Tinea versicolor, which is also called pityriasis versicolor, is a common fungal infection that we see frequently in our clinics at Advanced Dermatology of the Midlands, especially in the summertime. The condition is caused by a type of fungus and involves an overgrowth of a yeast organism (Malassezia type) on the skin, which disrupts pigment production temporarily. Tinea versicolor that develops in people with dark skin may result in the loss of skin color, known as hypopigmentation. Depending on the person, skin may appear lighter or darker. This skin infection occurs frequently in teens and young adults, as well as those with weakened immune systems, on the torso, neck, and/or the arms. Though it is very common, the good news is that it is harmless. A common misconception is that it can affect the face when in reality it essentially never shows up in that area.
The name tinea versicolor is derived from the appearance of the rash. The rash can be lighter areas, darker areas, pink areas, or a mixture of all 3 in the same person. Usually, these patches are very faint and slightly scaling. Most of the time they are free of symptoms though some affected people have mild itching. As we said before, the condition does not affect the face. There are numerous other skin conditions that can cause pigment change on the face like this and are frequently mistaken for tinea versicolor.
Some of us are more predisposed to having tinea versicolor than others. Individuals who have more oily skin are more susceptible. Also, those of us who frequently get sweaty, either from exercise or other physical activities relating to work, especially working outdoors, tend to be more likely to have tinea versicolor. It also generally affects young to middle-aged adults more commonly than any other age group.
Tinea versicolor is triggered by an overgrowth of a yeast organism that we all carry on our skin. In those of us who get sweatier or have more natural oils on our skin, the yeast tends to grow out of control, particularly at times of the year when temperature and humidity are higher such as in the summer. Progressively throughout the summer season, the patches may become more and more visible especially if there is natural sunlight exposure because the patches that are involved will not tan normally and uniformly like the remainder of your skin.
The best news of all is that this condition is completely harmless and is not contagious. Though it cannot be cured, treatment is generally quite effective at reducing the amount of yeast on the skin. One of the issues with the condition though is that if the surrounding skin is tanned, the contrast difference between the affected areas that were treated and the normal skin may take some time to fade back down to normal. Typically, this will not occur until the tan fades in the fall or winter months. So in other words, the pigment change may persist for weeks or even months.
Tinea Versicolor Treatments
The best dermatologists know that many different methods are available to treat the condition, but the best and safest treatments involve medications that are applied to the skin. Some of these are prescription strength and some of the treatments can be obtained over-the-counter like Vanicream Z-Bar or Zinc Therapy Soap (zinc pyrithione)
Over The Counter Treatment
Over-the-counter creams such as clotrimazole or miconazole can treat the yeast, and if applied once or twice a day for up to a few weeks may help some cases of tinea versicolor. Anti-dandruff shampoos such as Head and Shoulders or Selsun Blue (selenium sulfide) can be used as a body wash by lathering onto the affected areas, leaving the shampoo in place for 5 minutes or so then rinsing. This could be repeated 2 or 3 times a week for best results. This can clear some cases of the condition.
In other cases, prescription therapy or oral antifungal medications may be needed. Treating the condition early in the season and repeating the treatment periodically if there is any progression tends to work best to help with the appearance of the rash. As noted, late in the summer season, the pigment alteration is often so intense that the treatment may clear the yeast but is less likely to allow the pigment to balance out until a person’s tan has faded later in the year.
Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists
As you can see, this is a very common summertime skin eruption. Look for more reports from us on other seasonal eruptions coming soon. If we may be of any further assistance, please reach out to us for consultation at any of our two Omaha locations, Council Bluffs location, or outreach locations in surrounding rural communities.