Treatment of Tinea Versicolor

• Topical therapy is the treatment of choice for patients with Tinea Versicolor.
• Topical antifungal medications, topical selenium sulfide, and topical zinc pyrithione are effective and well tolerate, first line therapies for Tinea Versicolor.

Topical Therapies (First Line Treatment)
Drugs	Dosing	Comments
Azole Antifungals: Ketoconazole 2% Cream Ketoconazole 2% Shampoo *A/KK Terbinafine 1% Solution Ciclopirox Olamine 1% Cream Others: Selenium Sulfide 2.5% Shampoo *A/KK Selenium Sulfide 2.25% Foam Zinc Pyrithione 1% Shampoo	Once daily for 11 to 22 days (mean 14 days). Applied to affected areas and is washed off after five minutes as single application or on three consecutive days. Twice daily for one week. Twice daily for 14 days. Apply the shampoo to the affected area daily for one week, then rinsed off after 10 minutes. Applied twice daily for one week, without rinsing. Applied for five minutes per day for two weeks	Only Selenium Sulfide 2.5% Shampoo available in Hospital Keningau. A non-prescription Selenium Sulfide 1% Shampoo is also available, but the efficacy of this product for the treatment of Tinea Versicolor has not been studied.

• Oral therapy is reserved for patients with Tinea Versicolor that is refractory to topical therapy or widespread disease that makes the application of topical drugs difficult.

Oral Therapies ( Severe or Recalcitrant Disease)
Drugs	Dosing	Comments
Azole Antifungals: Itraconazole *A/KK Fluconazole *A	200 mg per day for five days.  300 mg dose once weekly for two weeks	Oral therapy is not typically used for the treatment of tinea versicolor in children.

• However, some other additional topical & systemic therapies have been used for Tinea Versicolor.

Other Therapies ( Additional topical & systemic therapies)
Drugs	Dosing	Comments
Topical Agents: Whitfield ointment and sulfur salicylic acid shampoo Propylene glycol and benzoyl peroxide. Oral Agents: Ketoconazole *A/KK	200 mg for five days.	Whitfield ointment and sulfur salicylic acid shampoo may cause skin irritation in a minority of patients. A single 400 mg dose or oral ketoconazole may be less effective than treatment with multiple doses.

References:

• <http://www.uptodate.com/contents/tinea-versicolor-pityriasis-versicolor>