Tinea versicolor
What is tinea versicolor?
Tinea versicolor is a very common rash caused by a harmless yeast on the skin. It usually doesn’t itch but can be frustrating because of how it looks. The spots may be pink (salmon-colored), lighter, or darker than your normal skin and often have fine, flaky scale. You can check by scraping a credit card across the spots to see if dry flakes appear.
If you only have 1–2 spots, it may be ringworm (see my Ringworm page). If your spots are itchy, it’s more likely nummular (coin-shaped) eczema (see my Eczema page).
Why do I have tinea versicolor?
Tinea versicolor (or pityriasis versicolor) is caused by a yeast that normally lives on everyone’s skin. It often shows up in the summer and is more common in hot, humid climates. Tight clothing and sweating also make it more likely to appear.
How do I fix tinea versicolor?
Most people can clear tinea versicolor with over-the-counter options (Color changes in the skin often take weeks to months to fade even after the yeast is gone):
1. Use medicated dandruff shampoo for the rash daily in the shower.
Wet your skin in the shower.
Massage the dandruff shampoo into the rash.
Leave the shampoo on for at least 5 minutes but ideally 10 minutes, then rinse off.
Shampoos with Active Ingredients:
Zinc pyrithione:
CeraVe shampoo (1%) and conditioner (0.5%)
Head and Shoulders (1%)
Vanicream (2%, for sensitive skin)
Amazon brand (1%)
Selenium sulfide: Selsun Blue
Salicylic acid: T/Sal
Coal Tar (0.5%): DHS or Amazon brand
NOTE: Coal tar shampoos often have a strong smell, but they work well for dandruff. To get rid of the odor, use a conditioner after shampooing.
Ketoconazole: Nizoral
2. Antifungal creams – Apply a thin layer of miconazole or clotrimazole twice daily.
Note: Strengths only matter for each specific medicine (e.g., ketoconazole 2% is stronger than ketoconazole 1%, but miconazole 2% is not stronger than clotrimazole 1%).
3. Antifungal powders – Helpful in hot, humid climates or if you sweat a lot. Powders keep the skin dry and speed healing.
4. Clinical-strength antiperspirant – Can reduce sweating that contributes to the rash in problem areas (see my Sweating page).
What if my tinea versicolor isn’t getting better?
Most people clear with the steps above. If not, try:
Leaving dandruff shampoo on longer – apply it like a lotion 30 minutes before your shower.
If it keeps coming back, you may need to use dandruff shampoo once a week for maintenance.
Other rashes (often eczema) can look like tinea versicolor. If over-the-counter options aren’t working or the rash recurs, look for a board-certified dermatologist in your area. Oral antifungal medications are very effective. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
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