Fungal Skin Infection: Tinea Versicolor

Is this a fungal infection?

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You have spots on your skin? Really pale spots? Or new really dark spots? They're not red. They're not freckles. They don't affect areas of your skin out in the sun. Instead, it's the back of your neck, your chest, your upper back.

The bad news: You may have a fungal infection.

The good news: If so, it's totally treatable.

What sort of new spots do you have on your skin?

Maybe on your upper back, your chest, your neck.

They are often lighter but they may be darker than the rest of your skin. They can be pinkish or even salmon colored. They can be tan or brown. 

They probably appeared slowly. Maybe over time the spots coalesced in to patches. These patches can be scaly and maybe measure a centimeter or 2 or 3.

Some may be itchy and dry.

They may get worse with a tan. They may go away when it gets cooler and then come back in summer when it's hot and humid.

If so, what causes it? 

In some cases this can be caused by Tinea Versicolor. This is a fungal infection caused by the fungus Malassezia furfur. [Say that word out loud, it's probably the best, most fun name of a fungus]. The fungus used to be called Pityrosporum.

Is this a problem?

This fungal infection doesn't usually cause anything more than spots. Most people don't like seeing spots on their skin, but there's not usually anything else associated with it.

There are rare (very rare) cases when this fungus (Malassezia furfur) is associated with more serious infections, such as in newborns (who can be very vulnerable to any infection) or an adult with immune deficiency (like leukemia or another cancer).

Can the spots go away?

Yes, the spots can go away. If you live in a place with cool winters, you may see the spots disappear as the temperature and humidity drop and you sweat less.

Treatments can also make the years go away. The skin may still stay a different color in these spots for a few weeks or months, but should turn back to normal. Be careful to protect your skin from the sun during this time so the color returns evenly. 

The infection can come back. When the weather is warm again or you travel to a warm spot, the yeast may quickly grow again on oily skin. You may have to be prepared with a cleanser to respond.

How do I treat this?

Once the infection is diagnosed by a healthcare professional, you can be offered a fairly easy and straightforward treatment.

Your healthcare provider may recommend antifungal creams (which may be over-the-counter, like ketoconazole) and shampoos containing selenium sulfide (often found in anti-dandruff shampoos) to use on affected areas.

You may be given cleansers to use every month or so, especially in hot or humid areas, to prevent multiple recurrences.

In rare cases, you may be given an anti-fungal pill. It's important to tell your doctor if you have any liver problems or are taking any other medications.

You should talk to your healthcare provider about what is best for you.

Did I get this when I was traveling?

Possibly, warm weather and sweaty, oily skin make this yeast thrive. Some find it returns in the summer or when traveling to hot and humid locales.

Who gets this?

  • Those in hot, humid weather, who are sweating
  • Those with oily skin
  • Teens and young adults are more prone to infection (with oily skin)
  • Anyone with any skin color can be affected.
  • Those with weakened immune systems 

The fungus lives on the oil (fat) from oily or sweaty skin. Older adults and young children are less likely to have this infection, as they have less oily skin. Some may have the infection recede and come back each year as the weather changes. 

How is it diagnosed?

The physical appearance of the spots and the history (hot, humid weather and oily skin) will point to a diagnosis. The diagnosis can be confirmed by one or two simple tests. Your healthcare provider can make the diagnosis by examination of the skin with a special light, a Wood’s lamp, which makes the fungus on the skin appear yellowish green. The diagnosis can also be made by gently scraping some affected skin and examining it under a microscope with methylene blue which will show what look like "spaghetti" - hyphae - and “meatballs” - spores.

 

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