From the FDA Drug Label
For treatment of tinea versicolor: Apply to affected areas and lather with a small amount of water. Allow product to remain on skin for 10 minutes, then rinse the body thoroughly. Repeat procedure once a day for 7 days. For treatment of tinea versicolor: Apply to affected areas and lather with a small amount of water. Allow to remain on skin for 10 minutes. Rinse body thoroughly. Repeat this procedure once a day for 7 days.
The recommended treatment for tinea versicolor is to apply selenium sulfide (TOP) to affected areas, lather with a small amount of water, and allow it to remain on the skin for 10 minutes before rinsing thoroughly. This procedure should be repeated once a day for 7 days 1 1.
- Key points:
- Apply to affected areas
- Lather with a small amount of water
- Remain on skin for 10 minutes
- Rinse body thoroughly
- Repeat once a day for 7 days
From the Research
The recommended treatment for tinea versicolor is topical antifungal medications, with oral antifungal therapy reserved for patients with extensive disease, frequent recurrences, or disease that is refractory to topical therapy, as stated in the most recent review 2.
Treatment Options
- Topical antifungal medications such as selenium sulfide 2.5% shampoo, ketoconazole 2% shampoo, or clotrimazole cream applied to affected areas daily for 1-2 weeks
- For selenium sulfide, apply to the affected skin for 10 minutes before rinsing off, repeating daily for 7 days
- Ketoconazole shampoo should be applied to affected areas, left on for 5 minutes, then rinsed off, used daily for 3 days
Oral Antifungal Therapy
- Reserved for patients with extensive disease, frequent recurrences, or disease that is refractory to topical therapy
- Options include fluconazole (300mg weekly for 2 weeks) or itraconazole (200mg daily for 5-7 days)
- Long-term intermittent prophylactic therapy should be considered for patients with frequent recurrence of the disease, as suggested by 2 and supported by the systematic review of systemic treatments 3
Important Considerations
- Even after successful treatment, the skin discoloration may take weeks or months to resolve completely, which patients should understand is not treatment failure
- Tinea versicolor is caused by an overgrowth of Malassezia yeast, which is normally present on skin but can proliferate in warm, humid conditions, producing acids that inhibit melanin production and cause characteristic light or dark patches
- Recurrence is common, so maintenance therapy with topical treatments once or twice monthly may be necessary, especially during warm months, as recommended by 2 and consistent with the findings of 4 and 5