Dear Doctor
I been getting white spots for over 2 months. They started on the side if my mouth, looked like red ring rash and then it became white and they are taking over my left side of my face. I’m going crazy here. HELP!!
Dear Patient
Your symptoms are suggestive of Tinea versicolor which was formerly known as pityriasis versicolor.
This is a fungal skin infection that is caused by Malassezia furfur.
The diagnosis can be confirmed by having skin scrapings from the white patches mixed with potassium hydroxide (KOH) in the lab. A characteristic spaghetti and meatballs appearance of the fungal spores and mycelium will be seen under the microscope.
Tinea Versicolor Treatment
A. Non-Prescription Products
Non-prescription over the counter products that are used to treat Tinea versicolor include those which contain selenium sulfide like Selsun Blue Shampoo. Selenium sulfide shampoos can be used for 10 days and should be left for 10 minutes until they dry on the skin before being rinsed off.
Nizoral shampoo which contains the antifungal ketoconazole can be applied on the affected area for 5 days and should be left for 5 minutes on the skin before being rinsed off.
Products containing pyrithione zinc like Noble Formula Pyrithione Zinc Soap can also be used.
B. Antifungal Creams
Antifungal creams used to treat Tinea versicolor include Clotrimazole which can be applied daily for 2 weeks. Miconazole cream can also be used.
Depending on where you live some of these antifungal creams can be obtained over the counter without a prescription.
C. Antifungal Tablets
Antifungal tablets used to treat this fungal skin infection include ketoconazole, fluconazole and itraconazole.
After completing your medication understand that the skin discoloration or white patches can take from 1 to 3 months before they return to your normal skin color. To make the discolaration less apparent, ensure that you apply sunscreen each day since it prevents the normal skin from tanning.
D. Recurrence Prevention
Since the Malassezia furfur which causes Tinea versicolor normally lives on the skin, these skin lesions tend to recur. To prevent recurrence you can:
1. Use the non-prescription shampoos and soaps weekly or fortnightly.
2. Use the non-prescription shampoos and soaps for three days before you leave for a vacation in a sunny area or any place where you will be spending a lot of time in the sun sweating.
3. Take prescribed antifungal tablets once a month.
Ask a Dermatologist your Question
Click here to get an answer by email within 72 hours
