Management of tinea versicolor

* Challenges for topical therapy include extensive skin involvement and a limited ability of the patient to apply topical treatment.

¶ Skin discoloration can persist for weeks to a few months after successful treatment and is not a reliable sign of treatment failure.

Δ The relative efficacy of these treatments is unclear. Refer to UpToDate content on tinea versicolor for details on treatment regimens and other treatments. Treatment courses generally range from a few days to 2 weeks.

◊ We treat most patients who require oral therapy with fluconazole because of a more favorable side effect profile and fewer potential drug interactions compared with itraconazole. Oral terbinafine and oral griseofulvin are not considered effective treatments.

§ Prophylactic therapy generally consists of periodic, one-day administration of an effective agent. Refer to UpToDate content on tinea versicolor for details.

¥ Multiple disorders may resemble tinea versicolor. Refer to UpToDate content on tinea versicolor for the differential diagnosis.

‡ Switch topical treatment (refer to Inset 1) or proceed to oral fluconazole or itraconazole. Reassess the diagnosis if failure of more than 1 treatment. Immunodeficiency is a less common cause of refractory disease.