What are the aims of this leaflet?

This leaflet has been written to help you understand more about pityriasis versicolor. It tells you what it is, what causes it, what can be done about it, and where you can find out more about it.

What is pityriasis versicolor?

Pityriasis means a type of fine skin scaling, and versicolor means changing colour. It is a common and harmless rash due to the overgrowth of yeasts that live on everyone’s skin. These yeasts, called Malassezia, are not in any way related to yeast in food or to those that cause thrush. It is also sometimes called tinea versicolor.

What causes pityriasis versicolor? 

Large numbers of tiny harmless organisms, known as ‘the resident flora,’ live on the surface of everyone’s skin. Some of them are yeasts. At times, these yeasts can overgrow becoming more visible resulting in  the rash known as pityriasis versicolor. This happens most often in warm moist climates. Most people with this condition are in good health.

The rash has a mixture of colours– hence the name ‘versicolor.’ It looks pale brown or pink on untanned (covered), white skin, but sunlight will cause the yeasts to make chemicals that prevent tanning, so the rash stays paler than the surrounding skin. For this reason, the rash is often noticed for the first time after exposure to the sun such as following a sunny holiday.

This condition is most common in people in their early twenties. People who get it may also have dandruff which is caused by a similar yeast overgrowth on the scalp. We do not understand why some people tend to get it and others do not.

Is pityriasis versicolor hereditary?

No.

What are the symptoms of pityriasis versicolor?

The rash can be mildly itchy but usually causes no trouble apart from its appearance. It often goes unnoticed if only a few patches are present.

What does pityriasis versicolor look like?

The rash usually affects the torso (chest and upper back) but can also affect the upper arms, neck, and stomach. Flat, slightly scaly areas of altered colour appear more obvious against a background of unaffected skin. The colour of the patches may vary from pale to dark brown. On white skin the affected areas usually appear darker than surrounding skin and in dark skinned people the affected patches can appear paler.

How will pityriasis versicolor be diagnosed?

The diagnosis is usually made by your doctor looking at the rash. A special ultra-violet lamp, known as Wood’s lamp, can be used to look for yellow fluorescence which is typical of pityriasis versicolor. Sometimes your doctor may take skin scrapings to confirm the diagnosis. If there is any doubt, very occasionally a skin (punch biopsy) [this is when a small sample of skin is cut out to look at under the microscope] may be considered.

Can pityriasis versicolor be cured?

Yes, the rash clears with treatment although the pale areas will take several months to return to their normal colour. Importantly, this does not mean treatment has failed. The rash often recurs as the yeasts that cause it live on normal skin and cannot be eradicated completely. Pityriasis versicolor does not leave scars.

How can pityriasis versicolor be treated? 

Treatments applied to the skin:

Most patients are treated with topical antifungal agents that are applied to the skin. Treatments that reduce the amount of skin yeasts include terbinafine cream, clotrimazole cream and miconazole cream. Ketoconazole and selenium sulphide shampoos can be used as body washes left on the skin for up to 15 minutes. Medicines taken by mouth:

These include itraconazole and fluconazole, which can be prescribed by your doctor. They are effective but can have side effects so are usually prescribed for widespread rashes, or when topical treatment has failed.

Recurrences:

The rash of pityriasis versicolor often comes back. Occasional use of an anti-dandruff shampoo as a short contact bodywash may reduce the chance of this happening.

What can I do?

It may help if you wash your upper body with an anti-dandruff shampoo for a few weeks before you go on a sunny holiday or to an area of high humidity to reduce the level of skin yeasts. There is no evidence that the complaint is related to yeast in food so there is no need to change your diet.

Where can I get more information?

Web links to detailed leaflets:

http://www.dermnetnz.org/fungal/pityriasis-versicolor.html

http://www.patient.co.uk/doctor/pityriasis-versicolor

https://cks.nice.org.uk/topics/pityriasis-versicolor/

Jargon Buster: https://www.skinhealthinfo.org.uk/support-resources/jargon-buster/

Please note that the BAD provides web links to additional resources to help people access a range of information about their treatment or skin condition. The views expressed in these external resources may not be shared by the BAD or its members. The BAD has no control of and does not endorse the content of external links.

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel

BRITISH ASSOCIATION OF DERMATOLOGISTS PATIENT INFORMATION LEAFLET

PRODUCED | MAY 2008

UPDATED | AUGUST 2011, AUGUST 2014, NOVEMBER 2017, JUNE 2023

NEXT REVIEW DATE | JUNE 2025