From the FDA Drug Label
Ketoconazole Cream 2% is indicated for the topical treatment of ... tinea (pityriasis) versicolor caused by Malassezia furfur (Pityrosporum orbiculare) 1. 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 2.
The treatment for Pityriasis (Pityriasis) versicolor includes:
- Topical ketoconazole 1
- Topical selenium sulfide, applied for 10 minutes and rinsed, repeated once a day for 7 days 2
From the Research
The most effective treatment for Pityriasis versicolor is topical antifungal therapy, which has a better safety profile and lower cost compared to systemic treatment, and is therefore the treatment of choice. According to the most recent study 3, tinea versicolor is caused by Malassezia species, and the condition is characterized by scaly hypopigmented or hyperpigmented macules/patches, primarily located on the upper trunk, neck, and upper arms. The diagnosis is usually based on characteristic clinical features, and if necessary, a potassium hydroxide preparation test can be performed to reveal numerous short, stubby hyphae intermixed with clusters of spores.
Some key points to consider when treating Pityriasis versicolor include:
- Topical antifungal medications such as selenium sulfide 2.5% shampoo, ketoconazole 2% shampoo, or clotrimazole or miconazole creams are effective treatments 3
- Oral antifungal therapy is typically reserved for patients with extensive disease, frequent recurrences, or disease that is refractory to topical therapy 3
- Long-term intermittent prophylactic therapy should be considered for patients with frequent recurrence of the disease 3
- Selection of antifungal agents depends on several factors, including efficacy, safety, local availability, ease of administration, likelihood of compliance, and potential drug interactions of the antifungal agent 3
It's worth noting that while oral antifungal medications like fluconazole may be effective in treating Pityriasis versicolor, as shown in earlier studies 4, 5, the most recent study 3 recommends topical antifungal therapy as the first-line treatment due to its better safety profile and lower cost. Additionally, preventive measures such as using antifungal shampoo once or twice monthly, wearing loose-fitting clothing, and avoiding excessive sweating when possible can help reduce the risk of recurrence 3.