Tinea Versicolor

What is tinea versicolor? How is it treated?

Tinea Versicolor

Dr. Greene’s Answer:

Tinea versicolor is a mild, superficial fungal infection, somewhat similar to ringworm (true ringworm can also result in white patches). Since the affected skin doesn’t change color well with sun exposure, it usually becomes apparent as white patches during the summer months. In the winter it may seem to disappear, or even seem to become slightly darkened patches as the surrounding skin gets paler (this is where the name versicolor comes from).

Tinea versicolor is most common in adolescents and young adults 15 to 30 years old (although it can certainly happen at any age). The infection is chronic and recurs easily, but it causes no other health problems. People are most susceptible to the fungus during hot months in humid areas. Taking steroids, excessive sweating, wearing tight-fitting clothing, and chronic illness can all predispose a person to tinea versicolor, but someone without any of these factors can still get this mild infection.

The patches of tinea versicolor can appear white, tan, or pink. The white patches look very similar to pityriasis alba. There are two good ways to tell them apart.

The most reliable way is to have a doctor gently scrape the white patch, dissolve the scrapings in potassium hydroxide, and look at what is left under a microscope. The classic “spaghetti-and-meatball” appearance of budding yeast confirms the diagnosis of tinea versicolor. A quicker and easier approach is to look at the patches under a black light. The patches of tinea versicolor will usually light up with a blue-white, yellow, or orange color.

Topical antifungal medicines are very effective for treating tinea versicolor, but there is a more convenient, less expensive, highly effective alternative. Selenium shampoos are great at getting rid of the fungus. Simply apply a thin layer over the affected skin before bed (with a wide surrounding margin, since it may already be beginning to spread). Wash thoroughly the next morning.

The problem is that no matter what the treatment, it comes back easily. Whatever treatment is used for tinea versicolor, all bedding and nightclothes should be changed after treatment to prevent recurrence. Also, re-treating once a week for 3-4 weeks and then once a month for 3-4 months makes it much less likely to come back.

Even when the condition is effectively treated, the white patches will remain for a while. At least several weeks must pass for the newly healthy skin to adjust its color to the amount of ongoing sunlight exposure, so that it will match the surrounding skin.

December 12, 2011

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Matthew chan

    Hi there,

    My 3yr old kid has white patches on her back hands and now face. She visited the national skin centre and they did a operation to remove a small part of her skin for test. But the Doctors couldn’t find anything wrong with the test report. The Doctors advise that they may have to operate a few times for skin test report. Please advise what should I do?

    • Lisa

      Could be pityairsis Alba, a benign condition. Review Medscape or Mayo clinic for an extensive explanation. I don’t know why they are taking numerous biopsies.

  2. Janet

    You might have Tinea Versicolor which is yeast that already lives on your skin. You’re susceptible to it if your immune system is lowered, cortisone shots, antibiotics, stress or a combination of the above. When the balance is disrupted, it becomes a fungal infection. It can mimic eczema but eczema is not an infection and there are no bumpy, scale lesions with macules. Eczema is more of flaky inflamed skin caused by an allergy with no lesions. Fungus does not grow well in cultures. The scales can be viewed under a microscope or a Wood’s ultraviolet lamp would show a yellow/green color. A dermatologist should be able to clinically diagnose Tinea Versicolor by looking at it. If they need to test it, they are probably not a good dermatologist but they could confirm the diagnosis looking at it under a microscope. Potassium hydroxide would have to be put on the slide or use the Wood’s lamp which is very easy to do. In addition, eczema is extremely itchy whereas Tinea Versicolor is mildly (pruritic) itchy and the itch maybe sporadic.

  3. Kristy

    I wanted to thank you for all of this great information but I do have a question or two.

    1. Is the infection on top of the skin or in the skin?

    — if it is on the skin can something harsher be used to quicken the process, such as 90% alcohol to kill the fungus, I know it can be harmful and dry out the skin but I have a job interview coming up and I am on a pill form of medication as well as two creams.

    Thanks again for the additional information and in advance for any answers you may be able to provide.

  4. Dan Armstrong

    Dr. Greene,
    Thank you so much for writing this. I have had issues with this since I was a child and never have been told what it is.

    It has been a while since it bothered me and in the past 6 or 8 months has returned as dry itchy patches. They get really pink when I sweat and get hot.

    I remember a dermatologist telling me it was a fungus years ago, I am 45 BTW.

    I showed it to a pharmacist and she thought it was hives. I told her it was a fungus, but she insisted. I took zyrtec for a few weeks and nothing.

    Now I know I knew what I was talking about.

    I will show her this article since it’s a small family owned pharmacy and I really like them.

    Thanks again, I will be buying shampoo tomorrow.

    Dan Armstrong
    Itching in Alabama LOL


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