Complaints & connections · borters.ch
Pityriasis versicolor
Many small, finely scaling patches on the trunk that do not tan along in summer. The yeast is gone quickly — the colour needs months.
Also known as: tinea versicolor · pityriasis versicolor · sun fungus
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The same yeast that lives on every skin can multiply more strongly in warmth and moisture and in doing so form substances that disturb pigment formation. Out of that arise many small, slightly scaling patches on the trunk — chest, back, shoulders and upper arms — that can run together. The name says the essential thing: versicolor, of varying colour. On light skin they look brownish or pink in winter; in summer they stand out as pale patches because they do not tan along. That is the most common reason for coming — and exactly what leads to the wrong expectation that the treatment has not worked: the yeast is gone quickly, but the differences in colour stay for weeks to months until the pigment evens out again. A fingernail or a wooden spatula drawn across the spot brings out a fine, bran-like scaling. It hardly itches, is not catching in the usual sense and has nothing to do with hygiene; the yeast belongs to the normal skin flora. Relapses are common, above all in summer and in a warm humid climate, and they mean no failure — for many a short treatment once or twice a year is the simplest way.
Apply an antifungal shampoo with ketoconazole or selenium disulfide to the affected areas, leave on for five to ten minutes, rinse off — daily for one to two weeks. That is the simplest and cheapest route.
After successful treatment it no longer scales, but the pale or dark places stay until the pigment has caught up. That often takes the whole summer. Knowing this stops unnecessary further treatment.
For many it returns in summer. A short treatment once or twice a year, or the shampoo once a week in the warm season, is simpler than starting from scratch every time.
Cotton instead of airtight synthetics, do not stay in damp clothing after sport, dry off well. Oily body oils on the trunk favour the yeast.
They hold less pigment and burn more easily. Sun protection on the affected areas also makes the difference look smaller, because the surrounding skin tans less.
Sharply bordered, chalk-white areas without any scaling, often on the hands, around the mouth and the eyes, are something else and are followed differently.
Antifungal shampoos and creams clear the fungus in two to four weeks — but the light or dark patches stay visible for weeks to months afterwards, because the pigment only evens out slowly. That is exactly what is taken for failure. The fungus belongs to the normal skin flora; it spreads with warmth, damp and oily skin, which is why it returns in summer and in the tropics. As prevention it is treated once or twice a month during the warm season.
The patches do not pale immediately after treatment: the pigment evens out over weeks to six months — that is most often taken for failure. Mainly adolescents and young adults are affected, considerably more in warm countries. The fungus belongs to the normal skin flora; recurrence affects about half within a year in warm summers, which is why preventive treatment is given once or twice a month.
Chest, back, shoulders, upper arms, less often neck and face. They start round and coin-small and run together into larger fields. Legs and forearms usually stay clear.
They do not tan along, so in the sun they stand out as pale patches. In winter they look rather brownish or pink on light skin. This change gives the name and is the most reliable sign.
A fingernail or a spatula drawn across the spot brings out a bran-like, floury scaling that is hardly visible on quiet skin. This simple manoeuvre secures the classification.
Most come because of the look, not because of complaints. Strong itching speaks more for something else.
Warmth, sweating, a warm humid climate, airtight clothing, oily skin care, cortisone, weakened defences — and a personal predisposition that does not change.
No sign of a lack of hygiene, no catching it from outside and not the white-patch disease: in vitiligo the pigment is missing completely, the patches are sharply bordered, chalk-white and do not scale.
A raised sugar favours yeasts on the skin and in the folds. With very widespread or repeatedly returning involvement that is a sensible look.
Without a demonstrated connection to this picture, but part of skin health and almost regularly low here in winter.
Normal — that belongs to the picture. A raised value speaks for something else being present.
Belongs to the workup if the patches itch or if there is a general dryness of the skin alongside.
Zinc pyrithione acts on the skin against the yeast and is in many anti-dandruff shampoos. A zinc deficiency in the body is something else and makes a dry skin picture of its own.
Selenium disulfide is one of the most effective preparations on the skin. That has nothing to do with selenium intake from food — it works locally, not from within.
Part of skin health in general, without a demonstrated link to this picture. Almost always low here in winter.
The yeast lives on fat. Rich body oils and greasy sunscreen on chest and back favour it — lighter bases are the better choice there.
The most important sentence for patience: after successful treatment the pale spots remain visible for weeks to months, because the skin there builds no tan. That is not a sign that it did not work — the fungus is long gone, the colour comes last.
As a wash for back and chest — let it work, do not rinse off at once — one of the simplest forms of prevention, because the yeast belongs to the normal skin flora and comes back every summer. Zinc in capsule form does nothing here.
Here it is the other way round than usual: this yeast lives on fat and grows better on oiled skin. Oily body lotions on back and shoulders are therefore, in someone prone to it, the trigger rather than the care.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
The yeast lives on sebum — which is why this rash occurs almost only between puberty and middle age, and prefers chest, back and shoulders, where the sebaceous glands sit densely.
Under cortisone and with weakened defences it spreads more easily. The pale patches remain for months after successful treatment — they only take on colour again with the next sun.
The yeast lives on skin oil, not on what is eaten. Treatment is topical; the patches stay pale for months after successful treatment until the tan catches up.
Effective against yeasts but markedly weaker than the usual antifungals. The pale patches remain for months after successful treatment — not a sign of failure.