Skin Health Fungal, Bacterial & Viral Infections Best Treatments for Tinea Versicolor Skin Infection By Heather L. Brannon, MD Heather L. Brannon, MD Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years. Learn about our editorial process Updated on September 16, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Casey Gallagher, MD Medically reviewed by Casey Gallagher, MD Casey Gallagher, MD, is board-certified in dermatology. He is a clinical professor at the University of Colorado in Denver, and co-founder and practicing dermatologist at the Boulder Valley Center for Dermatology in Colorado. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Causes Symptoms Diagnosis Treatment Options Duration Tinea versicolor is a fungal infection. It is caused by overgrowth of a fungus that naturally occurs on human skin. When you have tinea versicolor you may have patches of discolored skin and mild itching. The infection is not contagious. This article will discuss tinea versicolor and its causes and symptoms. It will also discuss common treatment options and how long you can expect the infection to last. Verywell / JR Bee What Causes Tinea Versicolor? Tinea versicolor is a common fungal skin infection. It is caused by yeast-like fungi called Malassezia. The infection affects melanocytes, which are pigment-producing cells in the skin. Tinea versicolor is also known as pityriasis versicolor. Since the infection is caused by an overgrowth of normal fungi, it is not contagious. Symptoms of Tinea Versicolor Infection with Malassezia produces a characteristic rash. The rash can sometimes be confused for other skin rashes. The rash is most common during adolescence and early adulthood, but it can occur at any age. The rash can consist of macules, which are flat skin lesions, or plaques, which are raised. The spots may be lighter or darker than the surrounding skin. They are usually more visible on tanned skin. The rash is most common on the torso, face, and shoulders. Some people report itching, though this does not happen for everyone. This photo contains content that some people may find graphic or disturbing. See Photo Pityriasis versicolor white. DermNet / CC BY-NC-ND This photo contains content that some people may find graphic or disturbing. See Photo Pityriasis versicolor pink. DermNet / CC BY-NC-ND This photo contains content that some people may find graphic or disturbing. See Photo Pityriasis versicolor brown. DermNet / CC BY-NC-ND Diagnosis of Tinea Versicolor The infection is usually diagnosed with a skin scraping. During this procedure, a dermatologist removes a small sample of skin. Under a microscope, Malassezia have a distinct "spaghetti and meatballs" appearance. Treatment Options for Tinea Versicolor Tinea versicolor can be treated a few different ways. The fungus lives in the epidermis, or top layer of skin. This means it is usually possible to treat with topical antifungal medications. These medications are most effective in the early stages or first occurrence of the infection. Extensive rashes may need to be treated with oral antifungal medications. If you have tinea versicolor, ask your healthcare provider about treatment options. 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 comes back 80% of the time. This means many people need repeat treatment. Patients may also need long-term maintenance treatment. Topical Antifungals Topical antifungals are a standard treatment for tinea versicolor. About 70% of cases respond to the most effective antifungals. Options include: 2% Nizoral (ketoconazole) cream or foam2% Nizoral (ketoconazole) shampoo1% Lamisil (terbinafine) solution1% Lotrimin (clotrimazole) solution Oral Antifungals Oral antifungal medications can be used for harder-to-treat cases. They may cause side effects such as nausea or reversible liver damage. Because treatment courses are short, these side effects are not common. Diflucan (fluconazole) is an oral antifungal that is effective against tinea versicolor. Dandruff Shampoos Dandruff shampoos can also be used to treat tinea versicolor. They are available over the counter and are less expensive than antifungals. Shampoos that have been shown to be effective against tinea versicolor include: Sulfur salicylic acid shampooZinc-pyrithione shampooSelsun Blue (selenium sulfide) 2.5% These remedies may cause skin irritation. Talk to your healthcare provider before using them. Recap Tinea versicolor can be treated with topical antifungals. Oral antifungals can be used for harder-to-treat infections. Dandruff shampoos have also been proven effective. How Long Does Tinea Versicolor Last? Tinea versicolor does not usually go away on its own. It responds well to treatment, but it is very likely to come back. The spots usually resolve quickly. The changes in color may take longer. Summary Tinea versicolor is a skin infection caused by overgrowth of a common fungus. It causes patches of discolored skin. The condition can be treated with antifungal medication. Topical medications usually work well. Oral antifungals may be used in some cases. Some people also have success with dandruff shampoos. Tinea versicolor usually responds well to treatment, but recurrences often happen. Talk to your healthcare provider about the right treatment option for you. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Thayikkannu AB, Kindo AJ, Veeraraghavan M. Malassezia-can it be ignored? Indian J Dermatol. 2015;60(4):332-9. doi:10.4103/0019-5154.160475 Gupta AK, Lyons DC. Pityriasis versicolor: an update on pharmacological treatment options. Expert Opin Pharmacother. 2014;15(12):1707-13. doi:10.1517/14656566.2014.931373 Bamford JTM, Flores‐Genuino RNS, Ray S, et al. Interventions for the treatment of pityriasis versicolor. Cochrane Database Syst Rev. 2018;2018(6):CD011208. doi:10.1002/14651858.CD011208.pub2 Gupta AK, Foley KA. Antifungal treatment for pityriasis versicolor. J Fungi. 2015;1(1):13-29. doi:10.3390/jof1010013 Additional Reading Weller RB, Hunter HJA, Mann MW. Clinical Dermatology. Chichester, West Sussex: John Wiley & Sons Inc; 2015.