Tinea versicolor, a fungal skin infection causing characteristic spots that are either darker or lighter than a person's normal skin color, is treated with topical antifungal creams, oral antifungal medications, antifungal shampoos and avoidance of factors that promote recurrent infection. For most people with tinea versicolor, a two-to-four-week course of antifungal cream applied to the skin is sufficient to clear the infection. People with severe, extensive or recurrent infections require oral medication.
Topical Antifungals
Most people with tinea versicolor have mild infections treatable with a topical antifungal cream. There are a number of different antifungal creams, including clotrimazole, miconazole, ketoconazole, terbinafine and naftifine. Some are available over the counter and some require a prescription from a doctor. Antifungal medications may also be available in gels or sprays.
Oral Antifungals
In an article published in the March 2010 issue of Clinics in Dermatology, Dr. Alexandro Bonifaz and colleagues recommend oral treatment of tinea versicolor for a person who has extensive or recurrent infection. While different options are available, the three most commonly used medications are ketoconazole, 200mg daily for seven to 15 days; itraconazole, 200mg daily for seven to 15 days; and fluconazole as a single 400mg dose.
Shampoos
Mild tinea versicolor may be treated with anti-dandruff or antifungal shampoos. Dr. Daniel Stulberg and colleagues describe two treatment options in the November 2003 issue of American Family Physician. Selenium sulfide shampoo can be applied once a day for one week and allowed to dry for 10 minutes before showering; alternatively, it is applied once a week for four weeks and left on the skin for 12 to 24 hours before showering. Ketoconazole shampoo at a 2 percent strength may be applied once and left on the skin for five minutes.
Avoid Predisposing Factors
In order to prevent a recurrence of tinea versicolor, a person with this infection should avoid excessive sun exposure, use sunblock, avoid oily tanning lotions and try to prevent excessive sweating, according to Bonifaz's review article.
References
- "Clinics in Dermatology"; Tinea Versicolor, Tinea Nigra, White Piedra and Black Piedra; Alexandro Bonifaz, MB, MSc, Fernando Gomez-Daza, BL, MSc, Vanessa Paredes, M.D., and Rosa Maria Ponce, M.D.; March 2010
- "American Family Physician"; Common Hyperpigmentation Disorders in Adults: Part II; Daniel Stulberg, M.D., Nicole Clark, M.D., and Daniel Tovey, M.D.; November 2003
