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What is the proper treatment for tinea versicolor?

Updated: Jun 1, 2023


This often appears as patches of discolouration on the skin; often on the neck, arms and chest, but can occur in other places too. The colour can vary, but are most often lighter than the surrounding skin: hypopigmentation. If the skin is darker, this is hyperpigmentation. They are often itchy and can make the skin look and feel scaly. It can look pretty similar to vitiligo, although the itching and scaly skin tend not to occur with vitiligo. The other somewhat similar condition is the rarer pityriasis rosea, but this usually starts as a red, scaly patch of skin, followed by an oval rash, usually on the trunk. None of them are contagious or dangerous, but it is always a good idea to get a proper diagnosis from a skin specialist or your general practitioner. TV is more prevalent in humid and warm weather, especially if it is hot enough to cause sweating and affects around 60% of people living in humid areas, especially if the skin is not washed regularly. Often in these conditions the phases of the fungus change and can enter the top layer of skin (the stratum corneum)and cause the inflammation and colour pigment change. Like other fungal infections, it can also appear when the immune system is weakened or if antibiotics have been taken frequently or for a sustained period. It can be treated effectively with over-the-counter antifungal creams, often clotrimazole or sodium thiosulphate, or with oral medication. Some people prefer to use ‘natural’ products, but very few oils have been thoroughly tested in clinical trials and found to be as reliable. Lemongrass essential oil is high in terpenes which have antimicrobial and anti-inflammatory properties and have been found to be effective applied in an oil at 3–5%. Dill seed essential oil and hydrosols have been used with some success (Anethum graveolens) as used in Ayurvedic medicine. 5% Artemisia sieberi essential oil in a lotion can be effective, although it is possible for the condition to recur. The most effective ‘natural’ remedy I have come across is a poly-herbal treatment with leadwort, sneezewort, black mustard, radish, India madder and vinegar. This apparently eradicated the fungus, the scaling and itching. As the antifungal creams are cheap, effective and have been around long enough that we can probably have confidence that they are safe - that would seem to be the most sensible treatment.
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