What Is Tinea Versicolor? Symptoms, Causes, Diagnosis, Treatment, and Prevention
The thought of the fungus Malassezia furfur living on you might make your skin crawl, but the fact of the matter is, it’s normal — and often unnoticeable. Sometimes, however, it can grow out of control and cause a harmless rash that shows up as small white patches.
Tinea versicolor, which is also known as pityriasis versicolor, is more common in young adults and in hot and humid climates.
The primary symptoms of tinea versicolor are scaly spots or patches on the skin. These patches are typically white and oval-shaped, though they can also be dark or reddish tan in color. On darker skin tones, the patches often appear lighter than surrounding skin.
Tinea versicolor patches occur most often on the shoulders, neck, and trunk (the central region of the body), but they can appear in other areas, as well. Rarely, patches can show up on the face.
The patches often have sharp borders or edges, and can look different in the sunlight. They also typically have a very fine scale that becomes more noticeable with gentle rubbing.
As the rest of your skin tans and darkens, the patches become more visible.
These spots can come and go, especially as seasons change and outside temperatures fluctuate. The spots may be more noticeable when the weather is hot and humid (as in summer) and may be less noticeable or even disappear in fall and winter. The condition is more common in people who exercise.
These other symptoms may also appear:
Itching
Scaling of the skin
Increased sweating
An increase of sebum likely creates an environment for the fungus that causes tinea versicolor to thrive.
Other conditions may also contribute to tinea versicolor, explains Ife Rodney, MD, a dermatologist and founding director of Eternal Dermatology and Aesthetics in Fulton, Maryland. Hormonal changes, particularly those that occur during pregnancy, and a weakened immune system can increase the risk of tinea versicolor. When the skin is sweaty, warm, or moist, the yeast can overgrow, resulting in slightly scaly light or dark oval patches usually on the back, neck, or chest.
Often, doctors can diagnose tinea versicolor by examining discolored patches on the skin. To confirm a diagnosis, your doctor can scrape off a piece of the affected skin and examine it for yeast cells under a microscope.
Your doctor can also use ultraviolet light (UV) to confirm a diagnosis of tinea versicolor. If you have this skin condition, the affected skin will appear as a yellowish-green color under UV light.
Tinea versicolor is generally easy to treat and many options are available.
Medication Options
Your doctor may suggest one of these over-the-counter antifungal creams, lotions, ointment, or shampoos as a first-line therapy:
clotrimazole (Lotrimin AF, Mycelex) cream or lotion
miconazole (Monistat, M-Zole) cream
selenium sulfide (Selsun Blue) 1 percent shampoo
terbinafine (Lamisil) gel or cream
zinc pyrithione (Head & Shoulders)
If they don’t work, you may need one of these prescription-strength topical remedies:
ciclopirox (Loprox, Penlac) gel, lotion, or cream
ketoconazole (Nizoral) foam, cream, gel, or shampoo
selenium sulfide in 2.5 percent lotion or shampoo
A doctor may prescribe an oral medicine if topical medications do not work. You might receive oral medication when the fungus covers a large area of your body or frequently returns. However, tablets are rarely needed to treat tinea versicolor. Commonly used oral medicines include these drugs:
fluconazole (Diflucan) tablets
itraconazole (Onmel, Sporanox) capsules or tablets
Light Therapy
Photo therapy, also called light therapy, may help with tinea versicolor, too, according to some research. In one study, 66 percent of participants diagnosed with tinea versicolor reported decreased itching, hyperpigmentation, and scaling when treated with narrow-band UV-B phototherapy three times weekly. Researchers believe the UV-B light helps inhibit the growth of the fungus Malassezia furfur.
Tinea versicolor can return after treatment. To reduce the chances of a recurrence, your doctor may recommend using a topical once a month or more often.
Some doctors also suggest using a medicated cleanser once a week — especially if you live in a warm, humid location — to prevent the yeast from growing excessively again.
To manage and prevent tinea versicolor, several lifestyle changes can help, including limiting the use of oily skin care products, wearing loose clothing, and minimizing time in hot and humid environments.
A tan can make the condition more noticeable, so protecting your skin from the sun can give the appearance of an even skin tone. Use sunscreen daily, at least SPF 30 or higher, and don’t use tanning beds.
Tinea versicolor doesn’t usually go away on its own, so treatment is often necessary. The duration of treatment varies from person to person. Once treatment begins, it might take one to four weeks to inhibit the growth of the fungus.
Most people clear the infection with antifungal treatment. Understand, though, that these infections often recur, especially in those who live in warm, humid climates. Some people periodically use antifungal creams and lotions to prevent future rashes.
Tinea versicolor doesn’t cause any serious complications. But the skin may become discolored, scaly, and itchy, explains Dr. Rodney, adding that even after treatment, it can take months for skin color to return to normal.
Up to 50 percent of people living in certain tropical areas have reported this skin infection. In countries with cooler temperatures such as Sweden only about 1 percent of residents are affected.
Teens and young adults are more likely to get a tinea versicolor infection than older or younger individuals, but it can occur in anyone. Both genders are affected.
The risk of infection is higher in those who have a weakened immune system. These conditions can trigger tinea versicolor:
