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The Crucial Differences Between Tinea Versicolor and Vitiligo

If you notice light- or dark-colored areas on your skin, you may wonder what’s causing them and how to treat them. Two common causes of skin discoloration are tinea versicolor and vitiligo. Even though these skin conditions may look similar, they have different causes, and you’ll need to try different strategies to get them to clear up.

Jordan Abbott, MD, a dermatologist with Banner Health, explained more about what these conditions look like and how to treat them.

Tinea versicolor (TV), also called pityriasis versicolor, develops when too much yeast grows on your skin. The excessive yeast leads to a rash that looks like round flat patches which can be lighter or darker than the surrounding skin. It most often strikes the chest and back.

Vitiligo is an acquired disorder of depigmentation of the skin cells. “Normally your skin has pigment-producing cells called melanocytes. They produce melanin, which gives the skin its color. In vitiligo patches, these pigment-producing cells are absent,” Dr. Abbott said.

Both conditions can appear as light spots on the skin, and they don’t usually have any other symptoms. “If you didn’t see them, you wouldn’t know they were there,” Dr. Abbott said. In rare cases, tinea versicolor can be slightly itchy or dry. Neither condition is contagious, so don’t worry about catching TV or vitiligo if you touch someone who has it. Both can develop in people with any skin color.

How can you tell them apart?

TV and vitiligo usually affect different parts of your body. You’ll usually spot signs of vitiligo on the face, hands, elbows and knees. It’s unusual to see tinea versicolor on the hands or legs. Symptoms of tinea versicolor are most commonly seen on the chest or back.

And the discoloration isn’t the same for both conditions. “While they both can have spots that are lighter than the surrounding skin, the color appears different to a trained eye,” Dr. Abbott said. TV can be a few shades lighter than the unaffected skin, due to decreased pigment in these spots. With vitiligo, the skin lacks all pigment in the affected areas, so it appears chalk or milk white. 

What to know about tinea versicolor

Tinea versicolor is a common fungal infection caused by a yeast called Malassezia, also known as Pityrosporum. This yeast normally grows on your skin and usually doesn’t cause any trouble unless here’s an overgrowth—that’s what causes tinea versicolor. 

Heat, humidity and excessive sweating can trigger TV, so you see it more often in warm, humid,  tropical climates. People also may develop this condition in the spring when the weather warms up. Oily skin is another risk factor, so it is more common in teens and young adults. And athletes are also at risk because of the sweaty, humid environment underneath their uniforms or workout clothes. To keep tinea versicolor infection from recurring, you should avoid excessive sweating, sun exposure and heat. Wearing sunscreen or protective clothing and opting for loose-fitting garments made of cotton can help reduce sweating.

How to diagnose and treat tinea versicolor

Your health care provider can usually diagnose tinea versicolor by observation—it looks different than vitiligo and other skin conditions. They might use a tool called a Wood lamp which uses utraviolet light to see the patches more clearly.

If you’re diagnosed with TV, your dermatologist will probably recommend a short course of topical antifungal medications you apply to your skin or take by mouth to help the rash clear up. 

“It may sound funny, but one of the common treatments is to use anti-dandruff shampoo, like selenium sulfide (Selsun Blue) as a body wash in the shower,” Dr. Abbott said. That’s because the same yeast that causes TV may also cause dandruff. “It works best when you lather the product on your skin and allow it to sit for 10 minutes before rinsing.” 

Some people who get tinea versicolor repeatedly use dandruff shampoo as body wash regularly to keep it at bay. Because the yeast that causes TV lives on your skin all the time, flare-ups are common.

What to know about vitiligo

Vitiligo is believed to be an autoimmune disorder where your immune system’s cells attack the melanocytes that produce pigment in your skin. It can be associated with other autoimmune conditions such as thyroid disease and type 1 diabetes. People commonly see it start around age 20. Some medications, such as immunotherapy used to treat certain cancers, can trigger vitiligo.

How to diagnose and treat vitiligo

Like TV, doctors can often diagnose vitiligo by examining your skin. If they need more information, they may take a skin biopsy so the cells can be evaluated in a lab.

If you have vitiligo, your doctor may recommend skin creams, pills or light therapy (phototherapy) for treatment. If the affected areas are smaller (less than 5% to 10% of your skin), you’ll probably try a skin cream first. 

If vitiligo is spreading quickly, your doctor may prefer an oral medication that can help slow down or stop the spread. “With vitiligo, the goal of treatment is initially to stop the progression. After that, the skin can begin to re-pigment,” Dr. Abbott said. Vitiligo can’t be cured, but it can be controlled. Some people use cosmetics to cover up the lighter areas.

The bottom line

Tinea versicolor and vitiligo are two skin conditions that can look similar but have different causes and treatments. If you have light or discolored patches on your skin, your health care provider can figure out what’s behind them and recommend a treatment that can help clear up your skin.

Need help diagnosing or treating symptoms of tinea versicolor or vitiligo?

Schedule an appointment with a dermatologist.

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