Tinea Versicolor

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Tinea Versicolor

What is tinea versicolor?

Tinea versicolor (TIN-ee-uh vur-si-KUL-ur) is a common skin infection caused by an overgrowth of yeast fungus. Having yeast on your skin is normal, but if it grows out of control, tinea versicolor can develop. The fungus disrupts the normal pigmentation (color) of the skin, and causes small, discolored skin patches. More common on the shoulders and torso, the patches can be lighter or darker than the surrounding skin. 

It’s more common in teenagers and young adults because their skin is oilier. It’s one of the most common skin infections in tropical and subtropical areas, where people can have it year-round. It can be treated successfully with antifungal medications, but the discoloration can last for months. It’s also called pityriasis versicolor.

Causes

What causes tinea versicolor?

It’s caused by a yeast that’s normal on everyone’s skin. It can happen to anyone of any skin color. It’s more likely to occur in people who live in hot, humid areas such as tropical or subtropical climates, where it can affect people year-round. Children and older people are rarely affected by it unless they live in the tropics. It can disappear during cooler, dryer months in non-tropical climates. 

People who sweat a lot and have oily skin, such as teenagers, are more susceptible to the fungal infection. Other causes can include a weakened immune system or hormonal changes. Too much sun exposure can make the discoloration more noticeable.

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Symptoms

What are the symptoms of tinea versicolor?

The first symptoms are usually spots on the skin. The spots can be lighter or darker than surrounding skin, and can be tan, brown, white, pink, salmon or red. It can also look like a rash. The spots are most common on shoulders, back chest, neck and arms, but can develop anywhere on the body. The discolored patches can disappear in cooler weather, only to return in summer when the air is more humid and moist.

In appearance, the patches can become:

  • Dry and scaly and grow slowly
  • Itchy
  • More noticeable on tanned skin because the yeast prevents skin from tanning 
  • Grown together, forming larger patches of lighter or darker skin

Some people have very faint patches that can be mistaken for vitiligo, a skin disease that causes skin to lose its natural color. 

Tinea versicolor is not contagious or painful. People who have clearly noticeable discolored patches can be very self-conscious about the infection, leading to emotional distress, especially in insecure teenagers. 

See your dermatologist if your skin isn’t improving with self-care (tips are described below), if the patches cover large areas of your body, or the fungal infection keeps returning. 

Diagnosis

How is tinea versicolor diagnosed?

A dermatologist can diagnose tinea versicolor by looking at the skin. He or she may use a Wood’s lamp, held about four or five inches from the affected skin. TInea versicolor appears yellowish-green in color under a Wood’s lamp. A skin biopsy may be performed by taking a small sample of the affected skin and examining it under a microscope.

Treatment

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.

References

American Academy of Dermatology Association. (N.d.) Tinea Versicolor: Signs and Symptoms. Retrieved 10-8-21, {https://www.aad.org/public/diseases/a-z/tinea-versicolor-symptoms}
American Academy of Dermatology Association. (N.d.) Tinea Versicolor: Diagnosis and Treatment. Retrieved 10-8-21, {https://www.aad.org/public/diseases/a-z/tinea-versicolor-treatment}
American Academy of Dermatology Association. (N.d.) Tinea Versicolor: Tips for Managing. Retrieved 10-8-21, {https://www.aad.org/public/diseases/a-z/tinea-versicolor-tips}
Mayo Clinic. (April 2020). Tinea Versicolor. Retrieved 10-8-21, {https://www.mayoclinic.org/diseases-conditions/tinea-versicolor/symptoms-causes/syc-20378385}
Mayo Clinic. (April 2020). Tinea Versicolor: Diagnosis and Treatment. Retrieved 10-8-21, {https://www.mayoclinic.org/diseases-conditions/tinea-versicolor/diagnosis-treatment/drc-20378390}

Information

Medically reviewed by:

Dr. Javeed Siddiqui, MD, MPH

Dr. Siddiqui is the Chief Medical Officer at TeleMed2U responsible for clinical and technical program development as well as maintaining a thriving telemedicine practice in infectious diseases which includes specialized care of Hepatitis and HIV.

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Initial Visit

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