Tinea Versicolor

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Images of Tinea Versicolor

Overview

Tinea versicolor, also known as pityriasis versicolor, is a common noncancerous (benign) skin condition caused by surface (superficial) infection with a type of yeast that normally lives on the skin. In the right conditions, such as warm, oily, and moist skin, the yeast (Malassezia) can overgrow and cause a rash, consisting of tan, pink, brown, or white patches. Although it is an infection, tinea versicolor is not contagious, as the yeast normally lives in the skin.

Who's at risk?

Tinea versicolor can develop in people of all ages, of all races, and of either sex.

However, tinea versicolor is most commonly found in tropical areas with high humidity and high temperatures. In milder climates, teens and young adults are affected most frequently. Tinea versicolor is uncommon in young (pre-pubertal) children or in adults older than 65 years.

Some conditions make tinea versicolor more likely to occur, including:

  • Living in a warm, humid climate.
  • Having oily skin.
  • Sweating frequently or excessively.
  • Being pregnant.
  • Being malnourished.
  • Using corticosteroids (cortisone).
  • Taking medications that weaken the immune system.

Signs and Symptoms

The most common locations for tinea versicolor include:

  • Chest and upper back
  • Upper arms
  • Abdomen
  • Neck
  • Thighs
Tinea versicolor appears as many white, pink, salmon-colored, tan, or brown patches ranging in size from 1–3 cm. The individual lesions can join together to form large patches. Most lesions have a very fine, dust-like outer 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 individuals.

Tinea versicolor does not usually cause any symptoms, though some people report minor itching, especially when they get sweaty.

Self-Care Guidelines

If you suspect that your child has 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 your child's doctor or a dermatologist for evaluation.

If your child has been treated for tinea versicolor, he or she should avoid wearing tight, restrictive clothing. Also, sun exposure may make the light-colored areas more apparent, so have your child avoid sun exposure or wear sunscreens until the spots have returned to their normal color.

When to Seek Medical Care

If the above self-care measures do not work or if your child develops a widespread rash that seems to be getting worse, see the doctor.

Treatments Your Physician May Prescribe

To confirm the diagnosis, the doctor might scrape some of the surface skin material (scales) onto a glass slide and examine them 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, the 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.

Trusted Links

Clinical Information and Differential Diagnosis of Tinea Versicolor

References

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.