Tinea versicolor is a fairly common, harmless yeast infection of the skin, that occurs mainly during the summer. Small, discolored spots arise on the skin of the neck, chest and back. The spots look darker on a white skin and lighter on a brown skin. Fine flakes often emerge on the spots and it may itch.
Cause
Tinea versicolor is caused by the yeast Malassezia furfur. This yeast is common on the skin, but usually doesn’t cause any clearly visible infection. Why the yeast leads to obvious skin defects in some people and not in others, isn’t entirely clear. The circumstances that favor the emergence of the disease are high levels of atmospheric humidity, usually in combination with a high temperature and a fatty (sebaceous) skin. In temperate climates, the symptoms often begin in summer. This is possibly also because the skin defects only then will stand out due to the tanning of the skin. Tinea versicolor is not contagious.
Symptoms
In people with a light skin color, tinea versicolor is characterized by light brown or reddish brown spots with a fine scaling. These spots look darker than the surrounding white skin. In people with darker skin tones, the spots are just paler than the surrounding normal skin. The spots may vary in size from a few millimeters to tens of centimeters and are mainly seen on the torso and upper arms. They can also overlap over large areas of skin and merge, possibly with extension to the forearms, back of the hands, upper legs and even into the back of the knees. Especially in tropical climates, also the face and scalp are sometimes affected. Apart from the cosmetically disturbing aspect, the skin defects cause at most slight itch symptoms.
Diagnosis
In most cases, tinea versicolor can be recognized by the doctor to the naked eye. Sometimes, flakes of skin are taken for microscopic examination.
Treatment
Tinea versicolor can be treated in different ways.
- External treatment. The treatment includes applying an antifungal cream. Selenium (di)sulfide suspension can also be used. This suspension is applied with a washcloth over the entire affected skin. It is believed that the scalp is an important reservoir for the yeasts. It’s therefore advisable to use ketoconazole head gel twice a week after washing the hair. With this measure, an attempt is made to prevent a return of the condition.
- Internal treatment. When the defects are very extensive or return regularly, tinea versicolor can be treated with medication. Usually, treatment for one week is sufficient.
Prognosis
The slight scaling associated with tinea versicolor usually disappears after a few days. The spots remain visible for a longer time, even if the skin is healed. It takes three to four months before the skin forms enough colorant (pigment) again. Therefore, one must be patient, but the spots will eventually disappear. Exposing the skin to sunlight can help. The chance exists that the condition will come back after a period of time.
Considerations
- Wash the skin without soap. If a patient does use soap or shampoo once in a while, then rinse the skin thoroughly afterwards, so no soap residues remain.
- Dry the skin well.
- Don’t use fatty creams or body lotions. These stimulate the growth of the yeast.
- For protection from the sun, use a sunscreen that includes no fatty or oily substances.
