Pityriasis Versicolor

  • Common: Very common, especially in young adults.

  • Requires medical diagnosis: Yes – clinical assessment, Wood’s lamp, or skin scraping may be used.

  • Symptoms: Flat, scaly patches that may be lighter or darker than surrounding skin; may cause mild itch.

  • Colour: Varies – can appear pink, pale brown, or lighter than surrounding skin (especially on darker skin tones).

  • Location: Typically affects the chest, upper back, shoulders, and neck.

  • Treatment: Antifungal shampoos (e.g. ketoconazole), antifungal creams (e.g. clotrimazole, miconazole); oral antifungals like itraconazole for severe or widespread cases.

Pityriasis versicolor is a common superficial fungal infection caused by the yeast Malassezia, which normally lives on healthy skin. It tends to overgrow in warm, humid conditions, especially on oily skin.

The condition is frequently seen in young adults and often becomes more noticeable after sun exposure, as the affected areas do not tan, resulting in uneven skin tone. Although harmless, pityriasis versicolor can persist and may return. It usually responds well to topical antifungal treatments, but the affected skin may take several months to return to its normal colour.

 

Symptoms

Pityriasis versicolor presents as sharply defined, mildly scaly patches that vary in colour from orangey to light brown. These patches often begin as individual spots that gradually merge into larger, irregular areas. The affected skin may feel slightly rough due to fine scaling. The chest and back are commonly involved, especially in areas rich in sebaceous glands.

 

What can I do?

Even though the disease is not contagious, it often needs to be treated with prescription medication.

 

Should I seek medical care?

Although pityriasis versicolor is harmless and not contagious, it usually requires treatment to clear the visible patches. You should avoid applying oily skincare products, especially in humid weather, as these can promote yeast growth. Using an anti-dandruff shampoo as a body wash during warm months may help reduce recurrence. If the condition persists or worsens, seek advice from a healthcare professional for appropriate antifungal treatment.

 

Treatment

Pityriasis versicolor is typically managed with topical antifungal treatments. Medicated shampoos like Selsun (selenium sulphide), Nizoral (ketoconazole), or Oilatum scalp treatment can be used as body washes—applied to the affected areas, left on for about 5 minutes, then rinsed off. This should be done daily for 1 to 2 weeks. For smaller patches, ketoconazole 2% cream can be applied directly to the skin.

To help prevent recurrences, using an antifungal shampoo once every 1–2 weeks long-term may be recommended. Treating the entire upper trunk and arms, not just visible lesions, is essential since relapse is common.

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References

NHS. Pityriasis versicolor. Available at: https://www.nhs.uk/conditions/pityriasis-versicolor/. Page last reviewed: 28 March 2023.

American Academy of Dermatology. Tinea versicolor. Available at: https://www.aad.org/public/diseases/color-problems/tinea-versicolor

British Association of Dermatologists. Pityriasis Versicolor. Available at: http://www.bad.org.uk/shared/get-file.ashx?id=226&itemtype=document

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