Tinea versicolor

Tinea versicolor: It is not harmful, but many people dislike the way it discolors their skin.

Tinea versicolor: Overview

Also called pityriasis versicolor

We all have yeast living on our skin. When the yeast grow out of control, a person can get a skin disease called tinea versicolor.

Your dermatologist may tell you that you have a fungal infection on your skin. Yeast is a type of fungus.

Many people get tinea versicolor. It is one of the most common skin diseases in tropical and subtropical areas of the world. People who live in tropical areas may have tinea versicolor year-round.

Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Tinea versicolor: It often looks like a rash.

Tinea versicolor: Signs and symptoms

The first sign of tinea versicolor is often spots on the skin. The other signs and symptoms are:

• The spots are lighter (sometimes darker) than the surrounding skin. The color of the spots can be white, pink, salmon, red, tan, or brown.
• The spots can appear anywhere on the body.
• Spots can be dry and scaly.
• Skin may itch where the spots appear.
• Spots become more noticeable as the skin tans. The yeast prevents the skin from tanning.
• Spots grow slowly.
• As the yeast grows, the spots can combine and form patches of lighter (or darker) skin.
• The spots may disappear when the temperature drops and return in the spring or summer when the air gets warm and humid.

Tinea versicolor: The spots of tinea versicolor can be dry and scaly. As the yeast grows, the spots can grow together.

Sometimes the spots are so faint that people do not realize they have tinea versicolor. If tinea versicolor causes light spots on the skin, it can be mistaken for vitiligo. Vitiligo is a skin disease that causes the skin to lose its color. Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Tinea versicolor: Who gets and causes

Who gets tinea versicolor?

The yeast that causes tinea versicolor lives on everyone's skin. It is not clear why the yeast overgrows on some people's skin and not others. We do know the following about tinea versicolor:

• People of all skin colors get it.
• Teens and young adults are most susceptible because they have oily skin.
• Older adults and children rarely get it unless they live in a tropical or subtropical area.
• People who live in non-tropical areas often see tinea versicolor disappear during the cool, dry months.

What causes tinea versicolor?

Yeast normally live on our skin. When the yeast overgrows, it causes the skin disease tinea versicolor. It is believed that the following can cause the yeast to overgrow:

• Hot, humid weather.
• Lots of sweating.
• Oily skin.
• A weakened immune system.

Tinea versicolor: Diagnosis and treatment

How do dermatologists diagnose tinea versicolor?

A dermatologist can often look at the skin and tell whether a patient has tinea versicolor. If there is any doubt, the dermatologist will do one of the following to make an accurate diagnosis:

• Gently scrape off a bit of the skin. This will be examined under a microscope.
• Look at the skin with a special device called a Wood's lamp. The dermatologist will hold the Wood's lamp about 4 or 5 inches from the affected skin. If the patient has tinea versicolor, the affected skin appears yellowish green in color when looked at with this lamp.

How do dermatologists treat tinea versicolor?

What a dermatologist prescribes depends on several things. These include where the tinea versicolor appears on the body, how much of the skin is affected, how thick the spots have grown, and climate.

Treatment for tinea versicolor may include:

• Medicine applied to the skin: This is the most common treatment. There are anti-fungal shampoos, soaps, creams, and lotions that can keep the yeast under control. The active ingredient in these medicines is often selenium sulfide, ketoconazole, or pyrithione zinc.
• Medicated cleansers: Tinea versicolor often returns, especially when a person lives in a place that is warm and humid. Using a medicated cleanser once or twice a month, especially during warm and humid periods, can prevent the yeast from overgrowing again.
• Anti-fungal pills: A dermatologist may prescribe these pills if the tinea versicolor covers a large area of the body, is thick, or often returns after it is treated. These pills are taken for a short time. But anti-fungal pills can cause unwanted side effects. They can interfere with other medicine that you take. A dermatologist will monitor a patient who takes this medicine.

Outcome

With treatment, the yeast is easy to kill. The skin, however, may stay lighter (or darker) for weeks or months. The skin will eventually return to its normal color. To help even out your skin tone, you should protect your skin from the sun and not tan.

Tinea versicolor can return. When the air outdoors is warm and humid, the yeast can quickly grow out of control. Some people who live in a tropical climate may need to use a medicated cleanser to prevent the yeast from overgrowing. People who live in an area that becomes warm and moist each spring may see tinea versicolor return every year.

Tinea versicolor: Tips for managing

If tinea versicolor is mild, you may be able to treat it yourself. There are anti-fungal products that you can buy without a prescription. These include:

• Shampoo that contains selenium sulfide.
• Anti-fungal cream or ointment that contains miconazole, clotrimazole, or terbinafine.

When using these products, dermatologists recommend the following:

• Wash and dry the affected skin.
• Apply a thin layer of the anti-fungal cream or ointment. Do this once or twice a day for at least 2 weeks.
• When using a shampoo, wait 5 or 10 minutes before rinsing.

Some people need stronger medicine, so they see a dermatologist. Whether you self-treat or see a dermatologist, these tips can help you get better results:

• Stop using skin care products that are oily. Use products that say non-oily or non-comedogenic.
• Wear loose clothes. Nothing should feel tight.
• Protect your skin from the sun. A tan makes tinea versicolor easier to see.
• Do not use a tanning bed or sun lamp. Again, a tan makes tinea versicolor easier to see.

How to protect your skin from the sun

To get the best results, you need to protect your skin from the sun. To do this, you should apply sunscreen every day. Be sure to apply the sunscreen 20 minutes before you go outside. And apply it to all skin that will not be covered by clothing. Make sure to use a sunscreen that offers:

• UVA and UVB protection (label may say broad-spectrum).
• Sun Protection Factor (SPF) of 30 or more.
• Non-greasy formula (label may say non-comedogenic).

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