Thursday, October 15, 2015

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>

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