Tinea Versicolor

What is tinea versicolor?

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Tinea versicolor is a type of fungal infection. The infecting fungus interacts with the skin’s pigmentation. This creates small but widespread discoloration, often in patches. Tinea versicolor patches can be lighter or darker than a person’s natural skin tone. This rash can appear anywhere on the body, but it is most commonly found on a person’s trunk and shoulders.

Humans have hundreds of thousands of fungi and bacteria growing on the skin. But, sometimes, these microorganisms can grow out of control. This causes the rash characteristic of tinea versicolor. However, this condition is easy to mix up with other, more serious skin disorders. If you’re unsure of your rash’s cause, schedule an appointment with your primary care provider or dermatologist. They’ll be able to provide a definitive diagnosis and recommend treatment options.

What causes tinea versicolor?

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Tinea versicolor is caused by Malassezia, a type of yeast commonly found on the skin’s surface. While this is a common and naturally occurring yeast, its overgrowth can result in infection. Doctors are unclear on the specific catalyst for this yeast to grow out of control. However, certain environmental factors can expedite microbial growth. These include:

  • Hyperhidrosis, or other reasons for excessive sweating
  • Consistent exposure to humid and hot weather
  • Oily skin

Additionally, people with weakened immune systems are generally at a higher risk for developing fungal and bacterial infections. Certain hormonal changes, like those associated with the birth control pill, may also contribute to tinea versicolor.

Tinea versicolor is a common condition in all people, regardless of race, ethnic background, and sex. However, it is more common in children, young adults, and folks with compromised immune systems. This is also a common post-vacation rash for people who have visited subtropical climates.

Are there any risk factors associated with tinea versicolor?

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Tinea versicolor risk factors are similar to other bacterial and fungal infection risks. These include:

  • A weakened immune system, either through an autoimmune condition or prescribed immunosuppressants
  • Living in a warm, humid climate
  • Hyperhidrosis
  • Frequent exercising in hot, humid conditions
  • A family history of bacterial and fungal infections

Additionally, some types of cancers can increase a person’s risk of succumbing to a fungal infection.

What are the symptoms of tinea versicolor?

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Tinea versicolor symptoms include noticeable patches on the skin. These discolored patches may be lighter or darker than a person’s natural skin tone. They may also be pink, tan, brown, or red, and they become more prominent with exposure to sunlight. Conversely, tinea versicolor patches may disappear in cool, dry weather. The severity of this rash often corresponds to how much fungus has grown.

Importantly, a tinea versicolor rash can be uncomfortable. Most patients experience excessive dryness and/or itching. Over time, these patches may become scaly, sometimes resembling psoriasis.

Tinea versicolor symptoms are similar to other skin conditions. When you visit a doctor for a diagnosis, they will take time to rule out these other conditions.

  • Vitiligo: People with darker skin may experience hypopigmentation with a tinea versicolor rash. This can often resemble vitiligo, which is a condition that affects the skin’s pigmentation. However, vitiligo does not affect the skin’s texture. This is an easy way to rule out the condition. Additionally, vitiligo does not often appear on the body’s trunk. By contrast, tinea versicolor most often appears on the trunk and abdomen.
  • Pityriasis Rosacea: Certain tinea versicolor rashes may resemble the rash associated with pityriasis rosacea. However, pityriasis rosacea is characterized by a larger “mother” or “herald” patch. Other red, scaly patches appear around this patch. While pityriasis rosacea is not dangerous, it is associated with higher rates of miscarriage and premature delivery in pregnant people. If you are pregnant and notice any new or developing rash, see your doctor immediately.
  • Psoriasis: Psoriasis is an autoimmune skin condition that causes scaly patches. If a case of tinea versicolor develops patches, it can have a similar appearance. However, psoriasis patches are often grey and silvery. Tinea versicolor patches are often red, brown, beige, or pink.
  • Bed Bugs: In some cases, a tinea versicolor rash may resemble bed bug bites. However, older bed bug bites can result in fluid-filled blisters, a burning sensation, and bleeding. Tinea versicolor does not often cause these symptoms.

If you have a new or developing rash, it’s important to see your primary care provider or dermatologist. While most rashes are benign, they can be uncomfortable. Only a doctor can provide a definitive diagnosis and make personalized treatment recommendations. Additionally, people with certain other conditions, like those who are pregnant and folks with autoimmune conditions, should seek medical care as soon as a new rash appears.

How is tinea versicolor diagnosed?

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Tinea versicolor is diagnosed in a doctor’s visit, often with a dermatologist or primary care provider. The doctor will examine the patches and surrounding skin. In some cases, they may be able to provide a diagnosis through observation alone.

However, many doctors prefer to confirm a diagnosis by taking a sample. This involves scraping a blade across the skin to remove cells. It is not painful and does not cause a cut or blood. Once these cells are removed, they are observed under a microscope. If the skin sample contains the yeast responsible for tinea versicolor, you will receive a positive diagnosis.

If the doctor suspects a different skin condition, they may run other tests. This can include blood tests or a skin biopsy. In many cases, a doctor will also use an ultraviolet light to examine the skin for signs of yeast.

Some people can self-diagnose and self-treat tinea versicolor without the help of a doctor. However, we do not recommend this if you have a compromised immune system, are pregnant, or have not had success with self-treatment.

How is tinea versicolor treated?

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Most people can treat tinea versicolor with over-the-counter products. If you have been diagnosed with or suspect you have a tinea versicolor rash, consider any of the following over-the-counter antifungal creams:

  • Monistat
  • Lotrimin
  • Lamisil
  • Selsun Blue

Medicated cleansers are also a common treatment. People with ongoing or severe cases of tinea versicolor may receive prescription medication from a doctor. Loprox, Nizoral, Extina, and Penlac are common topical prescription creams that can treat the rash. Some patients may also receive prescriptions for oral medication. This will usually include Onmel, Sporanox, or Diflucan.

If your rash and symptoms don’t resolve after a week of over-the-counter treatment, schedule an appointment with a physician. They will be able to rule out other conditions and/or prescribe a stronger treatment.

Is it possible to prevent tinea versicolor?

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There are certain lifestyle changes that can reduce the likelihood of developing this fungal infection. This includes avoiding excessive heat and humidity, limiting excessive sweating, and avoiding sun exposure. Additionally, avoid using oily skin products, and wear sunscreen (at least SPF 30) every day. Wearing loose, breathable clothing can also decrease your likelihood of developing a tinea versicolor rash.

However, once this condition occurs, it can be difficult to prevent it from recurring. Keep a watchful eye on your skin whenever you experience hot, humid climates, and keep an antifungal cream in your medicine cabinet.

What is the outlook for people with tinea versicolor?

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Tinea versicolor is not a dangerous condition, but it can have lasting effects. When left untreated, this fungal infection can cause long-term skin discoloration. This can last for weeks or months. In some cases, tinea versicolor will disappear with cooler, dryer weather and reappear with hotter, more humid climates. This type of fungal infection is likely to recur, so talk to your doctor if you consistently have a rash.

When treated quickly and efficiently, tinea versicolor will disappear without a trace. If you suspect you have this condition, or perhaps a different type of skin infection, schedule an appointment with a primary care physician or dermatologist. They’ll be sure to point you in the right direction.