tinea versicolor

Tinea versicolor (tin'-eah verse'-ih-color) is infection of the skin of the upper body around the shoulders and upper trunk with the fungus Malasezzia furfur. The fungus depigments the skin as it grows and the disease appears as many little light patches perhaps an eight to a quarter inch in diameter on the affected upper body areas. A tan just makes the depigmentation stand out more, so it seems to be a disease of the summer months, but it isn't. It's caused when fungal spores from the hair fall on the upper body and germinate on the skin.

It has been fairly easily treated in the past with Selsun® shampoo allowed to remain as a lather on the affected skin for about 10 minutes a day for a week, then once weekly for a month, then monthly. The light areas of skin will gradually fill back in with normal skin pigment.

That has been the standard treatment, but it is often pretty unpopular with the patients. Selenium sulfide smells rather like rotten eggs and is drying and irritating. A newer and much more effective and acceptable treatment is to use ketoconazole (Nizoral®) shampoo¹. The patient lathers up the shampoo over the affected areas and leaves it on about 5 minutes; then rinses it off in the shower. A single treatment is often effective; I recommend doing the treatment three nights in a row.

1. Journal of the American Academy of Dermatology 1998;39:944-950.

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