If you have white scaly spots on your back, shoulders, or chest that tend to cluster together and look like a map, you may have the condition known as tinea flava. Tinea flava, also called tinea versicolor and pityriasis versicolor, is a common infection of the skin caused by the fungus, Malassezia furfur. There’s no need to panic because it is easily treatable. What’s important is to go to your doctor immediately to confirm your condition.
What Causes Tinea Flava?
Malassezia furfur is a yeast fungus that is naturally found in the skin of animals and about 90% of all humans. It requires a rich supply of fatty acids to survive. Normally, everyday showering removes the fungus from your skin, but hot and humid weather, such as in tropical areas, may stimulate the fungus to grow rapidly.
Factors such as high humidity, and hormone or immune abnormalities can all stimulate the growth of Malassezia furfur. The fungus starts to appear as a tissue-thin coat of fungus when it spreads on the skin. It turns off melanin-producing cells, causing affected areas to change color, and become either lighter or darker than the surrounding skin. The condition is often called “tinea versicolor” because of the skin discoloration that occurs.
Common Symptoms of Tinea Flava
Some symptoms of tinea flava are similar to vitiligo and pityriasis alba, two entirely different skin conditions. The following list of common symptoms will help you determine if you indeed have the condition.
- Oval or irregularly-shaped spots 1/4 to 1 inch in diameter that often merge together to form a large map-like patch.
- Very fine and thin scaling on the skin
- Pale, tan, dark brown, or pink patches with reddish undertones that may darken when you’re overheated, such as during or after exercise, or when you’re in a hot shower
- Patches that have sharp borders
- Itching in discolored areas that usually begins when you’re body temperature increases. Itching usually stops however, when your body starts to sweat.
Tinea flava is more common in warm, humid temperatures. The body parts usually affected include the back, shoulders, upper arms, chest, neck, and, less commonly, the face. Since the fungus is a natural part of the human skin, the skin condition is not contagious.
Diagnosis of Tinea Flava
Diagnosis of tinea flava is usually straightforward, with the doctor just doing a physical examination of your skin patches. If your doctor suspects another skin condition though, he may scrape some samples off the discolored areas and study them in a lab. He’ll prescribe some drugs to improve your symptoms, and you can treat the condition at home.
Medical Treatment for Tinea Flava
While tinea flava can go away on its own, if left untreated, it may linger until you’re 50 to 60 years old, or until your skin becomes less oily. Medical treatment is still best to quicken your recovery. Your doctor will recommend the best treatment option for you after observing the sizes of your patches.
Topical Antifungals: The Simple Solution to Your Spots
Topical antifungals are usually very effective in treating tinea flava because the fungus affects the top layer of the skin. Antifungal creams and foams are available with or without prescription. You can apply them to your skin once or twice a day for two weeks. Examples of topical antifungals include:
- Ciclopirox olamine
Some topical antifungals like naftifine and ciclopirox olamine are also available in gel and form. In addition, ciclopirox olamine is available in lotion form, but it has to be applied in large amounts to affected areas. It’s also quite expensive.
Treatment regimen: Combining topical antifungals may also speed up the healing process. The following topical antifungal regimens produce a clinical response rate that’s greater than 70% in treating tinea flava:
- Apply 2% ketoconazole cream on affected areas once daily for 11 to 22 days.
- Apply 1% terbinafine solution on affected areas twice daily for a week. Terbinafine also comes in a pump spray.
- Apply 1% clotrimazole solution on affected areas once daily for a week.
Oral Antifungals: The Easy and Effective Treatment
Antifungal pills are easier to use than topical medications. Some oral antifungals work by coming to the surface of your skin as you sweat. For this reason, it’s best to exercise briskly after taking an antifungal pill. Experts also recommend waiting for about 12 hours before you go to shower, so that the medicine can work. Here are some oral antifungals that are available by prescription:
Treatment regimen: Antifungal pills can cause side effects, such as nausea and reversible liver damage, although these are uncommon because treatment for tinea flava is very brief. The following oral treatment regimens produce a clinical response rate that’s greater than 70% in treating the infection:
- Take 200mg of itraconazole every other day for seven days
- Take a single dose of 400mg ketoconazole
- Take a single dose of 400mg fluconazole
- Take 150mg or 300mg of fluconazole weekly for four weeks
Note: Do not use oral griseofulvin or oral terbinafine to treat tinea flava because they will not work. Griseofulvin and terbinafine are common antifungals used to treat other fungal skin infections.
Antifungal Shampoos: Froths that Flush Away the Fungi
Antifungal shampoos are easier to use than most creams, and they’re available without prescription. They’re a more practical choice if your patches cover a large area of skin. You can apply them on your body, as well as your head. Some experts though, claim that shampoos are less effective than other antifungal medications. Antifungal shampoos are also known to cause skin irritation in some patients. The following are some shampoos you can use to eliminate your symptoms:
- Selenium sulfide shampoo:
- Ketoconazole shampoo:
- Sulfur-salicyclic acid shampoo
- Zinc-pyrithione shampoo
Treatmen regimen: You can combine antifungal shampoos with other medications to make healing faster. Some brands of selenium sulfide shampoos are available by prescription, while others are not. Nonprescription shampoos though may be less effective than prescription shampoos because they only contain 1% selenium sulfide compared to the 2.5% of prescription shampoos. Ketoconazole-containing shampoos are also available in different strengths with or without prescription. Here are some treatment regimens recommended by experts:
- Use sulfur-salicyclic acid shampoo every night for a week
- Apply zinc-pyrithione shampoo on your body for two weeks. Leave it on for five minutes before rinsing.
- Use selenium sulfide shampoo for a week. Leave it on for 10 minutes before rinsing.
- Use 2% ketoconazole shampoo once daily for three days. Lather the shampoo over affected and surrounding areas; and leave it on for at least five minutes before rinsing.
Preventing Recurrence of Tinea Flava
Tinea flava has a recurrence rate of 80% after two years, which is pretty high. To make sure you’ll never have the large patches again, it’s recommended that you repeat the medications after a year or two. If you went through a severe case of tinea flava, your doctor may also prescribe topical or oral antifungal treatments that you can take once or twice a month, which may include:
- Application of selenium sulfide lotion on your skin every two to three weeks
- Taking ketoconazole tablets once a month
- Taking itraconazole capsules twice daily for one day each month
Tinea flava is very easy to get rid of. You don’t have to suffer the occasional itchiness and the cosmetic effects of the disease. If your symptoms match those that have been mentioned, go quickly to your doctor to get a proper diagnosis. Don’t wait until you’re 50 to 60 years old for the infection to go away on its own.
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