Tinea versicolor

Introduction

Photo of a man sweating a lot
PantherMedia / Ingeborg Knol

Tinea versicolor, also referred to as pityriasis versicolor, is a skin condition characterized by patches of lighter or darker skin. It is caused by a type of yeast (fungus) that is found on most people's skin. It is generally not harmful and it isn't contagious.

Topical treatments (applied directly to the affected area), such as special creams or shampoos, are usually effective.

Symptoms

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. The affected areas of skin may also be somewhat scaly. They rarely itch. If they do, then they only itch a little.

Illustration: Tinea versicolor on the upper body – as described in the information

Tinea versicolor on the upper body

Causes

Tinea versicolor is caused by a type of yeast (fungus) that is found on most people's skin. It’s not clear exactly why the fungus grows and causes visible patches in some people but not in others.

It's important to know that tinea versicolor has nothing to do with poor hygiene, and it’s not contagious.

Risk factors

Various factors can increase your chances of developing tinea versicolor. These include

  • a warm and humid climate,
  • sweating a lot (for instance in people who generally sweat more or who do a lot of sports) and
  • the use of oils or cosmetics that may clog the skin pores.

Genes probably play an important role too.

People who have a weakened immune system are generally more susceptible to infections, so they are also more likely to develop tinea versicolor. The may be weakened by things like certain types of cancer or medication that suppresses the – for instance, following an organ transplant.

Prevalence

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.

Diagnosis

Doctors can often recognize tinea versicolor just by looking at the typical groups of light or dark patches on the upper body and/or arms. To rule out other possible skin conditions, your doctor might use a strip of clear adhesive tape to take a sample of the scaly skin and look at it under a microscope. This is usually enough to determine whether it is tinea versicolor.

Treatment

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 antifungals (substances that kill the fungus or inhibit its growth). The creams and lotions are applied to the affected areas of skin. The shampoo is used too, so that the fungus doesn't spread back to the skin from the scalp and hair. Depending on the exact product used, it needs to be left on for anywhere from a few minutes to several hours. The creams and lotions 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. Treatment with tablets is only rarely needed.

Sometimes tinea versicolor comes back again after successful treatment. If this keeps happening, doctors may recommend using a special shampoo on your skin and hair every two to four weeks to prevent it from returning again. The shampoo contains an active ingredient like sulfide or ketoconazole. There are also oral medications (tablets) that can be taken every four weeks to prevent tinea versicolor from returning. Doing either of these things can greatly reduce the risk of it coming back.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.

Choi FD, Juhasz ML, Atanaskova Mesinkovska N. Topical ketoconazole: a systematic review of current dermatological applications and future developments. J Dermatolog Treat 2019 [Epub ahead of print]: 1-12.

Hu SW, Bigby M. Pityriasis versicolor: a systematic review of interventions. Arch Dermatol 2010; 146(10): 1132-1140.

Renati S, Cukras A, Bigby M. Pityriasis versicolor. BMJ 2015; 350: h1394.

Schwartz RA. Superficial fungal infections. Lancet 2004; 364(9440): 1173-1182.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on August 29, 2019
Next planned update: 2022

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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