Tinea versicolor
What is tinea versicolor?
Tinea versicolor is very common. I wish it had a simpler name, but it’s a very unique rash. The rash doesn’t itch, but its appearance can bother people. It is either pink (salmon-colored), lighter, or darker than your normal skin. It usually has fine scale or flakes (you can check by scraping a credit card along the spots and looking for dry patches). If it is just 1-2 spots, it may be ringworm (see my Ringworm page). If your spots are really itchy, it is usually nummular (coin-shaped) eczema (see my Eczema page).
Why do I have tinea versicolor?
Tinea versicolor is caused by a yeast we all have on our skin (so it should be called pityriasis versicolor but that’s even longer and harder to say). It appears in summer. It is more common if you live where it is hot and humid. Tight clothing and sweating increase your chances of getting tinea versicolor.
How do I fix tinea versicolor?
Nearly all of my patients clear their tinea versicolor with a combination of over-the-counter options:
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 on for at least 5 minutes (ideally 10 minutes).
Rinse off the dandruff shampoo.
Here’s the list of shampoos with active ingredients:
Zinc pyrithione:
Head and Shoulders (1%)
Free & Clear (2%, for sensitive skin)
Amazon brand (1%)
Selenium sulfide: Selsun Blue
Ketoconazole: Nizoral
Apply a thin layer of topical antifungal cream twice a day.
Use miconazole or clotrimazole.
NOTE: The percentages of each medicine are only important for that specific medicine, so ketoconazole 2% (prescription) is twice as strong as ketoconazole 1% (over-the-counter), but miconazole 2% is NOT stronger than clotrimazole 1%.
If you are sweaty or it is humid where you live, use an antifungal powder.
Powders help keep the skin dry and have an antifungal medication in them (brand name or generic) to help clear the skin quicker.
You can also use a clinical-strength antiperspirant (see my Sweating page).
What if my tinea versicolor isn’t getting better?
The steps help most people clear their tinea versicolor. If they aren’t working, you can try vinegar soaks and/or keep the dandruff shampoo on longer (apply it as a lotion 30 minutes before your shower. If it keeps coming back, you will just have to use the dandruff shampoo once a week for maintenance.
Other rashes can look like tinea versicolor (usually a type of eczema). If over-the-counter options are not working or the tinea versicolor keeps coming back, look for a board-certified dermatologist in your area to check them. There are oral antifungal medications that work really well for most people. 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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