Tinea Versicolor (Pityriasis Versicolor)

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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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 without therapy.

How is tinea versicolor diagnosed?

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. Two doses of fluconazole (Nizoral) prescribed by your doctor can clear most cases of this infection. Some common medications such as alprazolam (Xanax) and montelukast (Singulair) may interact with fluconazole, so your doctor will need to know what other medications are being taken before treating tinea versicolor orally.

Medically Reviewed by a Doctor on 11/4/2015
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