Symptoms

Tinea versicolor is a type of infection that appears as a tissue-thin coating of fungus on your skin. The infection causes patches of discolored skin that may be:

• Colored white, pink, tan or dark brown
• Slow-growing, scaly and mildly itchy
• More noticeable after sun exposure
• Located on the back, chest, neck and upper arms

When to see a doctor
See your doctor if:

• Your skin doesn't improve with self-care measures
• The fungal infection returns
• The patches cover large areas of your body

Causes

The fungus that causes tinea versicolor can be found on healthy skin. It only starts causing problems when the fungus overgrows. A number of factors may trigger this growth, including:

• Hot, humid weather
• Excessive sweating
• Oily skin
• Hormonal changes
• Weakened immune system

Preparing for your appointment

You're likely to start by first seeing your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes 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?
• Are there other possible causes for these symptoms?
• Do I need any tests?
• Is tinea versicolor temporary or long lasting?
• What treatments are available, and which do you recommend?
• What types of side effects can I expect from treatment?
• How long will it take for my skin to return to normal?
• I have other health conditions. How can I best manage them together?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me?

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

• 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?

Tests and 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 and drugs

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, while others are pills that you swallow. Examples include:

• Ciclopirox (Loprox, Penlac) cream, gel or lotion
• Fluconazole (Diflucan) tablets
• Itraconazole (Onmel, Sporanox) capsules or tablets
• Ketoconazole (Extina, Nizoral, others) cream, foam, gel, shampoo or tablets
• 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 warm, 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, Mycelex) cream or lotion
• Miconazole (Monistat, M-Zole) cream
• Selenium sulfide (Selsun Blue) 1 percent shampoo
• Terbinafine (Lamisil) cream or gel

Wash and dry the affected area. Then, apply a thin layer of the topical agent 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.

Prevention

To help prevent tinea versicolor from returning, your doctor can prescribe a skin or oral treatment that you use once or twice a month. Preventive treatments include:

• Selenium sulfide (Selsun) 2.5 percent shampoo
• Ketoconazole (Extina, Nizoral, others) foam, gel, cream, shampoo or tablets
• Itraconazole (Onmel, Sporanox) tablets or capsules