Best Treatments for Tinea Versicolor Skin Infection

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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.

How to Treat Tinea Versicolor Skin Infection
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.

pityriasis versicolor white
Pityriasis versicolor white.

DermNet / CC BY-NC-ND

This photo contains content that some people may find graphic or disturbing.

pityriasis versicolor pink
Pityriasis versicolor pink.

DermNet / CC BY-NC-ND

This photo contains content that some people may find graphic or disturbing.

pityriasis versicolor brown
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 foam
  • 2% Nizoral (ketoconazole) shampoo
  • 1% Lamisil (terbinafine) solution
  • 1% 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 shampoo
  • Zinc-pyrithione shampoo
  • Selsun 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.

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Article Sources
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  1. 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

  2. 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

  3. Bamford JTM, Flores‐Genuino RNS, Ray S, et al. Interventions for the treatment of pityriasis versicolorCochrane Database Syst Rev. 2018;2018(6):CD011208. doi:10.1002/14651858.CD011208.pub2

  4. 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.