Tinea Versicolor: What It Is And How To Treat

Tinea Versicolor

Today, I am posting a question of my own for Dr. Jo Herzog regarding a rash one of my daughters has on her back (see photo at left). My question and Dr. Jo’s answer are below.

Dr. Jo, one of the twins has this rash on her back and shoulders. Is it serious? Is it contagious? What do I do about it?

Dr. Jo Herzog, M.D.

You can relax, Jamie. This rash is harmless and is not contagious. She has Tinea Versicolor. This is a problem that we see at many ages, but it is most common in young adults.  It is a fungal infection caused by an organism that inhabits most of our skin but grows better on hers. The organism is called Pityrosporum orbiculare. This seems to be more common in warm climates.

When this occurs, we see fine scaling spots, often round or oval (might have to scratch to see the fine scale) of various colors (thus versiCOLOR) from tan to pink to brown, even white. They are most often on the trunk and upper arms but may go down the thighs, up the neck, and more rarely to the face. Diagnosis is usually made by visual identification.

The easiest treatment is taking oral medication which consists of two pills which are repeated in a week. This can also be treated with topical creams and shampoos.  Mild cases can be treated by washing with selinium sulfide (Selsun Blue) or Nizoral shampoo (to the body, not just on the head) and letting it sit 10-15 minutes and washing off. This can be done for several nights in a row initially and then once a week for prevention.

You can also use OTC lotrimin cream  twice a day for two weeks.  To keep this from recurring, you should use one of these shampoo regimens weekly. If you are unsure or unsuccessful, see your dermatologist (and in your case, Jamie, that would be me).

The white spots will stay for a while even after the rash is “cured,” but it will no longer scale when scratched.

Hope this helps.

Reminder: All Family Savvy readers can send any questions or concerns to me in the comments section of Family Savvy. I am happy to answer!

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  1. Hi Lisa, I am so sorry you are having such difficulty with a diagnosis. My recommendation is to find a good dermatologist who can see you in person. You may have to try several before you get the right one. Best of luck!!!

  2. I have been having skin issues for a few years now…. It started w/extreme dry itchy flaky skin that turned into scaly, embarrassing white snowfall like parts of me that kept me from wearing shorts, skirts /dresses. Esp in the winter. Tho the amount of scales/hard folicals/roots is still present, I’m still embarrassed to show my skin. I can’t seem to pinpoint what it is, as Google keeps showing me something different every time. My back, my scalp+my legs are the most affected-primarily my scalp. Nothing OTC has helped. Reference pics….

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