What is tinea versicolor?
Tinea versicolor (say "TIH-nee-uh VER-sih-kuh-ler") is a fungal infection that causes many small, flat spots on the skin. The spots can be flaky or mildly itchy. The many small spots may blend into large patchy areas, usually on the oily parts of the upper body like the chest and back. The spots can be either lighter or darker than the skin around them.
What causes it?
Tinea versicolor is caused by a fungus. This fungus lives all around us, including on the skin. Normally, regular washing and showering removes dead skin and fungi (more than one fungus). But in hot and humid weather, such as during the summer or in tropical areas, fungi may grow more rapidly. As these fungi grow in number, their natural balance on the skin is affected, the normal color of the skin changes, and spots appear.
People with oily skin, especially teens and young adults, are more likely to get tinea versicolor. It does not spread from person to person.
Other things that increase your chance of getting tinea versicolor include:
- Having an impaired immune system, which can occur during pregnancy or from some illnesses.
- Using certain medicines, such as corticosteroids, antibiotics, or birth control pills.
What are the symptoms?
Symptoms of tinea versicolor include small, flat, round or oval spots that may, over time, form patches. The spots occur on oily areas of skin on the upper chest, back, or upper arms or, less often, on the upper thighs, neck, or face.
The spots can be lighter or darker than the skin around them. If your skin tends to get darker with sun exposure, the spots may be easier to see in the summer because they don't tan with the rest of your skin. For people whose skin is lighter during the winter, the spots may be harder to see at that time of year.
The spots are flat and may be white, pink, red, tan, or brown, depending on your skin color. Each person's spots are usually just one color. The spotted skin may be scaly. Although it's not common, your skin may itch, especially when you are hot.
How is it diagnosed?
Your doctor often can tell if you have tinea versicolor by looking at the spots.
He or she may look at a sample (scraping) of the infected skin under a microscope. The test used most often for this is the KOH test. This can show whether the problem is caused by a fungus.
How is tinea versicolor treated?
Treatment can prevent the rash from spreading and improve the appearance of your skin. The condition is easy to treat. But not everyone chooses to get treatment. You only need to treat the infection if it bothers you or causes problems.
Products that you put on your skin (topical treatments) are the most common treatment for tinea versicolor.
- These may include antifungal shampoos, creams, and foams. Shampoos can be used on the body as well as the head and may be easier to use than creams or foams.
- Depending on how strong the medicine is, you may or may not need a prescription for these products. For example, shampoos used to treat tinea versicolor usually contain selenium sulfide. They are available in 2.5% strength with a prescription and in 1% strength without a prescription (for example, Selsun Blue, Head and Shoulders).
- You may need to use the product once or twice each day for 1 to 2 weeks or longer.
If the infection is severe, returns often, or does not get better with skin care, your doctor may prescribe antifungal pills. Pills tend to be easier for people to use than the products that you put on your skin. They may also work better at curing the rash. But they have side effects and can affect your heart and liver, so you may need blood tests while you're taking them. People with liver problems, heart problems, or other health problems may not be able to take the pills.
Treatment kills the fungi quickly. But it can take months for the spots to disappear and for your skin color to return to normal. Also, the infection tends to come back after treatment. It may come and go over the years. In general, it tends to get better as you get older.
How can you prevent it?
If you have frequent problems with tinea versicolor, there are a couple of things you can do so that it is less likely to come back.
- Use antifungal skin creams, shampoos, or solutions at least once a month. Ask your doctor if you should use them more often.
- Talk to your doctor about taking antifungal pills once a month. Most people don't need to do this, but it can help in some cases.
Some doctors believe that fungi that remain in clothing may cause the infection to return. Normal washing and cleaning is usually effective in removing the fungus from clothes. But for persistent tinea versicolor, you may need to dry-clean your clothes or wash them in the hottest possible water.