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Tinea Versicolor

Tinea Versicolor is a common skin condition due to overgrowth of  yeast (a certain type of fungus) that grows on our skin, and happens more commonly in tropical and sub-tropical climates. It thrives in oily areas such as the neck, upper chest and back. This overgrowth results in uneven skin color and scaling that can be unsightly and sometimes itch.

Why some people get Tinea Versicolor and others do not is not clearly understood. Since the yeast is normally present in small numbers on everyone’s skin, anyone can develop an overgrowth of this yeast. It usually grows slowly in the skin so that normal washing and cleansing removes the yeast along with dead skin. During the summer months when the temperature and humidity are high, the yeast can increase. The excess yeast on the skin prevents the normal pigmentation process, so both light and dark colored spots can result.

Tinea Versicolor may reappear. It’s important to remember that while the yeast is easy to kill, it can take weeks or months for the skin to regain its normal color.

What does Tinea Versicolor look like?

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, and may itch where the spots appear.
  • Spots become more noticeable as the skin tans. The yeast prevents the skin from tanning.
  • 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.

In most cases, the appearance of the skin is diagnostic, but a simple examination of the fine scales scraped from the skin can confirm the diagnosis. Scales are lightly scraped onto a slide and examined under a microscope for the presence of the yeast. A special light (Woods Lamp) may help to make the diagnosis by showing a yellow-green color where the skin is affected.

How is it treated?

Tinea Versicolor is treated with either topical or oral medications. Topical treatment includes special cleansers including some shampoos, creams, or lotions applied directly to the skin, once or twice a day. Oral medications have also been used successfully to treat Tinea Versicolor.

Medicine/Cleansers applied to the skin:  This is the most common treatment.

1) Ketoconazole

  •   2% Gel (Xolegel) – Apply thin layer once daily for 2 weeks. Wash hands before and after use. Do not rinse. Wait at least 20 minutes before applying cosmetics/sunscreen.
  •  2% Cream– Apply once daily for 2 weeks
  •  2% Shampoo (Nizoral)– Apply to damp skin of affected area. Lather, leave on for FIVE MINUTES and rinse.Repeat 1-2 times per week
  • Selenium Sulfide (2.5%) lotion or shampoo

2) 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.

  •  Fluconazole (Diflucan) 400mg once; repeat after one week
  • Ketoconazole (Nizoral Tablets) 200mg orally (PO) daily for 7-14 days OR 400 Mg Single Dose Orally

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