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Get rid tinea versicolor: Tinea versicolor: Diagnosis and treatment

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Tinea versicolor: Diagnosis and treatment

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Tinea Versicolor: Cause, Symptoms, and Treatments

Written by WebMD Editorial Contributors

  • What Is Tinea Versicolor?
  • Signs and Symptoms of Tinea Versicolor
  • Tinea Versicolor Causes
  • Tinea Versicolor Diagnosis
  • Tinea Versicolor Treatment
  • Lifestyle Tips for Managing Tinea Versicolor
  • More

Tinea versicolor is a fungal infection that causes small patches of discolored spots on your skin. It’s also called pityriasis versicolor. It results from a type of yeast that naturally lives on your skin. When the yeast grows out of control, the skin disease, which appears as a rash, is the result.

 

Acidic bleach from the growing yeast causes areas of skin to be a different color than the skin around them. These can be individual spots or patches. Specific signs and symptoms of the infection include:

  • Patches that are white, pink, red, or brown and may be lighter or darker than the skin around them.

  • Spots that don’t tan the way the rest of your skin does.
  • Spots that show up more boldly when you do tan.
  • Spots that may occur anywhere on your body but are most commonly seen on your neck, chest, back, and arms.
  • Spots that are dry and scaly and may itch or hurt, although this is rare.

The spots may disappear during cool weather and get worse during warm and humid weather.

Similar conditions

Some skin problems have symptoms that look like tinea versicolor, including:

  • Vitiligo: a disease that makes you lose your skin color
  • Pityriasis rosea: a rash that causes small spots that fan out on your body in the shape of a tree

These conditions have features that clue your doctor in to what you have, such as texture and rash pattern.

The yeast that causes tinea versicolor, Malassezia, grows on normal, healthy skin. But these things can trigger an overgrowth that causes the infection:

  • Oily skin
  • Living in a hot climate
  • Sweating a lot
  • Hormonal changes
  • A weakened immune system

Because the yeast grows naturally on your skin, tinea versicolor isn’t contagious. The condition can affect people of any skin color. It’s more likely to affect teens and young adults. For some people, it can cause emotional distress and feelings of self-consciousness.

Your doctor can diagnose tinea versicolor by what the rash looks like.

If they need more information, these tests can help:

  • Wood lamp (black light) examination. The doctor uses ultraviolet light, which may make the affected areas appear a fluorescent coppery orange color if they’re the result of tinea versicolor.
  • Microscopy using potassium hydroxide (KOH). Your doctor removes cells from your skin, soaks them in potassium hydroxide, then looks at them under a microscope.
  • Skin biopsy. The doctor takes a skin sample by scraping some skin and scales from the affected area to look at under a microscope. With children, the doctor may lift off skin cells by first firmly attaching clear tape to the affected area then removing it. The sample then can be stuck directly onto a slide to look at with a microscope.

Treatment of tinea versicolor can consist of creams, lotions, or shampoos that you put on your skin. It can also include medication given as pills. The type of treatment will depend on the size, location, and thickness of the infected area.

Treatment options include:

  • Topical antifungals. You put these directly to your skin. They may be in the form of lotion, shampoo, cream, foam, or soap. They keep yeast growth under control. Over-the-counter anti-fungal topical products containing ingredients such as clotrimazole, ketoconazole, miconazole, zinc-pyrithione, selenium sulfide, and terbinafine are available. Prescription products are available too.
  • Antifungal pills. These may be used to treat more serious or recurrent cases of tinea versicolor. Sometimes doctors use them because they clear up the infection faster. You’ll need a prescription for these medicines. They can have side effects. Your doctor will keep an eye on you while you’re taking antifungal pills.

Treatment usually gets rid of the fungal infection. But skin discoloration may take several months to resolve.
 

Episodes are very common because the yeast that causes the infection is a normal fungus that lives on your skin. You might use medicated cleansers once a week for 10 minutes at a time for a few months to help prevent tinea versicolor from coming back. You may need to use these cleansers if the infection keeps returning, especially if you live in a warm and humid area.

To help you manage tinea versicolor you can:

  • Avoid using oily skin products.
  • Reduce the time you spend in the sun. It may trigger or worsen an episode, and a tan makes the rash more visible.
  • Use an anti-fungal shampoo daily for a couple of days prior to sun exposure if you do have to go out.
  • Put on sunscreen every day. Use a broad spectrum, nongreasy formula with a minimum sun protection factor (SPF) of 30.
  • Try a dandruff shampoo with selenium sulfide.
  • Wear loose clothing.
  • Choose breathable fabrics, like cotton, to decrease sweating.

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Pityriasis versicolor: treatment, preparations, ointments

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Encyclopedia

Fungus

Pityriasis versicolor is a fungal disease of the superficial layers of the skin.

The author of the article

Tamrazova Olga Borisovna 9Moscow

Pityriasis versicolor – what is it?

Audio version of the page:

Pityriasis versicolor is not dangerous and not contagious, and also does not carry serious complications. However, members of the same family or people in close contact need to use personal hygiene products (towels). Microorganisms that provoke the appearance of pityriasis versicolor begin to actively multiply and cause disease if a person has predisposing factors. This disease requires treatment and supervision by a doctor in order to prevent the development of a chronic form 1, 2, 3 .

What is pityriasis versicolor and how is it treated? Watch a short video with a candidate of medical sciences, clinical pharmacologist Kukes Ilya Vladimirovich

Symptoms of pityriasis versicolor

Visually, pityriasis versicolor appears on the skin in the form of scarlet asymmetric spots of various sizes. They may merge with each other and have fuzzy, uneven edges 4, 9, 10, 11 .

Their color can vary from white to yellow, light brown, dark brown, grey-black or pinkish red.

Skin defect (spots) occurs in >80% of cases, causing psychological discomfort to the patient.

In some cases, another so-called “secondary” infection can join the fungal disease. A symptom of the presence of a secondary infection may be peeling on the surface of the skin and itching.

Chronic pityriasis versicolor

People who are exposed to fungus often do not always see a dermatologist.

This can be a big problem as the disease becomes chronic and more difficult to treat. The risk of relapses (repeated manifestations of the disease) increases.

Localization of pityriasis versicolor

Lichen may be localized on a smooth or hairy area of ​​the skin 4 .

The most common sites affected by are shoulders, back, abdomen, chest, neck. Less commonly affected areas groin, face, hands, mucous membranes.

Involvement of the scalp

When the scalp is affected, patches of pink first appear, then yellowish pink, later brown or red-brown; on their surface there is a small-lamellar peeling, similar to bran (pityriasis versicolor), easily determined by scraping. Pityriasis peeling is associated with loosening of the surface layer of the skin by a fungus.

Pityriasis versicolor pathogens

Pityriasis versicolor is caused by dimorphic lipophilic yeasts of the genus Malassezia, representatives of the typical skin microflora. The most frequently found are Malassezia globosa, M. sympodialis and M. furfur, less often – M. slooffiae, M. restricta and M. Obtusa 4 . It has been established that about 90% of healthy people are carriers of the saprophytic form of the fungus 4 .

Microscopic examination of a skin scraping is done to identify the Malassezia species. Particles are scraped off from the affected area of ​​the skin, then the scraping is transferred to the laboratory, where a specific type of fungus is established in the patient.

How to treat lichen caused by fungi? Watch in a two-minute video with Doctor of Medical Sciences, Professor of the Russian Academy of Sciences Olga Borisovna Tamrazova.

Other names for pityriasis versicolor

Other names for pityriasis versicolor disease:

  • Pityriasis versicolor
  • Pityriasis red hairy pityriasis

The presence of the words “red”, “multi-colored”, “bran-like” in the name is due to the appearance on the skin of orange-red areas with peeling, similar to bran. Mushrooms of the genus Malassezia live not only on the skin, but also in the sebaceous hair follicles – this explains the word “hairy” in the title.

90% of healthy people carry the fungus that causes pityriasis versicolor 5 .

Under the influence of various environmental factors or individual characteristics of the organism, the fungus can transform from a harmless form into a pathogenic one that causes a disease.

Predisposing factors

Unfavorable factors can aggravate the course of pityriasis versicolor and its manifestations on the skin. These include 7, 8 :

  • Overheating of the skin, wearing excessively warm clothes, excessive sweating (especially in people living in countries with hot and humid climates)
  • Reduced immunity due to stress, poor diet and lifestyle
  • A number of experts note the negative impact of using cosmetics that do not match the patient’s original skin type, as well as the impact of certain cosmetic procedures, such as peels and scrubs

Pityriasis versicolor mainly affects adolescents and young adults between the ages of 10 and 30, but can occur in people of any age group, including infants and the elderly. It is more often registered among the population living in regions with a hot and humid climate. There is no convincing evidence that sex or any particular ethnic group is more susceptible 4 .

Pityriasis versicolor in a child

In children, this disease occurs quite rarely under the influence of the same provoking factors as in adults, including improper skin care and poor hygiene.

Can you get pityriasis versicolor?

It is almost impossible to catch pityriasis versicolor from another person. The disease often develops in people with concomitant pathologies: chronic diseases of the lungs and gastrointestinal tract, endocrine pathology, vegetative-vascular disorders, immunodeficiencies of various nature 4 .

Diagnosis of pityriasis versicolor

Diagnosis of pityriasis versicolor is made on the basis of the clinical picture (symptoms of the disease), as well as patient complaints 12 . For a more accurate diagnosis, a dermatologist conducts a special test called the Balzer Iodine Test, and also checks the Besnier Symptom.

The dermatologist can also use a Wood’s lamp for diagnosis.

Balzer (Balser) test with iodine

Skin areas with small spots with clear boundaries are smeared with 5% alcohol solution of iodine. The horny layer of the skin affected by the fungus quickly absorbs iodine and stains more intensely than other areas. Spots of pityriasis versicolor are clearly distinguished by a dark brown color against the background of only slightly stained areas of healthy skin.

This property is associated with a loosened, disturbed disease of the upper layer of the skin – the epidermis, which is more conductive to staining.

Besnier’s symptom

The doctor selects an exposed area of ​​skin where spots are noted. Further, with the help of available medical instruments, he spends on the spots in the form of scraping. In the presence of pityriasis versicolor, increased peeling of the skin at the site of scraping will be characteristic.

Wood’s lamp

The procedure should be carried out in a dark room. Normal healthy skin does not glow under UV rays, and some bacteria and fungi emit a characteristic natural glow.

How to determine pityriasis versicolor at home?

An iodine test can be performed for self-diagnosis. Affected areas of the skin – spots are lubricated with 3-5% iodine solution. The horny layer of the epidermis, loosened by the fungus, absorbs iodine faster, due to which the lesions are stained much more intensely than healthy skin 6 . As a result, pityriasis versicolor stands out against the background of healthy skin with a dark brown color.

It is important to remember that only a doctor can make an accurate diagnosis!

One of the signs of pityriasis versicolor is uneven sunburn.

The fungus causes a disturbance in the production of melanin, the pigment responsible for tanning. In the presence of the disease, white spots that are immune to the sun may appear on the skin.

Why go to the doctor? Differential diagnosis of pityriasis versicolor

If you experience symptoms of the disease, you should contact a specialist immediately. At the appointment, a dermatologist will conduct an examination, conduct research, establish a diagnosis of the disease and prescribe treatment.

Important! You cannot self-medicate.

There are a number of diseases that may look like pityriasis versicolor 4 .

What can you confuse with pityriasis versicolor?

  • Vitiligo and lichen white (vitiligo is characterized by skin patches without pigmentation and without accompanying inflammation)
  • Post-inflammatory hyperpigmentation
  • Pityriasis rosea
  • Psoriasis
  • Seborrheic dermatitis
  • Progressive macular hypomelanosis
  • Confluent and reticular papillomatosis
  • Pityriasis rotunda
  • Pityriasis pigmentosa white (more common in children and adolescents, and also common in people with dark skin)

Treatment of pityriasis versicolor

The main goal of therapy for the disease is to achieve a stable remission 13, 14 .

Pityriasis versicolor is treated with topical antifungals, such as those based on sertaconazole (Zalain ® ).

In more severe cases, oral antifungals may be given.

Active ingredients for the treatment of pityriasis versicolor

  • Sertaconazole
  • Bifonazole
  • Ketoconazole
  • Clotrimazole
  • Miconazole
  • Terbinafine
  • Oxiconazole

Preparations for the treatment of pityriasis versicolor are available in various forms: gel, cream, solution, shampoo, tablets. Only a doctor can prescribe the correct treatment.

Sertaconazole (Zalain® Cream) for the treatment of pityriasis versicolor

Drugs based on sertaconazole (Zalain ® Cream) are often used to treat pityriasis versicolor.

Sertaconazole has a triple antifungal effect 17 , namely:

  • Prevents the growth and reproduction of fungi
  • Fungal cell death
  • Blocking the transition of fungi from a passive form to a pathogenic one (only for fungi of the genus Candida)

More than 60 international studies have been conducted demonstrating the effectiveness of sertaconazole and its high safety profile 15 .

Sertaconazole acts on all types of dermatophyte fungi that cause pityriasis versicolor.

Instruction

Zalain ® Pityriasis versicolor cream

Cream based on sertaconazole (Zalain ® ) has anti-inflammatory 18 and antipruritic 19 action, which is especially important in the treatment of lichen.

Has a triple effect: antifungal, antipruritic, anti-inflammatory

Used 1-2 times a day

Where to buy Zalain ® Cream for the treatment of pityriasis versicolor

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How does Zalain® work?

Sertaconazole (Zalain ® ) upon contact with a fungal cell destroys its membrane (protective shell) and causes the death of the fungus, and also blocks its growth and reproduction. When applied to the skin, the drug is not absorbed into the general circulation, which increases its safety profile 16 .

How to use Zalain®?

Sertaconazole cream (Zalain) is applied to the affected skin in an even thin layer twice a day, covering approximately 1 cm of the healthy skin surface 16 .

How long is the treatment?

The duration of treatment depends on the type of fungal pathogen and the localization of the disease. As a rule, the symptoms of the disease disappear after 2-4 weeks. The recommended duration of treatment is 4 weeks 16 .

Why do you need a doctor?

It is essential to consult a dermatologist. During the therapy, the doctor carefully analyzes the dynamics of treatment, looks at how the regression of skin lesions occurs. In the process of observation, a dermatologist can identify a patient with a chronic form of the disease and additionally prescribe antifungal drugs in the form of tablets, as well as prescribe additional laboratory tests, for example, a biochemical blood test 16 .

Anti-inflammatory effect of sertaconazole

Fungal infections of the skin can cause a local inflammatory reaction that leads to pain, irritation and itching 1 . Sertaconazole has an anti-inflammatory effect, stops the inflammatory reaction and blocks its further development 1 .

Other recommendations

During treatment and for some time after treatment, alcohol should be avoided and lifestyle adjustments should be made as much as possible if it is combined with stress, malnutrition and bad habits. All this affects the functioning of the immune system, the role of which is extremely important in the fight against infection.

Answers to questions about pityriasis versicolor

Pityriasis versicolor – is it serious?

Answer: Pityriasis versicolor is associated with cosmetic skin defects, in connection with which it can cause psychological discomfort to the patient. The spots may itch a little. In general, rashes are not dangerous to health and can be treated 4 .

Pityriasis versicolor – is it contagious?

Answer: No, you cannot get pityriasis versicolor from another person. The yeast-like microbe that causes the rash lives on the skin of a healthy person and usually causes no harm. Rashes appear when the fungus passes into the pathogenic form 4 .

How can I prevent the rash from coming back?

Answer: In the presence of predisposing factors, the fungus can recur even after successful treatment. For prevention, the doctor may prescribe antifungal medications and special skin care to prevent recurring rashes.

Is sunbathing effective for pityriasis versicolor?

Answer: No, sunbathing does not affect the course of pityriasis versicolor.

Can you treat pityriasis versicolor on your own?

Answer: In case of skin symptoms, you should consult a doctor who will diagnose the disease and prescribe a course of therapy. Drugs used to treat pityriasis versicolor can cause serious side effects, so self-medication is unacceptable.

Which doctor treats pityriasis versicolor?

Answer: Skin diseases, including pityriasis versicolor, are treated by a dermatologist.

How quickly does the skin recover after treatment for pityriasis versicolor?

Answer: Skin discoloration may persist after the symptoms disappear. Restoration of normal pigmentation may take several months after completion of treatment 4 .

Is the use of immunomodulators justified in the treatment of pityriasis versicolor?

Answer: You can often hear that various immunomodulators are recommended to improve immunity. From the standpoint of evidence-based medicine, they are drugs with unproven clinical efficacy and do not increase immunity.

Popular articles

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Sources

  1. Goldstein B. G. et al. Tinea versicolor (pityriasis versicolor) // Up To Date Waltham, MA.(Accessed on June 20, 2015). – 2018.
  2. Hebif T.P. Skin diseases: diagnosis and treatment / T.P. Hebif. – M.: MEDpress-inform, 2007. – 672s
  3. Galkina E.M., Utz S.R., Bakulev A.L., Minenok T.A. Pityriasis versicolor pilaris Devergy: a clinical case. Saratov Scientific Medical Journal 2016; 12(3): 504–509.
  4. Federal Clinical Guidelines for the Management of Patients with Pityriasis Multicolor, Russian Society of Dermatovenerologists and Cosmetologists, 2015.
  5. Sergeev A.Yu., Sergeev Yu.V. Fungal infections. Guide for doctors. 2nd ed. M.: Publishing house BINOM, 2008. S. 230–238.
  6. M.A. Abdulloeva, P.T. Zoirov. Clinical forms of multi-colored lichen of the skin / // Health of Tajikistan. – 2011. – No. 4. – P.12-15.
  7. Rosales, C.M., Jackson, M.A., Zwick, D., 2004. Malassezia furfur meningitis associated with total parenteral nutrition subdural effusion. Pediatr. dev. Pathol. 7, 86–90
  8. Cullingham K. Atrophying pityriasis versicolor / K. Cullingham, P.R. Hull // CMA J. – 2014. – 186(10). — P. 776
  9. Ellabib M.S. Dermatophytes and other fungi associated with skin mycoses in Tripoli, Libya / M.S. Ellabib, Z.M. Khalifa // Ann Saudi Med. – 2016. – No. 21 (3-4). – P. 193-195.
  10. Abdulloeva M.A., Zoirov P.T. // Modern view on versicolor versicolor: some aspects of pathogenesis and clinical features of the course in hot climates // Bulletin of Avicenna, 19 (1), 31-36
  11. Honnavar, P., Ghosh, A.K., Paul, S., et al ., 2018. Identification of malassezia species by MALDI-TOF MS after expansion of database. Diagn. microbiol. Infect. Dis. 92, 118–123
  12. Hu SW, Bigby M. Pityriasis versicolor: a systematic review of interventions. Arch Dermatol. 2010 Oct;146(10):1132-40. doi: 10.1001/archdermatol.2010.259. PMID: 20956647
  13. Leeming JP, Sansom JE, Burton JL. Susceptibility of Malassezia furfur subgroups to terbinafine. Br J Dermatol. 1997 Nov;137(5):764-7. PMID: 9415238
  14. Kubanov AA, Galliamova Yu. A. // Differential diagnosis and treatment of Devergy’s disease / Attending physician. – 2014. – No. 3. – P. 87-90
  15. According to scientific publications in the electronic database of the US National Library. Access: 03.2022, https://pubmed.ncbi.nlm.nih.gov/
  16. Based on the data specified in the instructions for medical use of Zalain cream reg. No.: P N015678
  17. Carrillo-Muñoz AJ, Tur-Tur C, Giusiano G, Marcos-Arias C, Eraso E, Jauregizar N, Quindós G. Sertaconazole: an antifungal agent for the topical treatment of superficial candidiasis. Expert Rev Anti Infect Ther. 2013 Apr;11(4):347-58. doi: 10.1586/eri.13.17. PMID: 23566144.
  18. Sur R., Babad J.M., Garay M., Liebel F.T., Southall M.D. Anti-Inflammatory Activity of Sertaconazole Nitrate Is Mediated via Activation of a p38-COX-2-PGE2 Pathway. J Invest Dermatol. 2008;128(2):336-344. doi:10.1038/sj.jid.5700972.
  19. Kaur S. , Sur R., Liebel F.T., Southall M.D. Induction of Prostaglandin D2 through the p38 MAPK Pathway Is Responsible for the Antipruritic Activity of Sertaconazole Nitrate. J Invest Dermatol. 2010;130(10):2448-2456. doi: 10.1038/jid.2010.152.

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