Diagnosis

Your doctor can diagnose tinea versicolor by looking at it. If there's any doubt, he or she may take skin scrapings from the infected area and view them under a microscope.

Treatment

If tinea versicolor is severe or doesn't respond to over-the-counter antifungal medicine, you may need a prescription-strength medication. Some of these medications are topical preparations that you rub on your skin. Others are drugs that you swallow. Examples include:

  • Ciclopirox (Loprox, Penlac) cream, gel or shampoo
  • Fluconazole (Diflucan) tablets or oral solution
  • Itraconazole (Onmel, Sporanox) tablets, capsules or oral solution
  • Ketoconazole (Ketoconazole, Nizoral, others) cream, gel or shampoo
  • Selenium sulfide (Selsun) 2.5 percent lotion or shampoo

Even after successful treatment, your skin color may remain uneven for several weeks, or even months. Also, the infection may return in hot, humid weather. In persistent cases, you may need to take a medication once or twice a month to prevent the infection from recurring.

Lifestyle and home remedies

For a mild case of tinea versicolor, you can apply an over-the-counter antifungal lotion, cream, ointment or shampoo. Most fungal infections respond well to these topical agents, which include:

  • Clotrimazole (Lotrimin AF) cream or lotion
  • Miconazole (Micaderm) cream
  • Selenium sulfide (Selsun Blue) 1 percent lotion
  • Terbinafine (Lamisil AT) cream or gel
  • Zinc pyrithione soap

When using creams, ointments or lotions, wash and dry the affected area. Then apply a thin layer of the product once or twice a day for at least two weeks. If you're using shampoo, rinse it off after waiting five to 10 minutes. If you don't see an improvement after four weeks, see your doctor. You may need a stronger medication.

It also helps to protect your skin from the sun and artificial sources of UV light. Usually, the skin tone evens out eventually.

Preparing for your appointment

You're likely to start by first seeing your family doctor or a general practitioner. He or she may treat you or refer you to a specialist in skin disorders (dermatologist).

What you can do

Preparing a list of questions beforehand can help you make the most of your time with your doctor. For tinea versicolor, some basic questions to ask your doctor include:

  • How did I get tinea versicolor?
  • What are other possible causes?
  • Do I need any tests?
  • Is tinea versicolor temporary or long lasting?
  • What treatments are available, and which do you recommend?
  • What side effects can I expect from treatment?
  • How long will it take for my skin to return to normal?
  • Can I do anything to help, such as avoid the sun at certain times or wear a specific sunscreen?
  • I have other health conditions. How can I best manage them together?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Do you have brochures or other printed material I can take home? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • How long have you had these discolored areas on your skin?
  • Have your symptoms been continuous or occasional?
  • Have you had this or a similar condition in the past?
  • Do the affected areas itch?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
April 22, 2015
References
  1. Ferri FF. Tinea versicolor. In: Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed March 9, 2015.
  2. Goldsmith LA, et al., eds. Yeast infections: Candidiasis, tinea (pityriasis) versicolor and malassezia (pityrosporum) folliculitis. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed March 9, 2015.
  3. Bamford J, et al. Interventions for the treatment of pityriasis versicolor. Cochrane Database of Systematic Reviews. http://ovidsp.tx.ovid.com/sp-3.14.0b/ovidweb.cgi. Accessed March 9, 2015.
  4. AskMayoExpert. Superficial fungal infections. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
  5. Tinea versicolor. American Academy of Dermatology. www.aad.org/dermatology-a-to-z/diseases-and-treatments/q---t/tinea-versicolor. Accessed March 9, 2015.
  6. Tinea versicolor. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/dermatologic_disorders/fungal_skin_infections/tinea_versicolor.html. Accessed March 9, 2015.