Pityriasis Versicolor Treatment

What is pityriasis versicolor?

Pityriasis versicolor is a common superficial yeast infection of the skin caused by overgrowth of Malassezia species, a type of yeast normally present on healthy skin. It presents with flaky, discoloured patches, typically on the chest, back, neck, and upper arms. The term "pityriasis" refers to the fine, bran-like scaling of the skin, while "versicolor" highlights the variable colour of the affected areas, which may appear lighter, darker, pink, or coppery-brown compared to surrounding skin.

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Pityriasis versicolor is sometimes also referred to as tinea versicolor, although "tinea" is technically reserved for infections caused by dermatophyte fungi, not yeasts.

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At Domain Dermatology, our telehealth dermatologists can diagnose and manage pityriasis versicolor for patients across metropolitan and rural Australia.

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Who gets pityriasis versicolor?

Pityriasis versicolor most often affects adolescents and young adults, particularly those living in warm and humid climates. It can also occur in children and older adults. Factors that increase the risk of developing pityriasis versicolor include:

• Hot, humid environments

• Excessive sweating

• Oily skin

• Weakened immune systems

• Genetic predisposition

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Although it is not considered contagious in the traditional sense, pityriasis versicolor may affect multiple members of the same household.

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What causes pityriasis versicolor?

Pityriasis versicolor is caused by the overgrowth of Malassezia yeast on the skin. While these yeasts are normally present in small numbers, certain factors can promote their proliferation, leading to visible skin changes.

The yeast can alter skin pigmentation by producing substances that either stimulate or inhibit melanin production. This results in patches of lighter (hypopigmented) or darker (hyperpigmented) skin. Mild inflammation induced by the yeast can also contribute to a pink appearance.

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Common triggers for overgrowth include heat, humidity, sweating, and oily skin conditions.

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What are the clinical features of pityriasis versicolor?

Typical features of pityriasis versicolor include:

• Discoloured patches (lighter, darker, pink, or coppery) with fine scaling

• Affected areas often include the upper trunk, neck, shoulders, and upper arms

• Minimal or no symptoms; some individuals experience mild itchiness

 

In people with darker skin tones, the lighter patches (pityriasis versicolor alba) may be particularly prominent. Sometimes, pink patches may co-exist with seborrhoeic dermatitis, another condition associated with Malassezia.

 

How is pityriasis versicolor diagnosed?

Pityriasis versicolor is usually diagnosed based on clinical examination by an experienced dermatologist.

 

Our dermatologists at Domain Dermatology can often diagnose pityriasis versicolor via telehealth based on your history and clinical photographs. Where needed, we can guide you on how to arrange confirmatory testing locally.

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How is pityriasis versicolor treated?

Topical treatments

Mild to moderate pityriasis versicolor is usually treated with topical antifungal medications. Options include:

• Selenium sulphide shampoo (used as a body wash)

• Topical azole creams/shampoos (e.g., ketoconazole, econazole, clotrimazole)

• Terbinafine gel (in some cases)

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Application guidance typically includes:

• Applying the treatment to affected and surrounding areas

• Leaving the treatment on for 5–15 minutes before rinsing

• Daily application for 1–2 weeks initially, then weekly maintenance if needed

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Oral treatments

For extensive, recurrent, or stubborn cases, short courses of oral antifungals may be prescribed.

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These treatments are effective at reducing yeast overgrowth but require careful consideration due to potential side effects and interactions. Oral terbinafine, used for dermatophyte infections, is not effective for pityriasis versicolor.

 

Our telehealth dermatologists can assess the extent of your condition and prescribe appropriate treatments directly to you, if needed.

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Preventative strategies

• Monthly use of a medicated body wash (such as selenium sulphide) can help prevent recurrences.

• Staying cool and dry where possible, and avoiding excessive sweating, may also reduce the risk of recurrence.

 

What is the outlook for pityriasis versicolor?

Pityriasis versicolor generally responds well to treatment. However, recurrence is common, especially in warm, humid conditions. Important points include:

• Discolouration of the skin often persists for several weeks or months after the yeast has been cleared, but this is not a sign of treatment failure.

• Ongoing maintenance therapy can help prevent future episodes.

• If you experience repeated recurrences, long-term preventative strategies can be discussed with your dermatologist.

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At Domain Dermatology, we are committed to helping you manage and prevent pityriasis versicolor, offering expert advice and continuity of care wherever you are located in Australia.