Images of Tinea Versicolor (11)
Tinea versicolor is a very common rash that is also known as pityriasis versicolor. It is called “versicolor” because the rash typically has many different colored patches, with the patches failing to tan in the summer and then looking relatively darker than the normal surrounding skin in the winter. In some people the patches are darker than their usual skin color, in others they may be lighter, and in some people they may be both lighter and darker in different areas. The rash is caused by an overgrowth of yeast called Malassezia, which is usually found on everybody’s skin but causes a rash when it overgrows. The overgrowth is more common in some conditions, such as when the skin is oily or moist and the weather is warm and humid. Tinea versicolor is not contagious, and it is easily treated by anti-yeast creams or pills that your doctor can prescribe.
Who's At Risk?
Anyone can develop tinea versicolor, though it is more commonly seen those who live in tropical climates. Teens and young adults are more commonly affected than children or the elderly.
Signs & Symptoms
The most common locations for tinea versicolor include:
- Chest and upper back
- Upper arms
Tinea versicolor appears as multiple white, pink, salmon-colored, tan, or brown patches ranging in size from 1–3 cm. The individual patches can join together to form large patches. Most patches have a very fine, dust-like layer of skin material (scale).
The yeast gives off (secretes) a substance that temporarily bleaches the underlying skin to a lighter color. Even after the infection has gone away, the spots may be visible as lighter (hypopigmented) patches, which may not get their normal color back for many months. Furthermore, these hypopigmented spots do not tan normally. The hypopigmented areas are more obvious in darker-skinned people.
Tinea versicolor does not usually cause any symptoms, though some people report minor itching, especially when they get sweaty.
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If you suspect that you have tinea versicolor, you might try an over-the-counter antifungal cream such as terbinafine, clotrimazole, or miconazole. An over-the-counter shampoo containing selenium sulfide can be used as a lotion by applying it to the affected areas overnight and rinsing it off in the morning. However, if the condition does not seem to be getting better after 2 weeks of daily treatment, see a dermatologist or another physician for evaluation.
If you have been treated for tinea versicolor, avoid wearing tight, restrictive clothing. Also, sun exposure may make the light-colored areas more apparent, so avoid sun exposure or wear sunscreen until the spots have returned to their normal color.
To confirm the diagnosis, your physician might scrape some of the surface skin material (scales) onto a glass slide and examine it under a microscope. This procedure, called a KOH (potassium hydroxide) preparation, allows the doctor to look for tell-tale signs of yeast infection.
Once a diagnosis of tinea versicolor has been confirmed, the physician may recommend one of the following treatments:
- Selenium sulfide lotion (or shampoo, which can be used as a lotion and then rinsed off)
- Pyrithione zinc shampoo (used as a lotion and then rinsed off)
- Antifungal cream or lotion such as ketoconazole, econazole, oxiconazole, or ciclopirox
- Antifungal pills such as ketoconazole, fluconazole, or itraconazole
Return of the infection (recurrence) is common. Because some people are more likely than others to get the infection, your doctor may recommend a preventive or maintenance treatment to use during the warmer, more humid months, consisting of antifungal cream, lotion, or shampoo applied every week or two.
If the above self-care measures do not work or if you develop a widespread rash that seems to be getting worse, see your doctor.
Bolognia, Jean L., ed. Dermatology, pp.989, 1171-1174. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.2014-2016. New York: McGraw-Hill, 2003.