What is the best topical treatment for Pityriasis (tinea) versicolor?

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Last updated: February 15, 2025View editorial policy

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From the Research

Topical Treatments for Pityriasis Versicolor

The following topical treatments have been studied for the treatment of pityriasis versicolor:

  • Ketoconazole 2% shampoo: A study published in 1998 found that ketoconazole 2% shampoo was effective in treating tinea versicolor, with a clinical response rate of 73% after 3 days of treatment and 69% after a single application 1.
  • Ketoconazole 2% foam: A study published in 2014 found that ketoconazole 2% foam was effective in treating pityriasis versicolor, with improvement in clinical and mycological assessments after 2 weeks of treatment 2.
  • Keratolytic agents: A systematic review and meta-analysis published in 2024 found that keratolytic agents, such as selenium sulfide, were as effective as azole preparations, such as ketoconazole, in treating pityriasis versicolor, although the quality of evidence was very low 3.
  • Itraconazole: A review published in 1990 found that itraconazole was effective in treating tinea versicolor, with a total dose of 1000 mg required for effective treatment 4.

Comparison of Topical Treatments

The following comparisons have been made between topical treatments for pityriasis versicolor:

  • Azole preparations vs keratolytic agents: A systematic review and meta-analysis published in 2024 found that azole preparations, such as ketoconazole, were not significantly different from keratolytic agents, such as selenium sulfide, in terms of clinical cure and adverse events, although the quality of evidence was very low 3.
  • Ketoconazole 2% shampoo vs placebo: A study published in 1998 found that ketoconazole 2% shampoo was significantly more effective than placebo in treating tinea versicolor 1.
  • Itraconazole vs placebo: A review published in 1990 found that itraconazole was superior to placebo in treating tinea versicolor 4.

Safety and Efficacy

The safety and efficacy of topical treatments for pityriasis versicolor have been studied, with the following findings:

  • Ketoconazole 2% shampoo: A study published in 1998 found that ketoconazole 2% shampoo was safe and well-tolerated, with no serious adverse events reported 1.
  • Ketoconazole 2% foam: A study published in 2014 found that ketoconazole 2% foam was safe and well-tolerated, with only one patient reporting a mild skin burning sensation 2.
  • Itraconazole: A review published in 1990 found that itraconazole was well-tolerated, with few adverse events reported 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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