From the FDA Drug Label
DOSAGE & ADMINISTRATION SECTION Cutaneous candidiasis, tinea corporis, tinea cruris, tinea pedis and tinea (pityriasis) versicolor: It is recommended that Ketoconazole Cream 2% be applied once daily to cover the affected and immediate surrounding area Patients with tinea versicolor usually require two weeks of treatment.
The treatment for tinea versicolor is Ketoconazole Cream 2% applied once daily for two weeks 1.
- Key points:
- Apply once daily
- Cover affected and surrounding area
- Treatment duration: two weeks
- Indication: Ketoconazole Cream 2% is indicated for the topical treatment of tinea (pityriasis) versicolor caused by Malassezia furfur 2.
From the Research
The most effective treatment for versiscolor is topical antifungal medications, with oral antifungals reserved for widespread or stubborn infections, and maintenance therapy with topical treatments recommended to prevent recurrence, as supported by the most recent study 3. The treatment of versiscolor, also known as pityriasis versicolor, typically involves the use of antifungal medications that can be applied topically or taken orally.
Topical Treatments
For mild to moderate cases, topical treatments are usually the first choice, including:
- Selenium sulfide 2.5% lotion (like Selsun)
- Ketoconazole 2% shampoo or cream
- Clotrimazole cream
- Terbinafine cream These should be applied to affected areas daily for 1-2 weeks, sometimes leaving them on the skin for 5-10 minutes before rinsing.
Oral Antifungals
For widespread or stubborn infections, oral antifungals may be prescribed, such as:
- Fluconazole (400mg single dose or 150mg weekly for 2-4 weeks)
- Itraconazole (200mg daily for 5-7 days)
- Ketoconazole (200mg daily for 10 days), although its use is generally discouraged due to potential liver toxicity 4
Maintenance Therapy
To prevent recurrence, especially in hot, humid climates, maintenance therapy with topical treatments once or twice monthly may be recommended, as suggested by the most recent study 3. It's also important to note that even after successful treatment, skin discoloration may persist for weeks or months until the skin regains its normal pigmentation. Tinea versicolor is caused by an overgrowth of Malassezia yeast, which is normally present on skin but can proliferate under certain conditions, leading to the characteristic discolored patches. The diagnosis typically relies on recognizing characteristic clinical features, and differential diagnosis is critical due to the wide variability in its clinical presentation 3. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence, as emphasized in the most recent study 3.
Some key points to consider when treating versiscolor include:
- The importance of proper diagnosis and differential diagnosis
- The use of topical antifungal medications as first-line treatment
- The potential need for oral antifungals in severe or stubborn cases
- The importance of maintenance therapy to prevent recurrence
- The need for patient education and good personal hygiene to reduce the risk of recurrence, as supported by the most recent study 3.