor

See your doctor if:

  • Your skin does not improve with self-care measures
  • The fungal infection returns
  • The patches that cover large areas of your body

Causes

The fungus that causes tinea versicolor can be found in healthy skin. Only begins to cause problems when the fungus grows. A number of factors that can trigger this growth, including:

  • Hot, humid weather
  • Oily skin
  • Hormonal changes
  • Weakened immune system

Risk factors

Risk factors for tinea versicolor include:

  • Live in a hot and humid climate.
  • Have oily skin.
  • Experiencing changes in hormone levels.

Prevention

To help prevent tinea versicolor return, your doctor may prescribe a skin or oral treatment that uses one or two times a month. You may need to use these only during the warm and humid months. Preventive treatments include:

  • Selenium sulfide (Selsun) to 2.5% lotion or shampoo
  • Ketoconazole (Ketoconazole Nizoral, others) in cream, gel, or shampoo
  • Itraconazole (Onmel, Sporanox) in tablets, capsules, or oral solution
  • Fluconazole (Diflucan) tablets or oral solution

Tinea versicolor

Diagnosis

Your doctor can diagnose tinea versicolor by looking. If there is any doubt, he or she may take skin scrapings from the infected area and view them under the microscope.

Treatment

If tinea versicolor is severe or does not respond to over-the-counter antifungal medications, you may need a prescription-strength medication. Some of these medications are topical preparations that are rubbed into the skin. Others are drugs that are swallowed. Examples include:

  • Ketoconazole (Ketoconazole Nizoral, others) in cream, gel, or shampoo
  • Ciclopirox (Loprox, Penlac) cream, gel or shampoo
  • Fluconazole (Diflucan) tablets or oral solution
  • Itraconazole (Onmel, Sporanox) in tablets, capsules, or oral solution
  • Selenium sulfide (Selsun) to 2.5% lotion or shampoo

Even after successful treatment, your skin color may remain uneven for several weeks, or even months. In addition, the infection may return it in hot, humid weather. In persistent cases, you may need to take a medication once or twice a month to prevent the infection from recurring.

Self-care

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

  • Clotrimazole (Lotrimin AF) cream or lotion
  • Miconazole (Micaderm) cream
  • Selenium sulfide (Selsun Blue) 1 percent of the lotion
  • Terbinafine (Lamisil AT cream or gel
  • Zinc pyrithione soap

When the use of creams, ointments, or lotions, wash and dry the affected area. Then, apply a thin layer of the product once or twice a day for at least two weeks. If you are using the shampoo, rinse 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.

It also helps to protect your skin from the sun and artificial sources of UV light. Usually, the skin tone evens out over time.

Preparing for your appointment

It is likely to start by seeing your family doctor or a general practitioner. He or she can treat you or refer you to a specialist in skin disorders (dermatologist).

What you can do

Prepare a list of questions in advance can help you make the most of your time with your doctor. For tinea versicolor, some basic questions to ask your doctor include:

  • How can I get the pityriasis versicolor?
  • What are other possible causes?
  • Do I need any tests?
  • Is tinea versicolor temporary or long-term?
  • What treatments are available, and which do you recommend?
  • What side effects can I expect from treatment?
  • How long will it take for my skin to return to normal?
  • I can do something to help, such as avoiding the sun at certain times or use a sunscreen specifically?
  • I have other health conditions. How can I best manage them together?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Do you have brochures or other printed material I can take home? What sites do you recommend?

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • How long have you had these discolored areas on your skin?
  • The symptoms been continuous or occasional?
  • Have you had this or a similar condition in the past?
  • Do the affected areas of the itching?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of pityriasis versicolor