Tinea Versicolor Treatment: Antifungal Medications and Natural Remedies

Tinea versicolor often shows up as small, white (hypopigmented) patches on the face, neck, trunk, and upper arms or legs. While it might look concerning, it’s a common and treatable skin condition. A healthcare professional can make the diagnosis and recommend a course of treatment. Most treatment options are only available by prescription. 

The good news? Tinea versicolor is usually easy to treat and manage. Keep reading to learn what causes it, how it spreads, and what you can do to clear it up. 

What is tinea versicolor?

Tinea versicolor, or pityriasis versicolor, is a common skin fungal infection. The organism that causes it is different from the fungi that cause athlete’s foot or nail fungus. It’s a lipid-dependent yeast called Malassezia — this means it needs fat to grow. Malassezia is normally found on skin and only causes a problem when it changes from a yeast form to a mycelial form (the branching part of a fungus). 

Tinea versicolor can look very different from person to person — even among people with similar skin color. 

Symptoms of tinea versicolor

Tinea versicolor can lead to patches of skin discoloration. But not everyone with tinea versicolor will react the same way. 

Symptoms of tinea versicolor include scattered patches on the skin that are:

• Discolored: These can be white, pink, brown, or red. On darker skin tones, the patches often look lighter than the surrounding skin, making them look noticeable. 

• Small and round or oval: They often start out this way but can become larger and more irregular with time. 

• Scaly or flaky: The surface can feel dry or rough, and fine scaling is often visible when the skin is gently scratched. 

• Mildly to moderately itchy: Some people don’t feel itchy at all. Others can have intense itching, especially in humid weather.  

• Commonly found on the upper body: The rash tends to show up on areas like the chest, back, shoulders, and upper arms. 

What causes tinea versicolor?

A fungus causes tinea versicolor. Fungus and yeast normally live on the skin. But if the fungus grows too much, it can lead to tinea versicolor.

As mentioned before, the type of fungus that causes tinea versicolor — Malassezia furfur — is lipophilic, which means it needs fat or oils to grow. So anything that makes the skin more oily can increase the risk for it. 

Tinea versicolor is more likely if you:

• Sweat a lot (for example, if you exercise regularly)

• Have diabetes or excess weight

• Live in a warm or humid climate

• Have moist or oily skin

• Use oils or cosmetics that can clog your pores

• Have a weakened immune system

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• Not sure it’s tinea? Check out our guide — with pictures — to common rashes like eczema and ringworm.

• Fluconazole side effects: Fluconazole can treat tinea versicolor. Here’s what to watch for if you take this medication. 

• What else might be making my skin itchy? Review common causes of skin itchiness, and what to do about it.

Is tinea versicolor contagious?

No, tinea versicolor isn’t contagious. This might seem confusing, since it’s caused by a fungus. But the type of fungus that causes it is often normally found on the skin. Getting tinea versicolor is related to the risk factors that cause the fungus to grow, not exposure to other people.

Tinea versicolor medications and treatments

A healthcare professional may prescribe medication for tinea versicolor. Treatment options usually involve topical antifungal medications (creams, gels, or shampoos that you apply to the affected area) or oral medications (taken by mouth). 

Let’s take a closer look at the different types of treatments and what clinical studies say about their success rates.

Topical tinea versicolor treatment

Topical treatments for tinea versicolor include:

• Azole antifungal creams like clotrimazole 1%, ketoconazole 2%, econazole 1%, and miconazole 2% are examples that work well when used once or twice daily for 1 to 4 weeks. After an average of 2 weeks, symptoms improved in more than 8 in 10 people. 

• Ketoconazole 2% shampoo works better with a shorter course of therapy. You apply the shampoo to the areas affected and leave it on for 5 minutes once daily for 3 days. After about a month, this treatment is effective for 9 in 10 people.

• Terbinafine (Lamisil) 1% cream or gel is used twice daily for 1 week. Around 2 months after the treatment, over 8 in 10 people saw a noticeable difference in how their skin looked.

• Ciclopirox 0.77% cream is effective when used twice a day for 14 days. This option works well for just under 8 in 10 people. 

• Selenium sulfide shampoo 2.5% works well when used as a daily 10-minute application for 1 week. This treatment option works well for almost 9 in 10 people. 

• Zinc pyrithione 1% shampoo can be used daily on areas affected for 2 weeks. It’s typically left on for 5 minutes. The exact success rate for this option isn’t available, but studies consider it to be an effective treatment.

Oral tinea versicolor treatment

Topical treatments are usually effective for tinea versicolor. But sometimes they might not work. If this happens, your healthcare team may recommend treatment with an oral medication. They may also prescribe pills if the discoloration from tinea versicolor covers so much of your skin that putting on a cream becomes difficult. 

Studies show that antifungal pills are effective at treating tinea versicolor:

• Fluconazole (Diflucan) 300 mg once a week for 2 weeks has shown to be an effective treatment for almost 9 in 10 people.

• Itraconazole (Spectazole) 200 mg per day for 5 days also works well. About 8 in 10 people experienced fewer symptoms with this treatment option.

Those who were given a single dose of itraconazole saw a higher recurrence rate after 8 weeks compared to those who were given a single dose of fluconazole. So, fluconazole may be a more effective treatment for tinea versicolor than itraconazole.

Keep in mind that pills have more side effects than topical treatments since they’re absorbed into the whole body. So while it might seem easier to take a pill, you may want to consider trying a topical treatment first. 

Natural treatments and home remedies

Some people try natural or over-the-counter (OTC) treatments to manage tinea versicolor — especially for mild cases or to help prevent it from coming back. OTC treatments for tinea versicolor aren’t as well studied as prescription treatments. But here’s what the research shows about some commonly used options: 

• Selenium sulfide shampoo (1%): The prescription strength (2.5%) selenium sulfide shampoo is proven to help treat tinea versicolor. The 1% shampoo hasn’t been studied, so we don’t know if it works as well for treatment. But it might be worth a try if you’re looking for an OTC option. 

• Honey: Honey has an antifungal effect. One study found that a mixture of equal parts honey, olive oil, and beeswax 3 times a day for 4 weeks led to resolution of tinea versicolor in 86% of participants. 

• Essential oils: Certain essential oils — like myrtle and dill seed extract — have been shown in lab studies to fight against the fungus that causes tinea versicolor. But that doesn’t mean it can treat the rash. One clinical study looked at lemongrass (C. citratus) essential oil and found that it might help, but wasn’t as effective as prescription medicine. 

• Apple cider vinegar: Apple cider vinegar has some antifungal properties but has not been tested as a treatment for tinea versicolor. So there’s no evidence to suggest that it helps. 

How can you tell if treatment for tinea versicolor is working?

It usually takes about 2 to 3 weeks for tinea versicolor treatment to work and get rid of the excess fungus that causes it. But it can take months after your treatment ends for your skin pigment to return to normal. 

The only way to tell for sure that tinea versicolor is gone is if a healthcare professional takes a skin scraping and looks at it under a microscope. 

Unfortunately, tinea versicolor does tend to come back over time — especially during the summer months. The good news is that if the medication worked before, it will usually work again. To prevent frequent outbreaks, sometimes healthcare professionals recommend monthly oral or topical medication.

Ways to save on tinea versicolor treatment

Treatment of tinea versicolor is generally affordable. Choosing generic versions of medications and using a GoodRx coupon can help you save. If you use a GoodRx coupon, the cost of topical treatments and antifungal pills is as low as $14. 

Remember that you’ll need to get a prescription from a healthcare professional in order to use a GoodRx coupon. 

The different treatment options for tinea versicolor have similar prices. So talk with your healthcare team to figure out which one might be right for you based on your situation.

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Written by:

Windy Watt, DNP, APRN, FNP-BC

Windy Watt, DNP, APRN, FNP-BC, is a board-certified family nurse practitioner with 30 years of experience. She has an extensive background in critical care, internal medicine, family practice, and urgent care.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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