Tinea Versicolor (cont.)

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What other conditions resemble tinea versicolor?

The following conditions are sometimes indistinguishable from tinea versicolor on simple inspection:

  • Pityriasis alba: This is a mild form of eczema (seen in young people) that produces mild, patchy lightening of the face, shoulders, or torso.


  • Vitiligo: This condition results in a permanent loss of pigment. Vitiligo is more likely to affect the skin around the eyes and lips or the knuckles and joints. Spots are porcelain white and, unlike those of tinea versicolor, are permanent.

How is tinea versicolor diagnosed?

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It is relatively simple procedure to confirm this diagnosis. A drop of potassium hydroxide is applied to a small scraping of involved skin which is then examined under the microscope. The yeast forms can be seen and confirm the diagnosis.

What is the treatment for tinea versicolor?

There are many antifungal agents available to apply to the skin for the treatment of tinea versicolor. Over-the-counter (OTC) remedies include clotrimazole (Lotrimin, Mycelex) and miconazole (Lotrimin). 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 (Nizoral). Some doctors recommend applying these for 15 minutes twice a week for two to four weeks.

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 or five daily doses of itraconazole (Sporanox) are two therapies your doctor can prescribe. Some common medications, such as atorvastatin (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.

Reviewed by William C. Shiel Jr., MD, FACP, FACR on 10/19/2011

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