Pityriasis versicolor
Pityriasis versicolor is a very common fungal infection of the outermost layer of the skin, and an entirely harmless one.
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Medicines commonly prescribed for Pityriasis versicolor
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: CAPSULE, 150 mg fluconazoleActive substance: fluconazoleManufacturer: Tecnimede España Industria Farmaceutica S.A.Prescription requiredDosage form: CAPSULE, 200 mg fluconazoleActive substance: fluconazoleManufacturer: Laboratorios Cinfa S.A.Prescription requiredDosage form: GEL, 2% ketoconazoleActive substance: ketoconazoleManufacturer: Sandoz Farmaceutica S.A.Prescription required
Pityriasis versicolor is a very common fungal infection of the outermost layer of the skin, and an entirely harmless one. It leaves patches in a different shade from the surrounding skin: paler on tanned skin, darker on fair skin. It is not passed from person to person, but neither does it clear on its own — it needs treating. Despite the similar name, it is not the same thing as pityriasis rosea.
Symptoms
- patches with clearly defined edges, lighter or darker than your usual tone — from whitish to pink or brown;
- a fine scale on the surface, easiest to see if you scratch lightly with a fingernail;
- a tendency to merge into larger areas;
- typically on the back, chest, shoulders and neck, less often the face;
- mild itching or none at all.
The patches stand out most in summer: the affected areas do not tan, so they show up as pale islands against a tanned background.
What it gets mistaken for
Telling it apart yourself is difficult. Paler patches may turn out to be vitiligo, where pigment is lost completely and there is no scaling. Raised, scaly plaques can belong to psoriasis or eczema. Pink patches with scaling at the edge suggest pityriasis rosea. That is why the diagnosis belongs to a clinician rather than to an image search.
When to see a clinician
- patches have appeared that change the colour of your skin and are not going away;
- they are spreading, or coming back after treatment;
- you are not certain this is pityriasis versicolor;
- the patches itch badly, hurt, or look inflamed.
How it is diagnosed
Usually an examination is enough. If needed, the clinician scrapes off some scale to look at under a microscope, or examines the skin under a Wood's lamp, under which affected areas glow in a characteristic way.
Treatment
The basis of treatment is antifungal medication applied to the skin:
- shampoos and lotions containing ketoconazole, selenium sulphide or ciclopirox. They go on the patches and the skin around them, are left for a few minutes and rinsed off, in courses as directed;
- creams, when only a small area is involved;
- tablets, if a large area is affected or topical treatment has not worked. These are prescription-only, since oral antifungals come with contraindications and drug interactions.
One important point about timing: the fungus dies quickly, but skin colour evens out slowly. Patches can remain visible for several months after the infection is cured, and that does not mean the treatment failed. Tanning to disguise them does not work — it only sharpens the contrast.
Why it happens, and why it returns
The organism responsible is a yeast of the Malassezia group, present on almost everyone's skin as a matter of course and harmless there. Trouble starts when it multiplies more than usual. A warm humid climate, heavy sweating, oily skin, tight synthetic clothing, hormonal changes and medication that suppresses immunity all encourage it.
It has nothing to do with poor hygiene and does not pass between people. Recurrences are common because the yeast never actually leaves the skin. If it keeps returning, a clinician may recommend using the shampoo preventively — every few weeks, for instance, and particularly during warm weather.
Common questions
Can I pass it to my family? No. The yeast is already on most people's skin.
Why won't the patches tan? The yeast produces substances that dampen the work of pigment cells in the affected areas.
How long until my colour is even again? Usually from a few weeks to several months after treatment ends.
Online consultation
In an online appointment a doctor can review photographs of the rash, help distinguish pityriasis versicolor from conditions that resemble it, set out a treatment course and a prevention plan if it keeps recurring, and refer you to a dermatologist where necessary.
This article is for general information and does not replace a consultation with a doctor.
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Medically reviewed by
Reviewed on Aug 7, 2026
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