From the Research
Tinea versicolor can be effectively treated with topical antifungal medications, and oral antifungal therapy is typically reserved for patients with extensive disease, frequent recurrences, or disease that is refractory to topical therapy. For mild to moderate cases, apply topical antifungals such as selenium sulfide 2.5% lotion (like Selsun Blue), ketoconazole 2% shampoo, or terbinafine cream daily for 1-2 weeks 1. Apply the medication to affected areas and leave on for 5-10 minutes before rinsing.
Key Considerations
- The diagnosis of tinea versicolor 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 1.
- Oral antifungal medications like fluconazole (300 mg/wk for 2 weeks) or itraconazole (200mg daily for 5-7 days) may be prescribed for more extensive cases 2.
- Even after successful treatment, skin discoloration may persist for weeks or months as the skin tone gradually normalizes.
- To prevent recurrence, especially in hot, humid climates or if you have a history of tinea versicolor, consider using selenium sulfide or ketoconazole shampoo once or twice monthly as maintenance therapy.
Treatment Options
- Topical antifungal therapy has a better safety profile, fewer adverse events, and lower cost compared to systemic treatment and is therefore the treatment of choice 1.
- Long-term intermittent prophylactic therapy should be considered for patients with frequent recurrence of the disease 1.
- 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 1.