Fungal Infections

November 14, 2008

Tinea Versicolor

Tinea Versicolor

Tinea versicolor (pityriasis versicolor) is a fungal infection of the topmost layer of the skin causing scaly, discolored patches.

The infection, caused by the yeast Malassezia furfur, is quite common, especially in young adults. It rarely causes pain or itching, but it prevents areas of the skin from tanning, producing patches that are lighter in color than surrounding skin. People with naturally dark skin may notice lighter patches; people with naturally fair skin may get dark or lighter patches. The color depends on how the yeast affect the melanocytes, the cells that make the pigment . The patches are often on the chest or back and may scale slightly. Over time, small areas can join to form large patches.

Diagnosis and Treatment

Doctors can diagnose tinea versicolor by its appearance. A doctor may use an ultraviolet light to show the infection more clearly or may examine scrapings from the infected area under a microscope to confirm the diagnosis.

Topical antifungal cream such as ketoconazole (NIZORAL) may be used, as well as terbinafine (LAMISIL AT) solution spray. Prescription selenium sulfide (SELSUN) shampoo is effective if applied full-strength to the affected areas (including the scalp) at bedtime, left on overnight, and washed off in the morning. Treatment is usually continued for 3 or 4 nights. Alternatively, the shampoo can be applied for 10 minutes a day for 10 days. Prescription ketoconazole (NIZORAL) shampoo is also effective; it is applied and washed off in 5 minutes. It is used as a single application or daily for 3 days.

Antifungal drugs taken by mouth, such as itraconazole (SPORANOX), ketoconazole (NIZORA),  or fluconazole (DIFLUCAN), are sometimes used to treat widespread, resistant infection However, because these drugs may cause unwanted side effects, topical drugs are usually preferred.

The skin may not regain its normal pigmentation for many months after the infection is gone. Tinea versicolor commonly comes back after successful treatment because the fungus that causes it normally lives on the skin. Therefore, many doctors recommend use of 2.5% selenium sulfide (SELSUN) shampoo or ketoconazole (shampoo monthly or every other month to prevent recurrences.


Tinea Versicolor

What is tinea versicolor?

Tinea versicolor is a common fungal skin infection characterized by lighter or darker patches on the skin. Patches are most often found on the chest or back and prevent the skin from tanning evenly. It occurs mostly in adolescence and early adulthood, but it can occur at any time.
What are the symptoms of tinea versicolor?

Usually, the only symptom of tinea versicolor is the white or light brown patches. Patches may scale slightly, but rarely itch or hurt. Other common characteristics of the rash include the following:

  • white, pink, or brown patches
  • infection only on the top layers of the skin
  • the rash usually occurs on the trunk
  • the rash does not usually occur on the face   

    patches worsen in the heat, humidity, or if you are on steroid therapy or has a weakened immune system

  • patches are most noticeable in the summer

The symptoms of tinea versicolor may resemble other skin conditions. Always consult your physician for a diagnosis.
<How is tinea versicolor diagnosed?

Tinea versicolor is usually diagnosed based on a medical history and physical examination. The patches seen with this condition are unique, and usually allow the diagnosis to be made on physical examination. In addition, your physician may use an ultraviolet light to see the patches more clearly. Also, your physician may do skin scrapings of the lesions to help confirm the diagnosis.
Treatment for tinea versicolor:

Specific treatment for tinea versicolor will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the condition
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

Treatment usually includes the use of dandruff shampoo on the skin, as prescribed by your physician. The shampoo is left on the skin overnight and washed off in the morning. To be effective, the shampoo treatment may be required for several nights. Tinea versicolor usually recurs, requiring additional treatments. Your physician may also prescribe topical creams or oral antifungal medications. It is also important to know that improvement in the skin may only be temporary, and a recurrence of the condition is possible. Your physician may also recommend using the shampoo monthly to help prevent recurrences. The treatment will not bring the normal color back to the skin immediately. This will occur naturally and may take several months.


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