Pityriasis Versicolor (Tinea Versicolor) ICD-10: B36.0

Fungal / Infectious skin condition

Often searched as: white patches on chest and back, skin that doesn't tan evenly, light spots after summer, discolored patches on shoulders, white spots from sun, skin spots that appear in heat, flaky white spots on back, pale patches on dark skin…

Clinical urgency level

lowmediumhigh

Systems Affected

skin

Severity Levels

mild

A few small discolored patches on the chest or back, mildly scaly, not spreading — responds well to over-the-counter antifungal shampoo or cream.

moderate

Widespread patches covering large areas of trunk, shoulders, or neck, more visible after sun exposure, recurring seasonally — requires prescription antifungal treatment.

severe

Extensive or recurring pityriasis versicolor resistant to standard topical treatment, especially in immunocompromised individuals — requires oral antifungal therapy and evaluation for underlying causes.

Red Flags

Patches spreading rapidly to the face or large body areas
No improvement after 4 weeks of antifungal treatment
Recurrence within weeks of completing treatment — possible immune suppression
Significant itching or inflammation beyond typical mild scaling
Patches that don't match typical presentation — rule out vitiligo, pityriasis alba, or other conditions

Clinical Presentation

Pityriasis versicolor — hypopigmented patches on the back after sun exposure

Source: Wikimedia Commons (CC BY-SA 3.0 )

Pityriasis versicolor image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

See a doctor if you're unsure whether your discolored skin patches are pityriasis versicolor or another condition (like vitiligo), if they keep coming back despite treatment, or if they spread to the face. A dermatologist can confirm the diagnosis with a simple skin scraping and prescribe more effective treatments for stubborn cases.

Differential Diagnosis

Vitiligo (truly white patches — no scaling, no yeast)
Pityriasis alba (common in children — hypopigmented, dry patches on face)
Seborrheic dermatitis (scaly, greasy — scalp, face, chest)
Tinea corporis (ringworm — circular, active border)
Post-inflammatory hypopigmentation
Confluent and reticulated papillomatosis (brown, velvety network pattern)

Comorbidities

Hyperhidrosis (excessive sweating — major risk factor)
Seborrheic skin type (oily skin)
Immunosuppression (HIV, corticosteroids — more severe or recurrent disease)
Malnutrition or nutritional deficiencies (rare)

Prognosis

Pityriasis versicolor responds well to antifungal treatment. Skin discoloration may persist for months after the fungus is eliminated as melanocytes recover — patients often mistake this for ongoing infection. Recurrence is extremely common (up to 80% within 2 years). Monthly preventive antifungal applications during warm months reduce recurrence significantly.

Detailed Overview

Causes, Symptoms, and When to Take Action Pityriasis versicolor, also known as tinea versicolor, is a common, benign, superficial fungal skin infection caused by yeast from the genus Malassezia, which is a normal component of skin flora. When it transforms into its pathogenic form, it can lead to noticeable skin changes. How It Looks Texture: Fine scaling on affected areas when gently scratched Color: Hyperpigmented (darker) or hypopigmented (lighter) oval or round patches Shape: Well-demarcated macules or patches that may merge to form larger patches Location: Typically appears on the trunk, neck, and proximal limbs Why Does It Appear? Malassezia yeast, normally harmless, becomes pathogenic when it converts to a filamentous form. Factors such as warm and humid climates, oily skin, pregnancy, and potentially genetic predisposition increase risk. Should You Be Concerned? Pityriasis versicolor is harmless and primarily a cosmetic concern. It often recurs and may affect self-esteem. Consultation is advisable if the appearance or persistence of lesions is bothersome. Can You Prevent It? Recurrence can be reduced by practicing proper skin hygiene, avoiding excessive humidity and oily skin products, and becoming familiar with early signs to manage flare-ups promptly. 👉 How Piel AI Can Help Piel AI enables tracking of skin changes through regular imaging. Although it isn't diagnostic, it helps monitor lesion patterns over time and supports effective communication with healthcare providers. Summary Pityriasis versicolor is a superficial, benign fungal infection manifesting as scaly, pigmented patches. Triggered by Malassezia yeast transitioning to a filamentous form under conducive conditions. Recurrence is common, but the infection causes no permanent damage. Monitoring and awareness help manage appearance and flare-ups.

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