Tinea versicolor, also referred to as pityriasis versicolor, is a skin condition characterized by small patches of lighter or darker skin. It is caused by a type of fungus that is found on almost everyone’s skin. It is generally not harmful and it isn't contagious.
Topical treatments, such as special creams or shampoos, are usually effective.
In tinea versicolor, small round or oval patches of skin appear at first, and later merge into larger patches with irregular shapes. They are especially common on the back, chest, neck and/or arms. They may occur on the face as well, particularly in children.
The patches may be yellow or brownish, or sometimes red or pink. They are usually lighter or darker than the surrounding healthy skin. Because these patches hardly change color in the sun, they are more noticeable if you have a suntan. But if you have a fair complexion, they may turn a little brownish. The affected areas of skin may also be somewhat scaly. They rarely itch. If they do, then they only itch a little.
Tinea versicolor on the upper body
Tinea versicolor is caused by a type of fungus that is found on almost everyone’s skin. It’s not clear exactly why the fungus grows and causes visible patches in some people but not in others. Tinea versicolor has nothing to do with poor hygiene, and it’s not contagious.
Some factors can increase your chances of developing tinea versicolor. These include
- a warm and humid climate,
- heavier sweating, for instance in people who sweat more generally, or who do a lot of sports, and
- the use of oils or cosmetics that may close the skin pores.
People who have a weakened immune system are generally more susceptible to infections, so they are also more likely to be affected by tinea versicolor. Things that can weaken the immune system include having certain types of cancer or taking medication that suppresses the immune system – following an organ transplant, for instance. Tinea versicolor also appears to run in families.
Tinea versicolor is a common skin condition. In countries with a more moderate climate it affects about 1% of the population, and in some tropical countries it affects about 40%. It is just as common in men as it is in women. Most people first get it at a young age.
Tinea versicolor can usually be diagnosed simply based on the typical groupings of smaller light or dark patches on the upper body and/or arms. To rule out other possible skin conditions, your doctor might use a transparent adhesive strip to take a sample of the scaly skin and inspect it under a microscope. This is usually enough to determine whether it is tinea versicolor.
Tinea versicolor may improve a little in cool or dry weather, but it usually doesn’t go away on its own. There are a number of effective treatments. These mainly include creams, lotions and shampoos that contain antifungal substances. They are applied to all of the affected areas of skin on the head and body. The shampoo is used too, in order to get rid of the fungus on the scalp and hair. Otherwise it might spread back to the skin again. Depending on the exact product used, it needs to be left on for anywhere from a few minutes to several hours. The products are often put on in the evening and then rinsed off in the shower the next morning.
But even when treatment works, it can take up to several weeks or months for the skin patches to disappear. Only in rare cases are tablets needed.
Sometimes tinea versicolor comes back again after successful treatment. If this keeps happening, doctors sometimes recommend using a special shampoo (containing an active ingredient like selenium sulfide or ketoconazole) on your skin and hair every two to four weeks. There are also oral medications (tablets) that can be taken every four weeks to prevent tinea versicolor from returning. This can greatly reduce the risk of it coming back.
Hu SW, Bigby M. Pityriasis versicolor: a systematic review of interventions. Arch Dermatol 2010; 146(10): 1132-1140.
Schwartz RA. Superficial fungal infections. Lancet 2004; 364(9440): 1173-1182.
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