Tinea Versicolor Treatment Options

Treatment for tinea versicolor can include topical over-the-counter (OTC) anti-fungal medications and prescription anti-fungal creams and oral medications. Untreated, the condition won't lead to serious issues. Treatment can help improve the patches of discolored skin and symptoms like itching, however.

Tinea versicolor is a yeast-like fungal infection of the skin. It is also known as pityriasis versicolor. The condition is neither contagious nor dangerous, but it can be persistent, recurring, and bothersome. Some people may need to use a tinea versicolor treatment every month to keep it at bay.

This article discusses types of tinea versicolor treatments, including home remedies, and when each is used.

What Is Tinea Versicolor?

Tinea versicolor is a common fungal skin condition caused by yeast-like fungi called Malassezia. It's called "versicolor" because the yeast produces a lightening substance that affects the pigment-producing ability of the melanocytes.

A tinea versicolor infection produces a characteristic rash on the torso and shoulders. The discolored patches can appear lighter or darker than the surrounding skin and are made up of either flat skin lesions (macules) or raised plaques. These are more noticeable on tanned skin.

Some people report itching with tinea versicolor, though this does not happen for everyone.

OTC Tinea Versicolor Treatment

Over-the-counter topical antifungal medications are usually effective in the early stages or first occurrence of the infection.

OTC anti-fungal treatments for tinea versicolor include:

• Lamisil AT (terbinafine) cream or gel
• Lotrimin AF (clotrimazole) cream or lotion
• Micaderm (miconazole) cream

Antifungal washes including zinc pyrithione soap, sulfur salicylic acid shampoo, and Selsun Blue (selenium sulfide) shampoo are also used to treat mild cases of tinea versicolor. These remedies can cause skin irritation and should be tested on a small patch of skin.

Topical Prescription Medications

If OTC remedies don't clear up the rash, your healthcare provider can prescribe a topical antifungal medication. The most effective prescription antifungals for tinea versicolor include:

• 2% Nizoral (ketoconazole) cream or foam
• 2% Nizoral (ketoconazole) shampoo
• 1% Lamisil (terbinafine) solution
• 1% Lotrimin (clotrimazole) solution

Oral Antifungal Treatments

Tinea versicolor lives in the top layer of skin (epidermis) and usually responds to topical antifungal medications. However, more often than not, the rash returns. The goal is to manage the yeast population, which requires constant maintenance when conditions for overgrowth are present.

Oral antifungal pills can be used for harder-to-treat cases. Diflucan (fluconazole) is an oral antifungal that is effective against tinea versicolor.

Side effects of oral antifungal medications include nausea and reversible liver damage. However, the course of treatment is usually short and these side effects are not common.

Home Remedies

Antifungal medications are the best treatments for tinea versicolor, but some people prefer to try home remedies. It won't hurt to try these remedies, however, it's important to keep in mind that there isn't strong evidence to support their effectiveness.

• Apple cider vinegar: One small study found that apple cider vinegar used alongside 2% ketoconazole shampoo was more effective than the ketoconazole shampoo alone. Symptoms also resolved faster in subjects who used the combination treatment. 
• Honey: Acacia honey has been shown to improve symptoms of tinea versicolor in small studies. One study also found that honey mixed with olive oil and beeswax is effective against tinea versicolor. 
• Aloe vera: Aloe vera may inhibit the growth of the fungus that causes tinea versicolor. One study found that aloe vera was effective even against strains resistant to anti-fungal medication.
  
• Turmeric: This Ayurvedic remedy is said to reduce itching and pigmentation. Try applying a turmeric powder paste to the affected area.
• Coconut oil: This remedy is said to prevent fungal growth. Some people add camphor to the oil before applying it to the skin.
  

Maintenance Treatments

Once successfully treated, tinea versicolor has an 80% chance of recurrence. Many people require ongoing maintenance treatments to keep the fungal infection in check.

Using dandruff shampoos as a body wash is a common, low-cost solution. Shampoos that have been shown to be effective as treatments for tinea versicolor include:

• Sulfur shampoo
• Zinc-pyrithione shampoo
• Selsun Blue (selenium sulfide) 2.5%

If these remedies cause skin irritation, talk to your healthcare provider about other preventive options.

Summary

Tinea versicolor is a skin infection caused by overgrowth of a common fungus. It causes patches of discolored skin that are treated with antifungal medication.

If you suspect you have tinea versicolor, talk to your healthcare provider about treatment options. Tinea versicolor treatment is usually based on the extent of your rash, how long you've had it, and if it is your first rash or a recurrence.

Tinea versicolor usually responds well to topical treatments but more stubborn cases may require prescription antifungal pills. Maintenance treatments may be needed to prevent recurrences. Some people have success using dandruff shampoos to treat tinea versicolor and prevent a recurrence.