Tinea Versicolor (cont.)
How is tinea versicolor treated?
There are many antifungal agents available to apply to the skin for the treatment of tinea versicolor. Over-the-counter (OTC) remedies include clotrimazole and miconazole. These should be applied twice a day for 10-14 days but come in small tubes and are hard to apply to large areas. Another OTC option is selenium sulfide shampoo 1% (Selsun Blue) or 1% ketoconazole shampoo. Some doctors recommend applying these for 15 minutes twice a week for
two to four weeks. Others suggest applying them overnight and washing them off in the morning for a week. This treatment can be irritating, however, and may lead to missing hard-to-reach spots on the mid-back.
There are also many prescription-strength antifungal creams that can treat tinea versicolor, as well as a stronger form of selenium sulfide (2.5%) and prescription-strength ketoconazole shampoo (2%). However, these pose the same application problems as their OTC counterparts.
Oral treatment for tinea versicolor has the advantage of simplicity. A single dose of ketoconazole (brand name Nizoral) or five daily doses of itraconazole (brand name Sporanox) are two therapies your doctor can prescribe. Some common medications, such as Lipitor used to lower cholesterol, may interact with these drugs, so your doctor will need to know what other medications are being taken before treating tinea versicolor orally.
What happens after the tinea versicolor has been treated?
As noted above, the rash of tinea versicolor tends to linger even after successful treatment, especially if the spots are lighter than surrounding skin. This persistent discoloration often leads people to think that the condition is still present long after it has been eradicated. It may take months for skin color to blend and look normal, but it always does. The red or brown variety of rash, on the other hand, clears up visually right away. It is, therefore, a good idea to have the condition treated as soon as new spots appear so that any discoloration lasts as short a time as possible.
Recurrence of the rash is all but inevitable, though it won't recur necessarily every year. Applying selenium sulfide or ketoconazole shampoo on affected areas once a week may slow the onset of recurrence, but is cumbersome and often not worth the effort, since the condition may not come back for a long time anyway.
Last Editorial Review: 5/28/2008
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