Tinea Versicolor Treatment: Everything You Need to Know

Tinea versicolor often shows up as small, white (hypopigmented) patches on the face, neck, trunk, and upper arms or legs. Your healthcare provider can make an official diagnosis and recommend a course of treatment. Most treatment options are only available by prescription. 

Here’s the good news: Tinea versicolor is easy to get rid of. Read on to learn more about how this skin condition can develop and the available treatment options. 

What is tinea versicolor?

Tinea versicolor, or pityriasis versicolor, is a common skin fungal infection. The organism that causes it is different from athlete’s foot or nail fungus. It’s a lipid (fat) dependent yeast called Malassezia. 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. 

People with lighter skin often notice small, white or light-brown patches. People with darker skin may see patches that are white or a dark-brown or gray-black color. But the most common way it shows up is in lighter or white patches on the upper arms, chest, and back. 

In children, tinea versicolor can also affect the face.

What causes tinea versicolor, and is it contagious?

A fungus causes tinea versicolor. Fungus and yeast normally live on the skin. But if they grow too much, problems like tinea versicolor can happen.

Risk factors for tinea versicolor include:

• Living in a hot or humid climate

• Having moist or oily skin

• Having lower immunity

Tinea versicolor seems to affect some families more than others. But the good news is that it can’t spread from person to person. In other words, it's not contagious. This is because getting tinea versicolor is related to the risk factors that cause the fungus to grow, not exposure to other people.

Tinea versicolor treatment

Treatment for tinea versicolor works well, but the condition often comes back. Remember, even when the infection is treated, it takes a couple months for the pigment to return to normal. Some people need long-term maintenance therapy to prevent it from coming back.

So what might your healthcare provider prescribe you to treat tinea versicolor? Treatment options usually involve topical 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. Of note, the over-the-counter 1% shampoo has not been studied, so we don’t know if it works for treatment.

• 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 provider 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 shows 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. 

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 your healthcare provider 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 providers 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 provider in order to use a GoodRx coupon. 

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

Why trust our experts?

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:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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