What are the treatment options for tinea versicolor?
Treatment depends where the tinea versicolor patches are on your body, how much skin is affected, the thickness of the patches and the climate where you live.
The first treatment for mild cases is with over-the-counter (OTC) antifungal creams, lotions or shampoos. These include:
- Clotrimazole (Lotrimin AF) cream or lotion
- Miconazole (Micaderm) cream
- Selenium sulfide (Selsun Blue) 1% lotion
- Terbinafine (Lamisil AT) cream or gel
- Zinc pyrithione soap
Before applying OTC remedies, wash and dry the affected area. Apply a thin layer of the cream, gel or lotion once or twice a day for at least two weeks. With shampoos, leave it one for five to 10 minutes and then rinse thoroughly.
While the yeast is easy to kill, expect the uneven skin color to remain for weeks, even several months. If you don’t see some improvement after a month of continual treatment, contact your dermatologist for an evaluation.
Prescription-strength antifungal medications are needed for severe cases or those that aren’t improving with OTC antifungals. Prescription strength medications come in topical (applied to the skin) or pills. Examples include:
- Ketoconazole or Nizoral cream, gel or shampoo
- Ciclopirox (Loprox, Penlac) cream, gel or shampoo
- Fluconazole (Diflucan) tablets or oral solution
- Itraconazole (Onmel, Sporanox) pills or oral solution
- Selenium sulfide (Selsun) 2.5% lotion or shampoo
The infection can return with hot, humid weather and will need retreating. During warm weather, persistent cases may require you to take medication once or twice a month to prevent the infection from returning. You may also be prescribed a medicated skin cleanser, to be used once or twice a month.
To maximize your OTC or prescription medications, you will want to:
- Stop using skin care products that contain oils; oil-free products are labeled “non-comedogenic.”
- Protect skin from the sun by using oil-free sunscreen every day, wearing protective clothing, and avoiding the mid-day sun.
- Stop using tanning beds and sunlamps.
- Wear loose clothing to improve air flow over the skin during warm months.
