What Are the Best Treatments for Tinea Versicolor?

Easy ways to get rid of this fungal infection

Dandruff shampoo can be used to treat tinea versicolor.
Dandruff shampoo can be used to treat tinea versicolor. Sarah Ashun/Getty Images

Treatment for the rash tinea versicolor typically is not difficult. That's because tinea versicolor occurs after the normal skin yeasts, Pityrosporum orbiculare or Pityrosporum ovale, transform to a pathogenic form and turn off melanin-producing cells in the skin. Because the yeast inhabits the top layer of the skin, topical anti-fungal medications tend to be very effective.

If the rash is extensive, oral anti-fungal medications may be needed.

Because tinea versicolor has a recurrence rate of 80 percent after two years, periodic use of medications may be needed to suppress the rash.

Treatment of Tinea Versicolor with Topical Antifungals

Topical antifungal medications are the treatment of choice for tinea versicolor. A number of topical anti-fungal treatment regimens have been shown to produce a greater than 70 percent clinical response rate. This includes prescribing patients 2 percent Ketoconazole cream to be applied once daily for 11 to 22 days.

Alternatively, prescribing patients a 2 percent Ketoconazole shampoo regimen (lathered over affected and surrounding areas and left on for at least five minutes before rinsing) also helps when applied once daily for three consecutive days. In addition, 1 percent Terbinafine solution applied twice daily for one week has proven to be effective, as has 1 percent Clotrimazole solution applied once daily for one week.

Treatment of Tinea Versicolor With Oral Antifungals

Oral anti-fungal medications can cause side effects such as nausea or reversible liver damage, but these side effects are not common with the short courses of therapy used for tinea versicolor. Oral griseofulvin and oral terbinafine are not effective treatments for tinea versicolor, but a variety of oral treatment regimens have been shown to produce a greater than 70 percent clinical response rate.

This includes prescribing Itraconazole 200 mg every other day for seven days or a single 400 mg dose of either Ketoconazole or Fluconazole. Prescribing Fluconazole 150 mg or 300 mg weekly for one month has been effective as well.

Treatment of Tinea Versicolor with Dandruff Shampoos

Until recently, dandruff shampoos were the mainstay of treatment for tinea versicolor. They are less effective than the anti-fungal medications and can cause skin irritation, but they are available over the counter and are less expensive. A number of regimens have been shown to be effective.

This includes sulfur salicylic acid shampoo applied nightly as a lotion for one week or a zinc-pyrithione shampoo regimen (applied daily as a lotion and left on for five minutes before rinsing) for two weeks. In addition, selenium sulfide 2.5 percent lotion regimen (applied daily as a lotion and left on for 10 minutes before rinsing) for one week has proven effective.

Wrapping Up

If you have tinea versicolor, consult your doctor about the variety of treatment options available to you.

Your physician can prescribe you topical or oral anti-fungal medications to get rid of the fungal infection. Depending on your particular situation, a simple dandruff shampoo may be recommended instead.

You may let your doctor know which treatment you prefer, but that's not necessarily the treatment she'll prescribe. Remember to keep an open mind and share with your doctor any concerns you have about the treatment or the infection itself.

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