Tinea Versicolor & Skin Pigmentation

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Tinea versicolor is also called pityriasis versicolor. It is a fungal infection which causes scaly patches of abnormal pigmentation on the skin. It is usually a harmless infection and is caused by the yeast Malassezia furfur. This infection is quite common.

What skin pigmentation changes are there?

Tinea versicolor causes patches of skin to have more or less pigmentation than the rest of the skin. This can range in colour from pale pink to brown to white. In people with darker skin the patches are usually lighter in colour. Often the patches are more noticeable in the summer as the rest of your skin gets tanned.

The areas of changed pigmentation can also be scaly and slightly raised from the rest of the skin and are usually found on the chest, back and arms. They often get bigger over time. The patches of changed pigmentation don’t usually itch and most of the time they aren’t painful.

Who can be affected?

Tinea versicolor infection most commonly occurs in young adults, but it is possible for it to occur in people of all ages. When children are affected, the patches of changed pigmentation often appear on the face. The yeast that causes the infection grows harmlessly on most adults without causing any changes in skin pigmentation.

What causes the change in skin pigmentation?

The yeast Malassezia furfur usually grows harmlessly but sometimes it changes and becomes more infectious. When this happens it grows into the skin, which is also usually harmless but can occasionally cause chemicals to be released into the skin. It is these chemicals which affect the pigmented cells in the skin and causes changes in the colour.

It is unknown what causes the yeast to become more invasive but it is known that there are a number of risk factors which make it more likely to happen. The yeast prefers warm conditions and so it occurs more commonly in hotter, more tropical countries. Skin problems such as those caused by immune system conditions can also increase the risk of developing tinea versicolor.

Tinea versicolor is most often found in young adults and especially teenagers due to the increased hormone levels.

How is tinea versicolor diagnosed?

Tinea versicolor can be easily diagnosed by your doctor just by looking at it. To confirm the cause your doctor may take skin samples. When an ultraviolet light is shone on the infected skin, the skin will be a yellow-green colour. This can be used to confirm that tinea versicolor is the cause of the changes skin pigmentation.

How is tinea versicolor treated?

Ketoconazole is an antifungal cream which can be applied directly to the infected area. Antifungals including terbinafine can also be sprayed onto the skin. There are also some antifungal shampoos containing selenium sulphide or ketoconazole which can be prescribed by your doctor.

Your doctor should be able to prescribe some antifungal drugs to take by mouth in order to treat tinea versicolor. Drugs that may be prescribed include itraconazole, ketoconazole and fluconazole. These drugs are more likely to cause side effects than the creams and shampoos described above.

After using antifungal treatment it can take a couple of months for the pigmented patches to go away. This is because you have to wait for the skin to be shed and replaced by new skin. There is also a chance that the infection will return so it is usually recommended that you use the shampoo once a month after the infection has cleared.

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