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.
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.
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.
Tinea versicolor (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. Vitiligo is also more likely to develop on both sides of the body than tinea versicolor.
Vitiligo (DermNet NZ)
Tinea versicolor on the neck (DermNet NZ)
Tinea versicolor tends to affect the neck, back, chest, upper arms, and stomach.
In vitiligo, depigmentation typically first occurs on areas of the body that are exposed to the sun, like the face, lips, hands, feet, and arms. It can also affect the eyes, scalp, eyebrows and eyelashes, and genitals.
Vitiligo on the eye, lips, and arm (DermNet NZ)
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.
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, a substance forms 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.
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.
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.
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.
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.
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.
For vitiligo that is spreading slowly, doctors may prescribe the oral drug minocycline, an antibiotic believed to work in cases of vitiligo due to its anti-inflammatory effects. 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. Note that taking corticosteroid medications may affect immune functioning, increasing a person’s risk of developing tinea versicolor.
Doctors may recommend phototherapy, also known as light therapy, for vitiligo. This treatment works by using light to restore the skin’s lost color. Phototherapy may be considered as an initial treatment or as a next approach if topical medications do not work.
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.
Your dermatologist may recommend ways of caring for your skin and managing your symptoms of tinea versicolor or vitiligo at home.
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.
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.
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.