Treatment of Tinea Alba (Pityriasis Alba)
Tinea alba appears to be a misnomer—you likely mean either pityriasis alba (a benign hypopigmented skin condition) or tinea versicolor (a fungal infection); if you're asking about tinea versicolor, use topical terbinafine 1% cream once daily for 1-2 weeks as first-line treatment. 1
Clarification of Terminology
- "Tinea alba" is not a recognized dermatologic diagnosis—this term may conflate two distinct conditions that require different management approaches
- Pityriasis alba is a non-infectious, self-limited hypopigmented dermatosis (not a fungal infection) that requires only reassurance and moisturizers
- Tinea versicolor (pityriasis versicolor) is the fungal infection caused by Malassezia species that presents with hypopigmented or hyperpigmented patches
If You Mean Tinea Versicolor (Fungal Infection)
First-Line Topical Treatment
- Apply terbinafine 1% cream once daily for 1-2 weeks to affected areas 1
- Alternative topical azoles (clotrimazole, tioconazole) applied twice daily for 2-4 weeks are also effective 2, 3
Systemic Treatment Options (For Extensive Disease)
- Fluconazole 400 mg as a single dose is highly effective for widespread tinea versicolor 4
- Itraconazole 200 mg daily for 5-7 days is an alternative systemic option 4
- Avoid oral ketoconazole due to hepatotoxicity risk—it has been withdrawn in some countries 1
- Note that oral terbinafine is ineffective for tinea versicolor, unlike its topical formulation 4
Essential Prevention Measures
- Completely dry affected areas after bathing to prevent recurrence 1
- Use separate towels for drying affected areas versus other body parts to reduce contamination 1
Common Pitfalls
- Hypopigmentation may persist for months after successful mycological cure—this represents post-inflammatory changes, not treatment failure 5
- Recurrence is common without proper hygiene measures, particularly in warm, humid conditions 2
If You Mean Pityriasis Alba (Non-Fungal Hypopigmentation)
- This is a self-limited condition requiring no antifungal treatment
- Management consists of emollients, sun protection, and reassurance that repigmentation occurs gradually over months to years
- Low-potency topical corticosteroids may reduce associated inflammation if present