Natural tinea versicolor treatment

How To Get Rid Of Tinea Versicolor + Symptoms, Causes, And Diet Tips Shaheen Naser Hyderabd040-395603080 December 19, 2019

Do you have discolored patches over certain areas of your skin? And do you live in a hot climate? If you answered yes to both these questions, you have most probably developed a fungal skin condition called tinea versicolor. To know more about this condition and its treatment options, continue reading.

Contents

Table Of Contents

  • What Is Tinea Versicolor?
  • Signs And Symptoms Of Tinea Versicolor
  • Causes And Risk Factors For Tinea Versicolor
  • ‎How Is Tinea Versicolor Diagnosed?
  • Home Remedies To Treat Tinea Versicolor
  • Diet Tips
  • Prevention Tips

What Is Tinea Versicolor?

There is a fungus called Malassezia that lives on the surface of your skin. Although it usually doesn’t cause any health problems, this fungus can sometimes grow out of control and cause changes in the natural color of your skin. As a result, you may develop patches that are lighter or darker than the surrounding skin.

This condition is referred to as tinea versicolor. Another term used for this condition is pityriasis versicolor.

One of the main signs of the onset of this condition is a discolored patch or patches that surface on your skin. These patches occur in various forms. The following section lists the symptoms of tinea versicolor.

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Signs And Symptoms Of Tinea Versicolor

The most prominent symptom of tinea versicolor are discolored skin patches that can occur on your arms, chest, neck, or even back.

These patches might be:

  • Discolored as compared to the surrounding skin
  • Red, brown, pink or slightly tanned
  • Itchy, scaly, and dry
  • More evident with tanning
  • Disappear in cooler and less humid weather

The exact cause of this uncontrolled growth of malassezia fungus is not yet established. However, some factors are known to promote the growth of this fungus and increase the risk of infection.

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Causes And Risk Factors For Tinea Versicolor

Factors that can promote the growth of malassezia fungus are:

  • Hot and/or humid climate
  • Sweating a lot
  • Oily skin
  • Weak immunity
  • Hormonal changes

Some factors can increase your risk of developing this skin condition. They include:

  • A family history of tinea versicolor
  • Living in a subtropical climate
  • Taking medications that may weaken your immune system
  • Cancer
  • Taking medications that may disrupt your hormonal balance

One of the easiest ways to find out if you have developed tinea versicolor is to observe yourself physically and look for discolored patches. Your doctor may also conduct the following tests to check for the onset of tinea versicolor.

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‎How Is Tinea Versicolor Diagnosed?

Tinea versicolor can usually be diagnosed by looking at your skin. However, if such a diagnosis is not possible, your doctor may ask to take the following tests:

  • A skin scraping test that involves scraping the affected skin and observing it under a microscope for the fungus.
  • Potassium hydroxide (KOH) microscopy, which involves observing scraped skin with a KOH solution under a microscope.
  • Biopsy, which requires the outer layer of your skin to be tested.
  • Wood’s lamp test, which involves the use of a special machine called Wood’s lamp that uses ultraviolet rays to check for the presence of fungus on your skin.

If the presence of the fungus is confirmed, you can begin with the treatment almost immediately. The treatment for this condition can also be initiated right at home with the help of some basic home remedies that are listed below.

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How To Get Rid Of Tinea Versicolor Naturally

    1. Essential Oils
    2. Baking Soda
    3. Garlic
    4. Vitamins
    5. Yogurt
    6. Coconut Oil
    7. Apple Cider Vinegar
    8. Aloe Vera
    9. Castor Oil
    10. Epsom Salt
    11. Grapefruit Seed Extract
    12. Neem
    13. Turmeric
    14. Candle Bush
    15. Honey

Home Remedies To Treat Tinea Versicolor

1. Essential Oils

a. Tea Tree Oil

  • 7 drops of tea tree oil
  • 1 teaspoon of coconut oil
  1. Mix seven drops of tea tree oil with a teaspoon of coconut oil.
  2. Apply the mixture to the affected areas.
  3. Leave it on for 30 to 60 minutes before washing it off.

You must do this 2 to 3 times daily.

Tinea versicolor might result in itchy and discolored skin. The anti-inflammatory properties of tea tree oil can help in relieving the itching, while its antifungal activities eliminate the fungus causing this condition (1).

b. Eucalyptus Oil

  • 6-7 drops of eucalyptus oil
  • 1 teaspoon of any carrier oil (coconut oil, jojoba oil, etc.)
  1. Take six to seven drops of eucalyptus oil and add a teaspoon of any carrier oil to it.
  2. Massage this mixture into the affected areas and leave it on for 30 to 40 minutes.
  3. Wash it off and pat your skin dry.

Do this multiple times daily.

Eucalyptus oil contains a compound called eugenol, which is popular for its anti-inflammatory and antimicrobial actions. It helps relieve the symptoms of tinea versicolor and can also be used to fight the malassezia fungus (2).

c. Patchouli Oil

  • 8 drops of patchouli oil
  • 1 teaspoon of coconut oil
  1. Mix eight drops of patchouli oil with a teaspoon of coconut oil or any other carrier oil.
  2. Massage this mixture gently into the affected skin.
  3. Leave it on for 20 to 40 minutes and wash it off.
  4. You can also leave this on overnight.

You must do this thrice daily.

Patchouli oil helps soothe inflamed and itchy skin. It is also a great remedy to fight fungal infections, thanks to its antifungal properties – which also help treat tinea versicolor (3), (4).

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2. Baking Soda

  • 1-2 teaspoons of baking soda
  • Water (as required)
  1. Take two teaspoons of baking soda and add a few drops of water to it.
  2. Apply the paste to the affected areas and leave it on for 20 to 30 minutes.
  3. Wash the mixture off with water.
  4. You can also mix a teaspoon of baking soda with a glass of water and consume it.

You must do this on a daily basis.

Fungi cannot survive in an alkaline environment. The pH of your skin is usually acidic. Baking soda makes it alkaline and soothes itching (5).

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3. Garlic

Minced garlic

  1. Mince some garlic and extract the juice.
  2. Apply the garlic extract to the affected area and leave it on for 20 to 30 minutes.
  3. Wash it off with water.
  4. You can also consume two cloves of garlic daily on an empty stomach.

Do this twice daily.

Garlic is a rich source of a compound called allicin. This organosulfur compound is known for its powerful anti-inflammatory and antimicrobial activities that can be used to treat tinea versicolor and its symptoms (6).

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4. Vitamins

Vitamins A, D, and E can help treat tinea versicolor. They regulate your melanin production and promote faster recovery (7), (8). These vitamins are also great antioxidants and exhibit healing properties.

These vitamins are available in spinach, turnips, kale, eggs, milk, fish, and broccoli. You can also take additional supplements you are deficient in these vitamins, but only after consulting a doctor.

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5. Yogurt

You Will Need

Plain yogurt (as required)

What You Have To Do

  1. Take some plain yogurt and apply it directly to the affected skin.
  2. Leave it on for 30 minutes, after which you can wash it off with water.

How Often You Should Do This

You must do this 2 to 3 times daily.

Why This Works

Yogurt is rich in probiotics, which display antifungal activities. They can be used to treat the malassezia fungus that causes tinea versicolor (9).

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6. Coconut Oil

Coconut oil (as required)

  1. Apply coconut oil to the affected areas.
  2. Leave it on for 30 minutes or overnight before washing it off.

You must do this 2 to 3 times daily.

The anti-inflammatory, analgesic, and antifungal activities of coconut oil can aid the treatment of tinea versicolor. The presence of monolaurin makes coconut oil a wonderful remedy (10), (11).

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7. Apple Cider Vinegar

  • 1 tablespoon of apple cider vinegar
  • 1 cup of water
  • Cotton pads
  1. Add a tablespoon of apple cider vinegar to the water.
  2. Dip a cotton pad into the solution and apply it to the affected areas.
  3. You can also drink this solution once a day.

Do this 2 to 3 times daily for effective results.

The acetic acid in apple cider vinegar exhibits remarkable anti-inflammatory properties, which (along with the antifungal properties) help relieve the inflammation and infection associated with tinea versicolor (12).

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8. Aloe Vera

1 tablespoon of aloe vera gel

  1. Take a tablespoon of aloe vera gel and gently spread it all over the affected area.
  2. Leave it on for about 30 minutes and then wash it off.

You must do this multiple times daily until you notice a difference.

Aloe vera’s healing nature can speed up your recovery. It also has powerful anti-inflammatory and antifungal properties that can help you get rid of tinea versicolor (13), (14).

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9. Castor Oil

Castor oil (as required)

  1. Take a little castor oil in your hands and apply it all over the discolored skin.
  2. Leave it on for 20 to 30 minutes and wash it off with plain water.
  3. You can also keep the oil on overnight.

Apply castor oil multiple times on the affected area daily.

The ricinoleic acid (ricinoleate) in castor oil exhibits anti-inflammatory and antimicrobial activities that help treat tinea versicolor (15), (16).

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10. Epsom Salt

  • 1 cup of Epsom salt
  • Water
  1. Add a cup of Epsom salt to a tub filled with water.
  2. Soak in it for 20 to 30 minutes.
  3. Pat your skin dry.

Do this once daily.

Epsom salt contains magnesium, which helps reduce inflammation. The topical application of Epsom salt helps in treating the inflammatory symptoms of tinea versicolor (17).

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11. Grapefruit Seed Extract

  • A few teaspoons of grapefruit seed extract
  • Cotton pads
  1. Dip a cotton pad in a few teaspoons of grapefruit seed extract.
  2. Apply it to the affected skin.
  3. Leave it on for 30 minutes and wash it off with plain water.

You must do this 2 to 3 times daily.

Grapefruit seed extract is a powerful anti-inflammatory and antifungal remedy that can be used to combat the fungus that causes tinea versicolor (18).

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12. Neem

  • A handful of neem leaves
  • Water
  1. Take a handful of neem leaves.
  2. Add water to them and blend.
  3. Apply the neem paste to the affected areas.
  4. Leave it on for about 30 minutes and rinse it off.

You must do this 3 to 4 times daily.

Neem is a popular herbal medicine. It helps reduce inflammation in your skin and fights fungal infections with its anti-inflammatory and antifungal properties (19), (20). The topical application of this herb can work wonders in treating tinea versicolor.

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13. Turmeric

  • 2 teaspoons of turmeric powder
  • Water (as required)
  1. Take two teaspoons of turmeric powder and add a little water to make a thick paste (not runny).
  2. Apply the paste all over the discolored skin.
  3. Leave it on for about 20 to 30 minutes.
  4. Wash it off with water.

Do this thrice daily.

The main constituent of turmeric is curcumin, which has antifungal as well as anti-inflammatory properties that amazingly work well against tinea versicolor (21), (22).

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14. Candle Bush

  • Candle bush leaves
  • Olive oil (as required)
  1. Take a handful of candle bush leaves.
  2. Pour a little olive oil – just enough to make a paste.
  3. Leave the concoction on for about 30 minutes and rinse it off.
  4. You can also apply the candle bush preparation that is readily available in the market for this purpose.

You must do this 2 to 3 times daily.

Candle bush leaves contain effective antifungal compounds. Which is why they can be effective against tinea versicolor, as per a study published in Ethnopharmacology in 1994 (23).

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15. Honey

Organic honey (as required)

  1. Take some honey and apply it to the affected areas.
  2. Leave it on for at least 30 minutes and then wash it off.

Do this several times daily.

Given the healing, anti-inflammatory, and antifungal properties of honey, it is no surprise that it can effectively treat tinea versicolor and its symptoms (24).

Along with these remedies, it is also important to consider altering your diet for treating tinea versicolor and preventing its recurrence.

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Diet Tips

If you are have tinea versicolor, you must pay extra attention to your regular diet. Following are two lists –foods that you must eat more of, and foods that are best avoided when you are suffering from tinea versicolor. Take a look.

What To Eat
  • Probiotic-rich yogurt
  • Low-carb foods like broccoli, green beans, avocados, etc.
  • Protein-rich foods like fish, meat, eggs, and poultry
  • Garlic
What Not To Eat
  • Sugar
  • Alcohol
  • Vinegar
  • Nuts
  • Fruits

You must also make a few changes to your usual lifestyle to assist your recovery. This can be done by simply following these prevention tips.

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Prevention Tips

  • Avoid hot and humid climates.
  • Do not tan or expose yourself to the sun too much.
  • Try and sweat minimally.
  • Do not indulge in intense exercises.
  • Take a bath twice a day.
  • Don’t let sweat dry up on your skin. Wipe it with a handkerchief.

Even if you follow the prevention tips, the chances of recurrence of this condition are high. Hence, you must be at your attentive best and avoid all triggers.

Most of the remedies discussed here are effective in treating cases of tinea versicolor and can be confidently tried at home. Would you like to share any more remedies with us? Get in touch with us via the comments section below.

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Expert’s Answers For Readers’ Questions

Is tinea versicolor the same as vitiligo?

No. Vitiligo is a result of dysfunctionalilty of the cells that produce melanin, while tinea versicolor is a skin condition caused by a yeast fungus called Malassezia.

How long does tinea versicolor last?

In about two weeks, the physical symptoms like scaly and dry skin will be resolved. However, it may take about 6 to 12 months for your normal skin color to be restored.

Which is the best soap for tinea versicolor?

Antifungal soaps (like Naturasil Tinea Versicolor) soap are often recommended for the treatment of tinea versicolor. Zinc pyrithione is another soap used for treating tinea versicolor.

Which antifungal cream is best for tinea versicolor?

Creams containing antifungal ingredients like clotrimazole, miconazole, selenium sulfide, and terbinafine are recommended for the treatment of tinea versicolor. Another popularly used lotion is the one made of selenium disulfide, which is also used as a shampoo, called Selsun Blue. You can also use any of the above remedies if you are looking for natural alternatives.

Does tinea versicolor itch?

Although the discolored skin patches are not contagious or painful, they may become scaly and itchy.

Which area of your body is most affected by tinea versicolor?

Tinea versicolor can affect any part of your body, but it is most likely to affect your neck, chest, back, and arms.

24 sources

Stylecraze has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

    • Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties, Clinical Microbiology Reviews, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360273/
    • Antimicrobial efficacy of eucalyptus oil and 1,8-cineole alone and in combination with chlorhexidine digluconate against microorganisms grown in planktonic and biofilm cultures. Journal of Antimicrobial Chemotherapy, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/19837714/
    • Anti-inflammatory activity of β-patchoulene isolated from patchouli oil in mice. European Journal of Pharmacology, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/27090925/
    • Antifungal effect of Allium tuberosum, Cinnamomum cassia, and Pogostemon cablin essential oils and their components against population of Aspergillus species. Journal of Food Science, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/23647469/
    • Sodium bicarbonate, PubChem, US National Library of Medicine, National Institutes of Health.
      https://pubchem.ncbi.nlm.nih.gov/compound/Sodium-bicarbonate#section=Therapeutic-Uses
    • Antimicrobial properties of allicin from garlic. Microbes and Infection, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/10594976/
    • Role of vitamins in skin care. Nutrition, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/11684391/
    • Vitamin E in dermatology, Indian Dermatology Online Journal, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976416/
    • Antimicrobial potential of probiotic lactic acid bacteria. Mededelingen / Faculteit Landbouwkundige en Toegepaste Biologische Wetenschappen, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/15954651/
    • Anti-inflammatory, analgesic, and antipyretic activities of virgin coconut oil. Pharmaceutical Biology, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/20645831/
    • In vitro evaluation of antifungal activity of monolaurin against Candida albicans biofilms. PeerJ, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/27366648/
    • Antifungal Activity of Apple Cider Vinegar on Candida Species Involved in Denture Stomatitis. Journal of Prosthodontics, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/25219289/
    • Antifungal activity of Aloe vera leaves. Fitoterapia, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/17336466/
    • Antiinflammatory activity of extracts from Aloe vera gel. Journal of Ethnopharmacology, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/9121170/
    • Synthesis and evaluation of antioxidant and antifungal activities of novel ricinoleate-based lipoconjugates of phenolic acids. Food Chemistry, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/23442675/
    • Effect of ricinoleic acid in acute and subchronic experimental models of inflammation. Mediators of Inflammation, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781768/
    • Magnesium Decreases Inflammatory Cytokine Production: A Novel Innate Immunomodulatory Mechanism, The Journal of Immunology, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3884513/
    • . Wiadomości parazytologiczne, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/16886437/
    • Anti-inflammatory, pro-apoptotic, and anti-proliferative effects of a methanolic neem (Azadirachta indica) leaf extract are mediated via modulation of the nuclear factor-κB pathway, Genes & Nutrition, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092905/
    • Antifungal activity of different neem leaf extracts and the nimonol against some important human pathogens, Brazilian Journal of Microbiology, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768785/
    • Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Alternative Medicine Review, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/19594223/
    • Antifungal curcumin induces reactive oxygen species and triggers an early apoptosis but prevents hyphae development by targeting the global repressor TUP1 in Candida albicans. Bioscience Reports, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/20017731/
    • A study on the therapeutic efficacy of Cassia alata, Linn. leaf extract against Pityriasis versicolor. Journal of Ethnopharmacology, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/m/pubmed/8046939/
    • Honey: A Therapeutic Agent for Disorders of the Skin, Central Asian Journal of Global Health, US National Library of Medicine, National Institutes of Health.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661189/

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Shaheen Naser

Shaheen holds a postgraduate degree in Human Genetics and Molecular Biology. She is a Geneticist with proficiency in Biotechnology, Immunology, Medical Genetics, Biochemistry, Microbiology, and Genetic Counseling. Her passion for writing and her educational background have assisted her substantially in writing quality content on topics related to health and wellness. In her free time, Shaheen loves to explore the world and the different flavors/cuisines it has to offer. Photography is another hobby she has developed of late.

Tinea Versicolor

Dr. Greene’s Answer

Tinea versicolor is a mild, superficial fungal infection, somewhat similar to ringworm (true ringworm can also result in white patches). Since the affected skin doesn’t change color well with sun exposure, it usually becomes apparent as white patches during the summer months. In the winter it may seem to disappear, or even seem to become slightly darkened patches as the surrounding skin gets paler (this is where the name versicolor comes from).

Tinea versicolor is most common in adolescents and young adults 15 to 30 years old (although it can certainly happen at any age). The infection is chronic and recurs easily, but it causes no other health problems. People are most susceptible to the fungus during hot months in humid areas. Taking steroids, excessive sweating, wearing tight-fitting clothing, and chronic illness can all predispose a person to tinea versicolor, but someone without any of these factors can still get this mild infection.

The patches of tinea versicolor can appear white, tan, or pink. The white patches look very similar to pityriasis alba. There are two good ways to tell them apart.

The most reliable way is to have a doctor gently scrape the white patch, dissolve the scrapings in potassium hydroxide, and look at what is left under a microscope. The classic “spaghetti-and-meatball” appearance of budding yeast confirms the diagnosis of tinea versicolor. A quicker and easier approach is to look at the patches under a black light. The patches of tinea versicolor will usually light up with a blue-white, yellow, or orange color.

Topical antifungal medicines are very effective for treating tinea versicolor, but there is a more convenient, less expensive, highly effective alternative. Selenium shampoos are great at getting rid of the fungus. Simply apply a thin layer over the affected skin before bed (with a wide surrounding margin, since it may already be beginning to spread). Wash thoroughly the next morning.

The problem is that no matter what the treatment, it comes back easily. Whatever treatment is used for tinea versicolor, all bedding and nightclothes should be changed after treatment to prevent recurrence. Also, re-treating once a week for 3-4 weeks and then once a month for 3-4 months makes it much less likely to come back.

Even when the condition is effectively treated, the white patches will remain for a while. At least several weeks must pass for the newly healthy skin to adjust its color to the amount of ongoing sunlight exposure, so that it will match the surrounding skin.

Tinea versicolor is a common condition that leads to the formation of dry, scaly and discolored patches on the skin. The patches vary from one person to another, and may sometimes be darker or lighter than the rest of the skin.

These patches often develop slowly to form large sections of discolored patches over a period of time. Some of the most common areas affected by this condition include the back, the upper arm region, the trunk and the neck. The condition is sometimes very itchy, but remains harmless for the most part. Many affected persons feel very self-conscious because the condition causes the skin to look unsightly.

There are home treatment options available for the natural treatment of tinea versicolor. To treat this effectively at home, it is important to know the causative agent of this skin condition. The condition, also known as pityriasis versicolor, is the result of a yeast infection known as malassezia. In many cases, the yeast grows normally on the skin.

When the yeast over multiplies, however, it causes the formation of the discolored patches associated with this condition. Some of the risk factors associated with the condition include excessive sweating, hormonal changes, living in a warm environment as well as having an excessive oily skin. Most importantly, the condition is not linked to poor hygiene, and is not contagious. Below are some of the simple home remedies available for tinea versicolor.

1. Aloe Vera:

Time Required: 20 Min
What You Need: Fresh aloe vera leaf and cotton wool. 5 drops of lavender oil (optional).
Difficulty: Easy

Aloe vera is one of the most common and effective home remedies for different skin conditions. When used for the treatment of tinea versicolor, the proteins present in aloe vera help eliminate the fungi that causes skin discoloration. This is attributed to the presence of anti-inflammatory properties in the natural gel. Its anti fungal properties also help curb the spread of the fungi, thus reducing the associated symptoms of the condition. Additionally, when applied on the skin, the aloe vera helps heal the damaged skin and speeds up the process of recovery. You may add a few drops of lavender oil to the gel in order to improve the remedy’s efficiency.

Directions:

  1. Make a sharp cut on the aloe vera leaf in order to extract the gel.
  2. Collect enough gel depending on the extent of the skin condition.
  3. If you opt to use lavender oil, add a few drops at this point and mix well.
  4. Soak the cotton wool in the gel and apply it on the skin.

2. Garlic Cloves:

Time Required: 30 Min
What You Need: Fresh garlic cloves, pestle and mortar, clean piece of cloth and warm bath water. Garlic supplements (optional).
Difficulty: Easy

In dealing with fungal skin conditions, one of the best home remedies you can use is fresh garlic cloves. Garlic is a potent anti-fungal, thanks to the presence of an active ingredient known as allicin. When applied topically, the garlic paste/juice destroys the fungal population and helps heal the discolored skin patches. Regular use of this home remedy works perfectly to eliminate the itching and provide much-needed relief from the symptoms of tinea versicolor. In addition to the raw garlic, you may also take supplements available from your local chemist.
NOTE: Consult your doctor if you have high blood pressure and associated conditions to prevent drug-drug interactions.

Directions:

  1. Peel and chop the garlic cloves before transferring them to the mortar.
  2. Pound the chopped garlic using the pestle until you have a paste-like substance.
  3. You may use this paste in its state, or place the paste in a clean cloth and squeeze to release the juice.
  4. Apply the paste or juice on the skin and allow to dry for a few minutes.
  5. Wind up the experience with a warm bath to wash off the garlic.
  6. Use this remedy daily, alongside garlic supplements.

NB: If you are concerned about the pungent smell of garlic, you can always rub your hands/skin using freshly squeezed lemon juice. This not only eliminates the characteristic smell, it also rejuvenates the skin and allows for quick healing.

3. Tea Tree Oil:

Time Required: 20 Min
What You Need: Tea tree oil, carrier oil (such as extra virgin olive/ coconut oil), cotton wool and warm water to rinse.
Difficulty: Easy

Tea tree oil, just like garlic cloves, has potent anti-fungal properties that make it a reliable remedy for the natural treatment of tinea versicolor. The oil not only prevents the spread of the infection, it also provides great relief from the severe itchiness. The advantage of using tea tree oil is that it effectively prevents the recurrence of the infection. Note that when using tea tree oil, you must add a carrier oil to prevent skin irritation. Coconut oil, jojoba and olive oil are excellent options for this.

Directions:

  1. Mix the 5 drops of tea tree oil with 1 tablespoon of carrier oil (either coconut or olive oil).
  2. Soak the cotton wool in the oil mixture and use it to apply on the affected skin.
  3. Let the oil mixture dry on its own in order to allow the healing properties of the oil set it.
  4. Rinse the skin using warm water and dry well.
  5. Use this remedy thrice daily for best results.

4. Oregano Oil:

Time Required: 30 Min
What You Need: Oregano essential oil, extra virgin olive oil, cotton wool and warm water. Oregano oil supplements.
Difficulty: Easy

You can easily treat tinea versicolor using orgenao oil as it is one of the most effective anti-fungal oils available. The oil also destroys the fungi and reduces the itchiness that abounds in this skin condition. In addition to the oil, you may also take oregano supplements to help speed up the healing process.

Directions:

  1. Mix the oregano essential oil with the olive oil.
  2. Use cotton wool to apply the oil mixture on the affected skin and leave it to dry for about half an hour.
  3. Rinse the oil mixture off after 30 minutes.
  4. Follow this remedy through on a daily basis until the skin patches clear.

5. Extra Virgin Coconut Oil:

Time Required: 30 Min
What You Need: 1 Tablespoon of extra virgin coconut oil and cinnamon oil (optional).
Difficulty: Easy

Coconut oil is an ideal home remedy for the natural treatment of any type of skin fungal infection. This is what makes it ideal for the treatment of tinea versicolor. In fact, the presence of medium chain fatty acids present in the oil halts the growth of the fungi responsible for this skin condition. Add cinnamon oil to reduce the itchiness and improve the efficiency of the remedy.

Directions:

  1. Simply apply the extra virgin coconut oil on the skin and let it dry on its own.
  2. Alternatively, mix the coconut oil with the cinnamon oil and apply on the skin patches affected by the fungal infection.

6. Yogurt:

Time Required: 30 Min
What You Need: Plain yogurt and warm water.
Difficulty: Easy

Yogurt is a natural remedy for fungal infections such as Tinea Versicolor. The presence of probiotics in the yogurt is responsible for keeping the growth and spread of the fungi in check. This has proven to be a reliable cure, one that also prevents the recurrence of the fungal infection. All you need for this remedy is yogurt (preferably plain/natural) and warm water for rinsing purposes.

Directions:

  1. Simply slather a generous amount of the yogurt on the affected part of the skin.
  2. Let the yogurt stay on the skin for half an hour or so and then wash off with warm water.

7. Neem Plant:

Time Required: 20 Min
What You Need: A handful of neem leaves, 2 cups of water and a strainer. Neem oil and choice carrier oil (optional).
Difficulty: Easy

Neem, also known as Indian Lilac, has long been used for the natural cure of skin fungal infections. The herb’s potent healing properties help manage the growth and spread of the fungi that leads to tinea viscolor. Used on a regular basis, the leaves provide relief from the itchiness as well as enhance speedy recovery. If you cannot get neem leaves, you may use neem oil as a substitute. Remember to add a carrier oil for this option in order to prevent skin irritation.

Directions:

Using Neem Leaves

  1. Wash the neem leaves well before preparing this remedy.
  2. Place the washed neem leaves in a pan and pour over the water.
  3. Boil the mixture for 10 minutes and then pass through a strainer.
  4. Let the solution cool and then apply to the affected skin.
  5. The other option for the use of neem leaves is to grind them until you get a paste which you can then apply on your skin. Rinse the skin well and pat dry.
  6. Use this remedy twice daily for a couple of weeks until you notice an improvement in your skin condition.

Using Neem Oil

  1. Neem oil has the same benefits as neem leaves, but must be used alongside a carrier oil to prevent skin irritation at the site of application.
  2. Simply mix the neem oil with your preferred carrier oil and apply on the affected skin twice daily until the infection clears and the discolored patches are treated.

8. Apple Cider Vinegar:

Time Required: 20 Min
What You Need: 1/2 Cup each of apple cider vinegar and warm water (used for dilution) and cotton wool.
Difficulty: Easy

Apple cider vinegar, like tea tree oil, is one of the most versatile home remedies for the natural treatment of tinea viscolor. This is because it has antimicrobial properties which are known to keep the proliferation of fungi in check. this remedy is simple to use, and all you need to do is dilute it as indicated in the directions below.

Directions:

  1. Mix equal amounts of the Apple cider vinegar with the warm water and soak the cotton ball in it.
  2. Apply the mixture on the affected skin and allow it to dry before rinsing using warm water.
  3. Use this remedy at least once daily for effective treatment.

9. Baking Soda:

Time Required: 30 Min
What You Need: Baking soda and warm water (amount varies depending on the extent of skin affected by the infection).
Difficulty: Easy

Baking soda, sometimes referred to as sodium bicarbonate (as this is the only active ingredient present), is recommended for the natural treatment of tinea viscolor. The remedy works because it is an antacid, and tinea viscolor requires an acidic environment to thrive in. By creating a balance in the pH levels and lowering the acidity, baking soda is able to contain the spread of the fungal infection. You need water to create a paste for topical application, preferably used after a shower.

Directions:

  1. Add some water to the baking soda and stir until you get a paste with the desired consistency.
  2. Apply the paste on the part of the skin ravaged by tinea viscolor.
  3. Leave the paste on for about 10 minutes and then gently scrub the skin. This allows for exfoliation and speeds up the healing process.
  4. Rinse the paste using warm water and use this remedy daily.

In addition to the home remedies listed above, it is important to eat healthy. The simple logic for this is that a weak immune system predisposes you to flares of tinea viscolor. Strengthening the immunity on the other hand, helps the body fight off infection and speeds up the healing process. If you have any concerns around tinea viscolor, book an appointment with a dermatologist to chart the way forward.

Malassezia yeasts, everywhere and sometimes dangerous

The article by Teun Boekhout, from the CBS-KNAW Fungal Biodiversity Center in Utrecht, The Netherlands, and colleagues from Greece and Italy, is the fifth and final one in a series on Malassezia, and focuses on its role as a pathogen. Most of the problems caused by Malassezia yeasts are skin diseases. Some of them, like dandruff and atopic eczema in humans or external ear infections in dogs, are very common.

While treatments exist for most of these, the researchers point out that when treating Malassezia skin diseases, “one should always bear in mind that Malassezia yeasts are integral components of the skin microbiota, and therefore the therapeutic target should be controlling the Malassezia population rather than eradicating it.”

Malassezia bloodstream infections are less common, but premature infants and immunocompromised patients with extended stays in intensive care are at risk. Such infections are often linked to catheterization that facilitates internalization of the yeasts, either from the patient’s own skin or from someone else’s. Because routine tests in patients with blood infections of un-known origin often do not detect Malassezia right away, diagnosis might be delayed, which can be dangerous. However, once Malassezia is identified as the culprit, therapy with antifungal drugs is usually successful in eliminating the pathogen from the bloodstream.

As humans, we are covered head-to-toe with Malassezia–but that is not all. As Keisha Findley and Elisabeth Grice describe in their contribution to the series, healthy skin is actually cultivated by a well-balanced mix of bacteria and fungi (yeasts and molds), and this “skin flora” does not appear to elicit defense reactions by our immune system. How Malassezia interacts with other skin microbes is not yet known, but researchers think that both changes in the flora and changes in the immune system can disturb this peaceful equilibrium and lead to a range of skin diseases.

One of the reasons why, despite our intimate association, we do not know more about Malassezia, is that the yeasts cannot easily be isolated and grown in a laboratory environment. Malassezia are lipophilic, meaning they like fat. Human skin contains sebaceous glands that produce fats to lubricate and waterproof the skin, and Malassezia brakes down these fats and uses them as its main energy source.

As the yeasts metabolize the skin surface fat, they form break-down products that can potentially trigger harmful reactions by the skin. For example, Boekhout and colleagues discuss the intriguing possibility that Malassezia is involved in the development of skin cancer, because some of its fat breakdown products can activate known tumor-promoting pathways in the skin that are similar to those triggered by sun light.

How Malassezia strains that live in radically different environments (including the marine forms discussed by Anthony Amend in his Pearl) interact with their surroundings and obtain energy is still a mystery. However, Malassezia yeasts have been found pretty much any place scientists have looked for them–often in very large numbers–and are likely to play important roles in the both the healthy and diseased states of these environments.

Tinea versicolor: What is it?

Share on PinterestTypical treatment options offered by doctors include specific creams and lotions.

Many treatment options are available for tinea versicolor. What a doctor uses to treat tinea versicolor depends on factors such as climate, area infected, thickness of the infection, and where on the body the infection appears.

The most typical treatment options include:

  • Creams and lotions containing selenium sulfide, ketoconazole, or pyrithione zinc
  • Medicated shampoos and body washes for use during times when flares are expected, such as during periods of very hot, humid weather
  • Oral antifungal medication for use when large areas of the body are infected

It is important for people to follow all instructions on how to use the medicine. Failure to use the full amount or inconsistency in the usage may cause the infection to grow back quickly.

Home remedies and lifestyle tips

Tinea versicolor can be prevented and managed with some simple home remedies and lifestyle changes. Keeping the skin clean and oil-free is the most important thing that can be done to keep a tinea versicolor infection from occurring.

Over-the-counter lotions and creams can help both prevent and treat mild flare-ups. Some example products include:

  • Clotrimazole cream or lotion
  • Terbinafine cream or gel
  • Miconazole cream
  • Selenium sulfide 1 percent lotion
  • Zinc pyrithione soap

Keeping the skin covered and avoiding prolonged exposure to ultraviolet light is also important. This includes ultraviolet light from being outside and from using a tanning bed.

Prevention

The most effective method of prevention is hygiene. Removing excess oils and dirt from the skin can help protect someone from contracting this infection.

Antifungal lotions and shampoos that are available over the counter offer a good means of prevention. These same products can also help keep a mild infection under control.

Additionally, taking some extra steps to keep dry in hot and humid weather and avoiding excessive exposure to sunlight may help to stop the growth of tinea versicolor.

Outlook

The outlook for people who contract tinea versicolor is very good. It is not generally painful, only mildly itchy, and is not contagious.

Despite being generally responsive to treatments, it is an easily recurring infection and difficult to get completely under control.

Abstract

Malassezia furfur, a lipophilic, dimorphic and yeast-like fungus, occurring in human skin as an opportunistic pathogen, causes diseases such as dandruff, pityriasis versicolar, seborrheic dermatitis, etc. Suitable media for culturing the organism were standardized. A modified medium for the culturing of M. furfur has been proposed. Growth of the fungus was also determined in the presence of different carbon sources under the influence of different temperature, pH and salinity. Plant extracts of 19 species were screened against the growth of the fungus by using disc diffusion method and the results are discussed.

Keywords: Dandruff, Malassezia furfur, biochemical characters, growth factors, medicinal plants

How to cite this article:
Vijayakumar R, Muthukumar C, Kumar T, Saravanamuthu R. Characterization of Malassezia Furfur and its control by using plant extracts. Indian J Dermatol 2006;51:145-8

Introduction

Mycotic infection of the skin by the dermatophytes may be categorized into superficial and deep fungal infections. Malassezia furfur (Pityrosporum ovale) , a lipophilic fungus, affects the hair and causes diseases called dandruff and also called pityriasis versicolar, tinea circinata, seborrheic dermatitis. Dandruff is a condition, which causes small white flakes of skin that separate and fall from the scalp. People who suffer from dandruff have over active sebaceous glands, which make their scalp oily. It has been investigated and reported that there was no complete cure for this disease. The influence of the plant extracts of 19 species on the growth of M. furfur has been investigated and reported.

Materials and Methods

Collection and maintenance the culture
Pure culture of M. furfur (MTCC: 1374) was obtained from Institute of Microbial Technology, Chandigarh, India. The culture was maintained in Emmon’s modified medium (dextrose 40 g, peptone 10 g and agar 18 g with corn oil 2 ml/litre).
Morphological characteristics
Culture was stained with methylene blue and examined under the high power objective of the microscope, and the characters were recorded.
Biochemical tests
The organism was biochemically analysed by using gelatin hydrolysis test, litmus milk reaction, carbohydrates viz., dextrose, xylose, rhamnose, raffinose and mannital fermentation tests also performed and the results were recorded.,

Effect of fatty substances on the growth of M. furfur:
Six different fatty substances namely, corn oil, butter, olive oil, coconut oil, oleic acid and castor oil were mixed (2 ml) with both liquid and solid media of Sabouraud’s dextrose medium, and without fatty substance medium also maintained. Growth rate of M. furfur was recorded.
Screening of suitable media:
Since the Emmon’s modified medium did not show well developed growth of the organism, eight different media namely, Czapek’s dox medium, corn meal medium, rose bengal medium, nutrient medium, potato dextrose medium, malt extract medium, Sabouraud’s dextrose medium and Sabouraud’s maltose medium both solid and liquid media were screened for determining the suitable medium.
Effect of temperature on the growth of M. furfur:
One ml of the pure culture broth of M. furfur was inoculated into each tube containing sterilized liquid Sabouraud’s dextrose medium and incubated at 10 ± 2, 20 ± 2, 30 ± 2 and 40 ± 2oC for 7 days.
Effect of pH on the growth of M. furfur:
pH of liquid Sabouraud’s dextrose medium was adjusted to 4.10 by using 1N NaOH and 1N Orthophosphoric acid. one ml of pure culture of M. furfur was inoculated into the tubes containing the liquid medium adjusted with different pH, and incubated 30 ± 2oC for 7 days.
Effect of salinity: Liquid Sabouraud’s dextrose medium has the salinity 20 ppt. It was adjusted to 40, 60, 80 and 100 ppt by using Sodium Chloride (NaCl). Pure culture of the organism was inoculated into each tube and incubated at 30 2°C for 7 days.

Effect of carbon sources

a) Peptone: Peptone was added to the liquid Sabouraud’s dextrose medium in the concentration of 0, 5, 10, 15 and 20 g/litre. Pure culture of M. furfur grown in liquid medium was inoculated and incubated at 30 ± 2°C for 7 days.
b) Dextrose: Similarly dextrose was added to the liquid medium in the concentration of 0, 20, 40, 60 and 80 g/litre. Pure culture of the organism, grown in liquid medium, was inoculated and incubated at 30 ± 2°C for 7 days. The growth of the organism was determined by using spectrophotometer (Turbidity method).
Effect of plant extracts on the growth of M. furfur:
Nineteen plant spp.were collected from in and around Karur District of Tamil Nadu and for their antimycotic activity against M. furfur . The plant partswere washed thoroughly in tap water followed by sterile distilled water and ground by using mortar and pestle. The crude extract was filtered through a nylon cloth and centrifuged at 5,000 rpm for 10 minutes. The supernatant was collected and used for the assay of antimycotic activity. This extract was considered as 100% and it was diluted to 25, 50 and 75% with sterile distilled water.
Antimycotic assay (Disc diffusion method):
The broth culture of M. furfur was swabbed over the Sabouraud’s dextrose agar by using sterile cotton buds. Sterile 5mm diameter Whatman no. 32 filter paper discs were dipped in plant extracts and Clotrimazole (reference antibiotic) were placed equidistantly (3 cm apart) round the margin of the plates. Three replicates were maintained. The plates were incubated at 30 ± 2°C and the zone of inhibition was observed after 7 days. Control was maintained with filter paper discs dipped in distilled water.

Results

Malassezia furfur (Robin) Baillon was developed as white to tan cream in colour and smooth pasty yeast like appearance over the mediuma. Microscopically, the cells are bottle shapedb.
Biochemical characterization
The biochemical tests proved that dextrose and xylose produced acid but there was no gas production. Maltose, lactose, rhamnose, raffinose and mannital were not fermented by M. furfur . Liquefaction of gelatin was observed and there was acidification of litmus milk with curdling after 7 days.
Effect of fatty substances
Among the six fatty substances tested, M. furfur grew well in Sabouraud’s dextrose broth and agar medium containing butter followed by corn oil, olive oil, coconut oil, oleic acid and castor oiland.
Screening of suitable media
Among the different media tested, M. furfur , grew well in Sabouraud’s dextrose agar and its broth contained 2% of buttera followed by Sabouraud’s maltose medium, potato dextrose medium, cornmeal medium, Czapek’s dox medium, malt extract medium, nutrient medium and rose bengal medium.
Influence of temperature, pH, salinity, carbon sources (peptone and dextrose) on the growth of M. furfur
The present investigation establishes that dextrose at 40 g/litre and peptone at 10 g/litre are optimum for the growth of M. furfur in the Sabouraud’s dextrose agar supplemented with butter. It is also established that the optimum temperature 30 ± 2°C, pH as 7-9 and salinity 40ppt for the growth of M. furfura-f.
Effect of plant extracts
Among the nineteen plant extracts tested, the extracts of four plants namely Aloe vera, Eucalyptus globulus, Phyllanthus emblica and Wrightia tinctoria were more effective than other species. The volatile oil of Eucalyptus globulus significantly reduced the growth of M. furfur .

Discussion

Malassezia furfur is a pleomorphic yeast like fungus. It is referred to as Pityrosporum orbiculare and P. ovale depending on the morphology of the cells. When the yeast like cells are rounded and budding from with narrow neck, they are called P. orbiculare and when the yeast like cells are oval and budding form with broad neck, they are called P. ovale . However, commonly in recent years the name Malassezia furfur is widely accepted for all forms of yeast like cells produced by Pityrosporum orbiculare. Hence, in the present study the name M. furfur is used for the yeast like cells of the organism. It has been reported that the growth and morphology of Candida albicans , another yeast like fungus, was controlled by various physicochemical characteristics and the composition of the media., It is also well known that the optimum requirement of physicochemical parameters varies depending on the species and the habitat in which they grow. Optimization of the requirements of Malassezia furfur in the present study showed that the organism grew well at pH 7 to 9, temperature 30 ± 2°C and the salinity at 40 ppt. Similarly, the carbon sources-dextrose and peptone were suitable at 40 g and 10 g/litre respectively.

Commonly Sabouraud’s dextrose agar medium is used for the culturing of dermatophytes. Emmon’s (1970) modified this medium by adding corn oil for the culturing of M. furfur . But, the present study clearly established that the growth of M. furfur was more favoured in the presence of butter than corn oil. Hence, it is suggested that Emmon’s modified medium can be further modified by supplementing Sabouraud’s dextrose agar medium with butter in the place of corn oil.
Antipityrosporum activity of herbal drug, a combination of Wrightia tinctoria and Hibiscus rosasinensis was tested in vitro against the isolates of Pityrosporum ovale recovered from dandruff. In the present investigation nineteen plant extracts were tested for the antimycotic activity against M. furfur . Aloe vera, Eucalyptus globulus, Phyllanthus emblica and Wrightia tinctoria leaf extracts and oil showed antifungal property as they progressively inhibited the growth of M. furfur on Sabouraud’s destrose agar medium. E. globulus (30 ± 1.63) and A. vera (29 ± 1.14) were more effective than other species and antibiotic of Clotrimazole (24.6 ± 0.94) tested. Hence, the extractions of active principle from these plants and their assay against M. furfur have been suggested as future course work.

1. Ranganathan S, Gogul Shangar S, Ranjith MS. Fungal disease of the skin, The Hindu Magazine: 22nd April, 2001.
2. Rippon JW. Superficial Mycoses. Medical Mycology , 2nd ed, 2000. p. 140-53.
3. Chakraborthy U. Why do people get dandruff? Did you know? The New Indian Express: 25th December. 2000.
4. Emmon’s CW. Pityriasis versicolar. Medical Mycology 2nd ed, 1970. p. 156-62.
5. Kannan N. Laboratory Manual of General Microbiology, 1st ed, Palani Paramount Publication: Palani; 1996. p. 120-55.
6. Moore M. Cultivation of Malassezia furfur , etiological agent of pityriasis (tinea) vesicolor. Mycopathol 1938;1:53-61.
7. Damodaran S, Venkataraman S. A study of the therapeutic efficacy of Cassia alata Linn. Leaf extract against pityriasis versicolar. J Ethanopharmocol 1993;42:19-23.
8. Sivamani P. Pityriasis versicolor. In : Medical Mycology, 1st ed, Arcot: 1999. p. 43-4.
9. Rai MK. Effect of different media on the morphology of cultural characteristics of Candida albicans . Curr Sci 1989;58:861-3.
10. Vijayakumar R, Udhayakumar J, Chandrasekaran R. In vitro effect of aqueous garlic extract on Candida albicans , J. Microb World 2004;6:158-61.
11. Krishnamurthy JR, Ranganathan S. Anti Pityrosporum ovale activity of herbal drug combination of Wrightia tinctoria and Hibicus rosasinensis . Indian J Dermatol 2000;45:125-6.

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Tinea Versicolor and Homeopathy
Homeopathic remedies will help a person with tinea versicolor to heal, naturally. Contact us to learn more!

Homeopathic Remedies for Tinea Versicolor

  • Bacillinum
    This is an important nosode for tinea versicolor and also ringworm as well as those with enlarged and tender neck glands. People needing this remedy have a continuous tendency to get colds.

  • Caulophyllum
    Discoloration of skin in women with hormonal disturbances, menstrual and uterine disorders. These people have spots on the forehead and are prone to repeat miscarriages.

  • Chrysarobinum
    This remedy is used successfully in tinea versicolor and various other skin ailments. The person may have itchy and dry scaly eruptions especially around the eyes, ears and extremities.

  • Dulcamara
    Used to for tinea versicolor on hands, arms and face that gets worse on exposure to damp weather and icy coldness. The eruptions are more visible before the appearance of menses or on sexual excitement. The person has itching, which gets worse from cold and wet weather.

  • Sepia
    This remedy for those who are weak with a yellow complexion. Indifference to their loved ones. Aversion to work and family. Discolored patches behind ears, on nape of neck, cheeks, abdomen, bends of elbows and knees with itching not relieved by scratching. The patches get visible every spring. Those needing this remedy will always sit with their limbs crossed. They sweat a lot on feet which have a bad odor.

Other Supports include:

  • Avoid oily products to your skin.

  • Avoid wearing tight, restrictive clothing.

  • Avoid excessive heat and sweating.

  • Avoid excessive sun exposure.

  • Eat a well balanced and healthy diet.

  • Garlic is a very good antifungal agent.

  • Get adequate Vitamin D.

  • Get adequate hydration.

  • Get adequate sleep daily.

  • Practice good hygiene.

Pityriasis versicolor

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Text: Miiskin

What is pityriasis versicolor?

Pityriasis versicolor is a common yeast infection of the skin, in which flaky discoloured patches appear on the chest and back.

The term pityriasis is used to describe skin conditions in which the scale appears similar to bran. The multiple colours of pityriasis versicolor give rise to the second part of the name, versicolor. Pityriasis versicolor is sometimes called tinea versicolor, although the term tinea should strictly be used for dermatophyte fungus infections.

Who gets pityriasis versicolor?

Pityriasis versicolor most frequently affects young adults and is slightly more common in men than in women. It can also affect children, adolescents and older adults.

Pityriasis versicolor is more common in hot, humid climates than in cool, dry climates. It often affects people that perspire heavily. It may clear in the winter months and recur each summer.

Although it is not considered infectious in the conventional sense, pityriasis versicolor sometimes affects more than one member of a family.

What are the clinical features of pityriasis versicolor?

Pityriasis versicolor affects the trunk, neck, and/or arms, and is uncommon on other parts of the body. The patches may be coppery brown, paler than surrounding skin, or pink. Pale patches may be more common in darker skin; this appearance is known as pityriasis versicolor alba. Sometimes the patches start scaly and brown, and then resolve through a non-scaly and white stage.

Pityriasis versicolor is usually asymptomatic, but in some people it is mildly itchy.

In general, pale or dark patches due to pityriasis versicolor do not tend to be more or less prone to sunburn than surrounding skin.

See more images of pityriasis versicolor.

What is the cause of pityriasis versicolor?

Pityriasis versicolor is caused by mycelial growth of fungi of the genus Malassezia.

Malassezia are part of the microbiota (microorganisms found on normal skin). They are dependent on lipid for survival. Fourteen different species of malassezia have been identified. The most common species cultured from pityriasis versicolor are M globosa,M restricta and M sympodialis.

Usually malassezia grow sparsely in the seborrhoeic areas (scalp, face and chest) without causing a rash. It is not known why they grow more actively on the skin surface of patients prone to pityriasis versicolor. One theory implicates a tryptophan-dependent metabolic pathway.

The yeasts induce enlarged melanosomes (pigment granules) within basal melanocytes in the brown type of pityriasis versicolor. It is easier to demonstrate the yeasts in scrapings taken from this type of pityriasis versicolor than in those taken from the white type.

The white or hypopigmented type of pityriasis versicolor is thought to be due to a chemical produced by malassezia that diffuses into the epidermis and impairs the function of the melanocytes.

The pink type of pityriasis versicolor is mildly inflamed, due to dermatiits induced by malassezia or its metabolites. Pink pityriasis versicolor and seborrhoeic dermatitis may co-exist, as both are associated with malassezia.

Hyperpigmented, hypopigmented and inflamed pityriasis versicolor are usually seen as distinct variants but may sometimes co-exist.

How is pityriasis versicolor diagnosed?

Pityriasis versicolor is usually diagnosed clinically. However, the following tests may be useful.

  • Wood lamp (black light) examination— yellow-green fluorescence may be observed in affected areas
  • Microscopy using potassium hydroxide (KOH) to remove skin cells—hyphae and yeast cells that resemble spaghetti and meatballs are observed
  • Fungal culture—this is usually reported to be negative, as it is quite difficult to persuade the yeasts to grow in a laboratory
  • Skin biopsy—fungal elements may be seen within the outer cells of the skin (stratum corneum) on histopathology. Special stains may be required.
Microscopy of Malassezia furfur

What is the treatment of pityriasis versicolor?

Mild pityriasis versicolor is treated with topical antifungal agents.

  • Topical azole cream/shampoo (econazole, ketoconazole)
  • Selenium sulfide
  • Terbinafine gel
  • Ciclopirox cream/solution
  • Propylene glycol solution
  • Sodium thiosulphate solution

The medicine should be applied widely to all the affected areas before bedtime for as long as directed (usually between 3 days and about two weeks, depending on extent of the rash).

Oral antifungal agents, itraconazole and fluconazole, are used to treat pityriasis versicolor when extensive or if topical agents have failed. Oral terbinafine, an antifungal agent used to treat dermatophyte infections, is not effective for malassezia infections such as pityriasis versicolor.

Vigorous exercise an hour after taking the medication may help sweat it onto the skin surface, where it can effectively eradicate the fungus. Bathing should be avoided for a few hours. A few days’ treatment will clear many cases of pityriasis long term, or at least for several months.

Recurrences of pityriasis versicolor

Pityriasis versicolor generally clears satisfactorily with treatment but often recurs when conditions are right for malassezia to proliferate. When the scaly component of pityriasis versicolor recurs, antifungal treatment should be repeated.

In those who have frequent recurrences, antifungal shampoo or oral antifungal treatment may be prescribed for one to three days each month.

Occasionally white marks persist long after the scaling and yeasts have gone and despite exposure to the sun. In such cases, further antifungal treatment is unhelpful.

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