Tinea Versicolor

Tinea versicolor is a common, benign fungal skin infection that causes the pigmentation of the skin on the chest and back to appear “blotchy.” Prevalence of the condition can vary from 2-8% of the general population. Larger numbers of people are affected in the hotter, humid zones as opposed to the dryer, colder climates.

The most common symptom of tinea versicolor is the noticeable patches of discolored skin (i.e. either lighter or darker than the surrounding area) that can occur most commonly on the back and chest, but can occasionally appear on the arms and legs, and rarely on the face, scalp or genital areas.

The color of these patches can vary from off-white to reddish brown. During tanning season, these areas will not darken and become perhaps more noticeable. Sometimes, slight scaling of the lesions can occur. Typically, the patches start out smaller, and over time merge together to form larger, irregularly shaped patches. People with naturally darker skin may see lighter patches, and people with fair complexions may see either lighter or darker patches. In a few cases, mild itching may occur.

Causes

Malassezia furfur is type of fungi classified as a “yeast” that is naturally occurring on the skin surface. On some people and in some places - these fungi can cause tinea versicolor. On others, it can cause seborrheic dermatitis or atopic dermatitis.

Factors that seem to contribute to the likelihood of this skin disease include a genetic predisposition; immune system dysfunction; hormonal changes; oily skin; hot, humid environments; malnutrition; and Cushing disease. No linkage to sex or race has been found.

Treatment

For milder symptoms of tinea versicolor, topical antifungal creams (i.e. ketoconazole) are typically prescribed. Prescription strength selenium sulfide (2.5%) or ketoconazole creams or shampoos can be effective if applied full strength to the affected areas and removed after the prescribed length of time.

More resistant forms of the infection may require oral antifungal mediations, such as ketoconazole, fluconazole or itraconazole. These can create other sometimes serious side-effects, and so topical creams are a much preferred course of treatment.

After successful treatment, skin coloration may take weeks or months to correct. And in some cases, pigmentation may never return to normal.

Preventative Measures

Because the fungi that cause this infection are normally found on the skin, reoccurrences are quite common. To help prevent a reoccurrence, we suggest the use of a prescription strength selenium sulfide or ketoconazole shampoo used once or twice a month. Over-the-counter (OTC) pyrithione zinc soap used regularly may also be useful in helping to limit recurrence.

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