Tinea Versicolor


What is tinea versicolor? How is it treated?

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.

Last medical review on: June 29, 2014
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Recent Comments

hi how long does it take to heal by using aloe vera?

Hi Dr. Green,

I have a tiny white spot (5mm in diameter) on my arm since 6 years now. The dermatologists I have shown to have all said it’s tinea versicolor. They didn’t use any lamp or scraping to diagnose. Now the spot seems to be changing shape very slightly. Is this phenomena possible with tinea versicolor. I have read everywhere that tinea spots don’t grow, rather they multiply and coalesce to form a patch.

Exfoliation is the most important aspect of ridding yourself of this infection!!! In the morning, use a bath brush and “scrub” all of the affected areas. Bathe with selsum blue and after 10 years it appears to be gone! I have been utililizing this treatment for two months now and I’m shocked at how well the infection has responded to the treatment. The exfoliation “removes” the food source the tinea thrive on… It’s the key to your success.

A safe and effective way to get rid of Tinea Versicolor a/k/a Pityairsis Versicolor, is to use organic apple cider vinegar with the mother and mix it in a 3 ounce bottle adding some hydrogen peroxide (either 2 or 3 %). Then pat it on the infection area three times per day. Do not rub, scratch or pick the fungus because it will just grow more. The fungus will flake off naturally until you see normal skin. Do not put coconut oil on the skin even though it has anti-fungal properties, the oil feeds the fungus because Tinea Versicolor is a lipophilic yeast fungal infection. Use clean cotton balls to pat it on the skin. Wash your hands before and after. The reason most people get this condition is because there is an overgrowth of Candida Albicans in the colon as a result of cortisone shots, antibiotics, consuming too much sugar, refined carbohydrates or consuming too much oil and fat in your diet which upsets the balance in your colon. Or a combination of the above. Cortisone lowers your immune system and allows opportunistic yeast to flourish. You can get the Tinea Versicolor on your rectal area in which case you can use it in that area to eradicate the fungus. It will initially burn but it will feel better afterwards from killing the fungus. The itch will also subside since it is killing the yeast fungal infection. Remember not to rub your skin. This works better than the anti-fungal creams because the fungus will never be resistant to this protocol and it is keeping your skin dry which deters fungal infections. You will not have to take those toxic anti-fungal pills which damage your liver.

Dear Dave,
I would like to know from you what is the exact proportion of apple cider vinegar and Hydrogen peroxide that should be used for tinea infection. You say, it is due to the overgrowth of candida in the colon, is candida not different from Tinea? Also some internal treatment must be taken if the tinea infection is due to an infection of the gut? Will appreciate your reply.

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?

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.

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.

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.

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