Tinea Versicolor Is Way More Common Than I Thought, And Here's How I Treated Mine

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Courtesy of Emily Rekstis

When I was around 14 years old, I started to notice white patches popping up on my neck. It was strange, but not a huge deal. They didn’t hurt, and they were only faintly visible. But then they started to spread down to my chest. And the tanner I got, the whiter they looked on my skin. Sometimes they would itch, but I was mostly annoyed with how they looked—and bathing suit season only made it worse. If I was around kids, they would point at the white patches and demand to know what was going on. And I had no idea how to explain it. To say the least, it was embarrassing. I found myself covering my chest as often as possible with big necklaces in the summer and scarves in the winter.

During one of my routine visits to the dermatologist (I had pretty persistent acne as a teen), I finally asked the dermatologist about it. She identified it as tinea versicolor. She gave me a prescription, which calmed the itching. But my pigment never came back, and the white patches remained in place. Then, late last spring I started noticing more white patches spreading down on my stomach. I thought I had taken care of this! Why was it back? I finally decided to get it checked out by another NYC-based dermatologist Neal Schultz, M.D. And he quickly confirmed that my tinea versicolor was back.

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What is tinea versicolor?

Tinea versicolor is very common, and though it’s annoying, it’s fortunately not dangerous. “It’s a skin condition caused by a specific kind of yeast called malassezia,” New York City dermatologist Janet Prystowsky, M.D. tells SELF. Malassezia is something that exists naturally on the skin, and tinea versicolor is an overgrowth of this yeast. Malassezia is also the cause for other skin conditions like dandruff and psoriasis. And while it can’t be spread by skin-on-skin contact (meaning it’s not contagious), it’s hard to determine just what causes tinea versicolor, says Schultz.

The rash typically begins to appear on the upper arms, chest, and back. The yeast infection causes skin to change color, typically in small one-eighth or quarter-inch spots. The skin can turn pinker, lighter, or darker. “Light-colored skin tends to get darker spots, while dark-colored skin seems to [turn] lighter,” says Schultz. In some cases of tinea versicolor (like mine) skin turns white because the fungus produces azelaic acid, which bleaches and lightens the skin. And once the infection has passed, it could take a few months for the skin to get back its proper pigment, explains Prystowsky.

The yeast tends to live on dead skin and gravitates towards oil. Also, the yeast tends to spread in warm, humid weather, which is why I was always noticing it more in the late spring and summer. “The yeast is an opportunist, so when conditions are ripe for it to multiply, it gets going,” says Schultz. No wonder the American Academy of Dermatology lists it as one of the most common skin diseases in tropical and sub-tropical areas. Once you’ve been diagnosed with tinea versicolor, it’s not something that can be cured. The yeast malassezia is always there as a part of the microbial ecosystem on your skin, and the patches can keep recurring, but there are ways to manage the symptoms.

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So how do you treat it?

Schultz recommends over-the-counter shampoos or body cleansers with chemical exfoliants like salicylic or glycolic acid to get tinea versicolor under control. “Because it just lives in the superficial layers of skin, anything that gets rid of the top layer of dead cells is really going to work,” he says. Or you can use anti-fungal shampoos with active ingredients that actually kill the yeast instead of just peeling it off. Look for selenium sulfide on the label, which you can find in Selsun Blue shampoo ($9, walgreens.com). And if you see a dermatologist, they’ll probably prescribe you Ketoconazole shampoo, which is a stronger anti-fungal shampoo. No matter which product you choose, the method is the same: Apply the product to the hair and on your body where the rash is present. Leave on for 5-10 minutes, then rinse.

“The way we know the infection has been controlled is that there’s no flaking left, the edges aren’t raised anymore, and there’s no itching or pinkness,” says Schultz. But it can come back and spread, especially in the summer months or if you’re not treating the malassezia. When it returns, restart the treatment with a medicated shampoo.

I used the Ketoconazole shampoo every day for a week, then once a week for a month. And it helped tremendously. It stopped the spreading down my stomach and back, making this summer the first time I’ve had clear skin for a full season. Although there is still a faint discoloration, I’m really the only one who can tell it’s there. There’s no one asking what’s going on when I wear a V-neck. No pointing children, and I no longer hide under big necklaces.

After talking to Schultz and Prystowsky, it’s good to know how common tinea versicolor really is. It’s not some freaky genetic thing my sisters and I have, but something a lot of people deal with. “I think the main thing to know is that it’s a nuisance, but something [you] shouldn’t be medically afraid of,” says Prystowsky.

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