From the Research
Tinea versicolor should be treated with topical antifungal medications as the first line of treatment, with oral antifungal therapy reserved for widespread or resistant cases, as recommended by the most recent and highest quality study 1. The treatment of tinea versicolor, a common fungal skin infection caused by the yeast Malassezia, has been extensively studied. Key points to consider in the treatment of tinea versicolor include:
- Topical antifungal medications, such as selenium sulfide 2.5% shampoo, ketoconazole 2% shampoo, or clotrimazole or miconazole cream, are effective in treating tinea versicolor 2, 1.
- Oral antifungal therapy, such as fluconazole, may be prescribed for widespread or resistant cases, with a recommended dose of 400mg single dose or 300mg weekly for 2 weeks 3, 4.
- After treatment, skin discoloration may persist for weeks or months, even after the fungus is eliminated 1.
- To prevent recurrence, patients should avoid excessive sweating, wear loose-fitting clothing, and consider monthly prophylactic treatment with topical antifungals during warm months 1, 5. Some studies have compared the efficacy of different antifungal medications, such as fluconazole and ketoconazole, and found similar results 3. However, the most recent and highest quality study 1 recommends topical antifungal medications as the first line of treatment, with oral antifungal therapy reserved for widespread or resistant cases. The Malassezia yeast, which normally lives on skin, can overgrow and cause characteristic light or dark patches that may be slightly scaly, particularly on the chest, back, and shoulders 2, 1. Overall, the treatment of tinea versicolor should prioritize topical antifungal medications, with oral antifungal therapy reserved for severe cases, and prevention of recurrence through lifestyle modifications and prophylactic treatment.