Pityriasis versicolor: why it appears and how it is treated
The cause of patches on the back and chest, how they are diagnosed and treated, and how to prevent them coming back.
AuthorDr. Sheyla JafarovaDermatovenereologist, aesthetic dermatologist, acne expert
Pityriasis versicolor is a superficial fungal infection of the skin. Do not let the name scare you: it is not a dangerous disease, and it can be treated. But it tends to come back, so it is important to know its causes.
What it looks like
- Light, pink or brown patches on the back, chest, neck and shoulders
- Fine, bran-like flaking on the patches
- Patches that stand out more after sun exposure in summer, because those areas do not tan
- Sometimes mild itching
Why it appears
It is caused by the Malassezia yeast, which normally lives on everyone’s skin. In hot and humid weather, with heavy sweating, oily skin or weakened immunity, the yeast becomes active and the patches appear. That is why pityriasis versicolor is not considered contagious.
Treatment
- The diagnosis is made by examination, sometimes with a Wood’s lamp or by checking a skin scraping under the microscope
- An antifungal shampoo (for example, with ketoconazole or selenium sulfide), cream or spray
- Oral preparations for widespread cases
- A preventive routine for cases that keep recurring
Even after treatment kills the fungus, it can take several weeks, sometimes months, for the skin colour to even out. That does not mean the treatment has not worked.
Scientific references
The information in this article is based on the following peer-reviewed papers and international clinical guidelines.
- Gaitanis, G., Magiatis, P., Hantschke, M., Bassukas, I. D., & Velegraki, A. (2012). The Malassezia genus in skin and systemic diseases. Clinical Microbiology Reviews, 25(1), 106-141. [PMID: 22232373] | [DOI: 10.1128/CMR.00021-11]
- Renati, S., Cukras, A., & Bigby, M. (2015). Pityriasis versicolor. BMJ, 350, h1394. [PMID: 25852089] | [DOI: 10.1136/bmj.h1394]
- Gupta, A. K., & Foley, K. A. (2015). Antifungal Treatment for Pityriasis Versicolor. Journal of Fungi, 1(1), 13-29. [PMID: 29376896] | [DOI: 10.3390/jof1010013]
- Hald, M., Arendrup, M. C., Svejgaard, E. L., et al. (2015). Evidence-based Danish guidelines for the treatment of Malassezia-related skin diseases. Acta Dermato-Venereologica, 95(1), 12-19. [PMID: 24556907] | [DOI: 10.2340/00015555-1825]
