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Tinea Versicolor vs. Vitiligo: What’s the Difference?

Updated on May 10, 2022

Tinea versicolor, also known as pityriasis versicolor, is a fungal infection that affects the top layer of the skin. This infection may be mistaken for vitiligo, as it causes discolored patches of lighter skin. Despite their similar appearances, tinea versicolor and vitiligo are very different skin conditions with their own causes and treatments.

If you have noticed any new or worsened skin symptoms, including discolored patches, talk to your health care provider or a dermatologist. They will be able to identify the cause of these changes and work with you to find the best treatment or management options.

Symptoms of Tinea Versicolor and Vitiligo

Both tinea versicolor and vitiligo only affect the skin. In some cases, tinea versicolor may not cause any symptoms. Both conditions can cause very similar changes in skin coloration.

What Do Tinea Versicolor and Vitiligo Look Like?

Both vitiligo and tinea versicolor can cause patches of discolored skin. Patches of skin affected by tinea versicolor may have sharply defined edges and appear lighter or darker than the surrounding areas. They may also appear brown, tan, pink, or yellow. These changes in skin color usually resolve after several weeks or months.

Patches of tinea versicolor may appear lighter or darker than the surrounding skin. (DermNet NZ)

Vitiligo, on the other hand, is characterized by permanent loss of skin color (also called loss of pigment or depigmentation). Areas of depigmentation may be a few shades lighter than a person’s natural skin tone or look completely white. Patches of depigmented skin may have smooth or jagged edges. Unlike in tinea versicolor, these skin patches usually have the same texture as a person’s unaffected skin.

Patches of vitiligo may be lighter than a person's skin tone or completely white. (DermNet NZ)

Where Do Tinea Versicolor and Vitiligo Develop?

Tinea versicolor often affects the neck, but rarely the face. (DermNet NZ)

Both tinea versicolor and vitiligo cause discolored patches to appear on any part of the body. However, certain areas may be more susceptible than others.

Tinea versicolor tends to affect the neck, back, chest, upper arms, and stomach. It usually does not affect the face, hands, elbows, knees, and feet.

In vitiligo, depigmentation can occur anywhere. The most common locations include the face, neck, underarms, elbows, hands, knees, feet, and genitals.

Vitiligo often appears on the face and hands. (DermNet NZ)

Other Symptoms of Tinea Versicolor and Vitiligo

Vitiligo frequently doesn’t cause any other symptoms. Tinea versicolor, however, may lead to dryness and scaliness on the affected patches. People with the infection can also experience occasional mild itching or excessive sweating.

What Causes Tinea Versicolor and Vitiligo?

Neither vitiligo nor tinea versicolor are contagious — you cannot catch them from someone else, and you cannot give them to someone else. Aside from this commonality, however, the two conditions have very different causes.

Tinea versicolor is a skin condition that results from the overgrowth of Malassezia furfur — a type of fungus (yeast) that occurs naturally on the skin. Although this yeast is normally found on the surface of the skin, in some cases, it starts to grow out of control. When small colonies of Malassezia furfur start to form, they produce a substance that does not allow the skin to get darker when exposed to sunlight. This is what causes the hypopigmentation and other symptoms of tinea versicolor.

In vitiligo, melanocytes — the cells responsible for making skin pigment — are destroyed, resulting in a loss of pigment and the appearance of lighter, depigmented patches. There are many theories about what causes vitiligo, but most researchers agree that, in most cases, vitiligo is an autoimmune condition. In other words, depigmented patches and other symptoms of vitiligo are caused by the body’s immune system thinking the body’s own melanocytes are foreign and attacking them.

Risk Factors for Tinea Versicolor and Vitiligo

Tinea versicolor is common among people who live in tropical and subtropical climates. People living in these warm, moist environments may even experience tinea versicolor throughout the entire year.

The infection tends to affect those going through puberty, because people with particularly warm, oily, or moist skin are at higher risk. People with compromised immune systems — from taking corticosteroid medications or living with a condition like diabetes, for example — are also at an increased risk of developing tinea versicolor. It’s also possible to be genetically more susceptible to developing the infection.

One theory about the cause of vitiligo is that a trigger event causes stress to melanocytes in a person who is genetically predisposed to develop vitiligo. Researchers have identified an array of environmental factors linked to the development of vitiligo. These environmental factors may trigger vitiligo to develop in some people; in most people with vitiligo, the trigger is not known.

Vitiligo does not appear to be directly inherited from parents in any clear genetic pattern. About 20 percent of people with vitiligo have a first-degree relative with vitiligo. Among identical twins, if one has vitiligo, the other has a 23 percent risk of developing the skin condition.

Diagnosing Tinea Versicolor and Vitiligo

Both tinea versicolor and vitiligo are usually diagnosed by a dermatologist — a skin specialist whose training allows them to distinguish between similar skin conditions. Typically, a dermatologist will look at a person’s medical history and conduct a physical examination. The dermatologist will conduct a full body examination to evaluate your skin for signs and symptoms of tinea versicolor or vitiligo.

In some cases, a dermatologist may also order blood work or remove a small sample of skin for examination. If they believe you may have tinea versicolor, this sample will be examined for the presence of yeast cells.

A doctor may also use a device called a Wood’s lamp, which emits ultraviolet light, to look at the skin more closely. Using a Wood’s lamp allows your doctor to see the areas of discoloration more clearly, especially for people with lighter skin tones. The Wood’s lamp can help determine if skin depigmentation is caused by vitiligo, tinea versicolor, or another condition. If you have tinea versicolor, the affected patches will appear yellow-green.

Learn more about how vitiligo is diagnosed.

Managing Tinea Versicolor and Vitiligo

There are several approaches to managing vitiligo, but the condition cannot currently be cured. Similarly, though tinea versicolor can be treated with medications and other therapies, the infection frequently comes back, since the yeast that causes it occurs naturally on the body.

Medications for Tinea Versicolor

Most people recover from tinea versicolor with medical treatment. Because it is a fungal infection, dermatologists treat the condition with antifungal medications, such as topical antifungals ketoconazole and miconazole. Shampoos containing selenium sulfide and ketoconazole are helpful treatments. More severe cases of tinea versicolor may require oral antifungal drugs like fluconazole. The type of medication your doctor prescribes will depend upon the location, severity, and extent of your symptoms.

Medications for Vitiligo

Topical medication is usually the first line of treatment prescribed for vitiligo. Corticosteroids, the most commonly prescribed topical medication for vitiligo, are usually prescribed when the condition involves small areas of skin. These medications work by reducing inflammation and modifying the immune system. Tacrolimus is another topical medication that may be used alone or in combination with corticosteroids.

A new class of medications known as Janus kinase (or JAK) inhibitors are currently in development and will soon be available in topical and oral forms for vitiligo.

If vitiligo is worsening rapidly — with existing patches expanding and new patches emerging each week — a doctor may prescribe oral corticosteroids.

Other Treatments for Vitiligo

Doctors may recommend phototherapy, also known as light therapy, for vitiligo. This treatment works by using light to restore the skin’s lost color.

In cases where medication and phototherapy are not effective in treating generalized vitiligo, surgical procedures may be considered. Most surgical techniques used to treat vitiligo involve transferring skin or skin cells from an area of skin that is still pigmented to a depigmented area. In general, surgery is only considered for adults whose lighter patches have not changed for at least six months.

At-Home Management of Tinea Versicolor and Vitiligo

Your dermatologist may recommend ways of caring for your skin and managing your symptoms of tinea versicolor or vitiligo at home.

Skin Care

For people with tinea versicolor, the American Academy of Dermatology recommends wearing loose clothing and avoiding oily skin care products. If you’re unsure whether a product contains oil, look for packaging that reads “non-comedogenic” or “oil-free.”

If you live in a warm or humid climate, your dermatologist may also recommend using a medicated wash or skin cleanser regularly throughout the year to keep Malassezia furfur from overgrowing.

Sun Protection

The patches of discolored skin that develop in vitiligo and tinea versicolor do not tan with the surrounding skin. What’s more, vitiligo patches can still burn painfully in sunlight. Wearing sunscreen daily is important for both conditions. Sunscreen will help protect your depigmented skin and prevent lighter patches from standing out. The American Academy of Dermatology recommends applying sunscreen with a SPF of 30 or higher at least 20 minutes before getting out in the sun.

Meet Your Team

Living with vitiligo can be challenging. The good news is that you don’t have to go it alone. MyVitiligoTeam is the social network for people with vitiligo and their loved ones. Here, members from around the world come together to ask questions, offer support and advice, and meet others who understand life with vitiligo.

Have anything to add to the conversation? Share your thoughts in the comments below or by posting on MyVitiligoTeam.

In partnership with the Global Vitiligo Foundation, which strives to improve the quality of life for individuals with vitiligo through education, research, clinical care, and community support.

References
  1. Tinea Versicolor — Cleveland Clinic
  2. Tinea Versicolor — Merck Manual Consumer Version
  3. Vitiligo: Overview — American Academy of Dermatology Association
  4. Vitiligo: Signs and Symptoms — American Academy of Dermatology Association
  5. Vitiligo — NHS
  6. Vitiligo Signs and Symptoms — AVRF
  7. Pityriasis Versicolor — NHS
  8. Vitiligo — Mayo Clinic
  9. Tinea Versicolor — Merck Manual Professional Version
  10. Vitiligo: Who Gets and Causes — American Academy of Dermatology Association
  11. Vitiligo — MedlinePlus
  12. Tinea Versicolor: Overview — American Academy of Dermatology Association
  13. Genetic Susceptibility in Pityriasis Versicolor — Dermatologica
  14. Recent Advances in Understanding Vitiligo — F1000Research
  15. Vitiligo: Pathogenesis, Clinical Variants, and Treatment Approaches — Autoimmunity Reviews
  16. Will My Children/Family Get Vitiligo? — UMass Chan Medical School
  17. Vitiligo — Questions and Answers — Vitiligo Research Foundation
  18. Diagnosing Vitiligo — NYU Langone Health
  19. Tinea Versicolor: Diagnosis and Treatment — American Academy of Dermatology Association
  20. Treatment Guidelines — Vitiligo Research Foundation
  21. Vitiligo: Diagnosis and Treatment — American Academy of Dermatology Association
  22. Steroids — MedlinePlus
  23. Advances in Vitiligo: An Update on Medical and Surgical Treatments — The Journal of Clinical and Aesthetic Dermatology
  24. Tinea Versicolor: Tips for Managing — American Academy of Dermatology Association
  25. Vitiligo — Harvard Health Publishing
  26. Vitiligo — American Osteopathic College of Dermatology
All updates must be accompanied by text or a picture.
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Amit G. Pandya, M.D., President of the Global Vitiligo Foundation is a dermatologist at the Palo Alto Medical Foundation in Mountain View, California. Learn more about him here.
Victoria Menard is a writer at MyHealthTeam. Learn more about her here.

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