What Is Tinea Versicolor? Symptoms, Causes, Diagnosis, Treatment, and Prevention

The thought of fungus living on you might make your skin crawl, but the fact of the matter is, it’s normal — and often unnoticeable. Sometimes, however, it is noticeable. In the case of tinea versicolor, fungus can grow out of control and cause a rash. (1)

“Tinea versicolor is a common skin disorder caused by the fungus Malassezia furfur,” explains Yoram Harth, MD, a board-certified dermatologist and medical director of MDacne. “This fungus temporarily modifies the normal pigmentation of the skin, resulting in small white patches. It’s asymptomatic, doesn’t interfere with general health, and isn’t contagious — it’s also more common in young adults and in hot and humid climates.” (2)

Tinea versicolor is also known as pityriasis versicolor. (3)

The primary symptoms of tinea versicolor are scaly spots or patches on the skin. These patches are typically white and oval-shaped, though they can also be dark or reddish tan in color, notes Dr. Harth. (4)

Tinea versicolor patches occur most often on the shoulders, neck, and trunk, but they can appear anywhere on the body. Sometimes patches show up on the abdomen or face.

The patches often have sharp borders or edges, and they don’t darken in the sun. (3) They also typically have a very fine scale that becomes more noticeable with gentle rubbing, similar to a scratch-off lottery ticket.

That explains why the patches might be more visible after recent sun exposure. As the rest of your skin tans and darkens, the patches show up more. (5)

These spots can come and go, especially as seasons change and outside temperatures fluctuate. The spots may be more noticeable when the weather is hot and humid (as in summer) and may be less noticeable or even disappear in fall and winter. (6)

These other symptoms may also appear: (4)

• Itching
• Scaling of the skin
• Increased sweating

“It’s not clear why some people get tinea versicolor more than others,” says Harth. “One theory is that it depends on the composition of the sebum or skin oils in those people.” An increase of sebum likely creates an environment for Malassezia to thrive. (7)

Other conditions may also contribute to tinea versicolor, explains Ife Rodney, MD, founding director of Eternal Dermatology and Aesthetics in Fulton, Maryland. When the skin is sweaty, warm, or moist, the yeast can overgrow, resulting in slightly scaly light or dark oval patches usually on the back, neck, or chest. (4)

Often, doctors can diagnose tinea versicolor by examining discolored patches on the skin. (1) To confirm a diagnosis, your doctor can scrape off a piece of the affected skin and examine it for yeast cells under a microscope. (8)

Your doctor can also use ultraviolet light to confirm a diagnosis of tinea versicolor. If you have this skin condition, the affected skin will appear as a yellowish-green color under UV light. (8)

Prognosis of Tinea Versicolor

Most people clear the infection with antifungal treatment. Understand, though, that these infections often recur, especially in those who live in warm, humid climates, warns Harth. Some people periodically use antifungal creams and lotions to prevent future rashes. (8,9)

Tinea versicolor doesn’t usually go away on its own, so treatment is often necessary. (6) The duration of treatment varies from person to person. Once treatment begins, it might take one to four weeks to inhibit the growth of the fungus. (1)

Many treatments for tinea versicolor are available.

Medication Options

Your doctor may suggest one of these over-the-counter antifungal creams, lotions, ointment, or shampoos as a first-line therapy: (10)

• clotrimazole (Lotrimin AF, Mycelex) cream or lotion
• miconazole (Monistat, M-Zole) cream
• selenium sulfide (Selsun Blue) 1 percent shampoo
• terbinafine (Lamisil) gel or cream
• Zinc pyrithione soap

If they don’t work, you may need one of these prescription-strength topical remedies: (7,10)

• ciclopirox (Loprox, Penlac) gel, lotion, or cream
• ketoconazole (Nizoral) foam, cream, gel, or shampoo
• Selenium sulfide in 2.5 percent lotion or shampoo

Some people with tinea versicolor might prefer oral medicines, as they aren’t as messy and can be more convenient. A doctor may prescribe an oral medicine to achieve better results. You might receive oral medication when the fungus covers a large area of your body or frequently returns. However, tablets are rarely needed to treat tinea versicolor. (6) Commonly used oral medicines include these drugs: (7,10)

• fluconazole (Diflucan) tablets
• itraconazole (Onmel, Sporanox) capsules or tablets

Photodynamic therapy, also called light therapy, may help with tinea versicolor, too, according to some research. In one study, 66 percent of participants diagnosed with tinea versicolor reported decreased itching, hyperpigmentation, and scaling when treated with narrow-band UV-B phototherapy three times weekly. (11) Researchers believe the UV-B light helps inhibit the growth of Malassezia.

Alternative and Complementary Therapies

Applying over-the-counter dandruff shampoos to the skin for about 10 minutes a day while in the shower can be a useful home remedy. Ask your doctor if this might help you. (2)

Other home remedies sometimes suggested include honey, olive oil, and beeswax. Ask your doctor or dermatologist before trying any of them. (12)

In one small study, an application of equal parts honey, olive oil, and beeswax helped a majority of patients. They applied the mixture three times a day for about a month. (12)

Tinea versicolor can return after treatment. To reduce the chances of a recurrence, your doctor may recommend using a topical or oral treatment once a month or more often. (9)

Some doctors also suggest using a medicated cleanser once or twice a month — especially if you live in a warm, humid location — to prevent the yeast from growing excessively again. (4)

Tinea versicolor doesn’t cause any serious complications. (9) But the skin may become discolored, scaly, and itchy, explains Dr. Rodney, adding that even after treatment, it can take months for skin color to return to normal. (1)

A tan can make the condition more noticeable, so protecting your skin from the sun can give the appearance of an even skin tone. Use sunscreen daily, at least SPF 30 or higher, and don’t use tanning beds. (5)

Up to 50 percent of people living in certain tropical areas have reported this skin infection. (7) In countries with cooler temperatures such as Sweden only about 1 percent of residents are affected. (7)

Teens and young adults are more likely to get a tinea versicolor infection than older or younger individuals, but it can occur in anyone. Both genders are affected. (6)

The condition is more likely to be a problem if any of these apply to you: (3,4)

• Excessive sweating
• A compromised immune system
• Oily skin
• Very poor nutrition
• On birth control pills
• Pregnant
• Have diabetes
• Use corticosteroid medicines

The risk of infection is higher in those who have a weakened immune system. These conditions can trigger tinea versicolor: (3,6)

• Diabetes
• HIV infection
• Cancer
• Pregnancy
• Malnutrition

Taking a corticosteroid also makes you susceptible to tinea versicolor, as does having an organ transplant. (3)

Favorite Orgs for Essential Tinea Versicolor Info

Mayo Clinic

The Mayo Clinic offers a wealth of patient care information related to various health topics, including tinea versicolor. You’ll find an overview of symptoms, causes, complications, treatments, and prevention tips. Got a skin concern? Use the website’s Find a Doctor tool to locate a dermatologist.

American Academy of Dermatology (AAD)

The AAD is another excellent source for trustworthy information about tinea versicolor. Its website not only provides a comprehensive overview of this skin infection but you’ll find self-care tips and a handout on how to care for a child with tinea versicolor. There’s also a tool to locate a board-certified dermatologist near you.

American Osteopathic College of Dermatology (AOCD)

The mission of the AOCD is to provide support and education in the field of dermatology. Its website provides images of tinea versicolor, as well as information on symptoms and causes. There’s even a video explaining how to self-treat the infection at home.

KidsHealth

Looking for more information on tinea versicolor? KidsHealth provides resources for parents, kids, teenagers, and educators. Other useful tools on the website include videos, expert answers, and newsletters.

Favorite Resources for Online Support

MDLive

Need advice on a skin condition? For $75 (or less) you can speak with an MDLive dermatologist online and get a quick answer anytime, anywhere. Send a few photos of your skin for a doctor to diagnose your condition — and if necessary, they’ll write a prescription.

SkyMD

This is another affordable way to consult a dermatologist online. The board-certified dermatologists from SkyMD are available 24/7 to diagnose your skin condition and write a prescription, if necessary.