Question: I am 22 years old with a scaly brown-colored rash on my chest and back that will not tan. My boyfriend told me it was ugly and I have a fungus. He thinks I am contagious and wants me to see a dermatologist. Any suggestions for my skin condition?
Answer: Your spots probably represent a skin condition called “tinea versicolor.” The scaly spots are due to the over-growth of a superficial fungus which lives in the outer layer of the skin in everyone. Therefore, it is not contagious. The fungus just likes your skin oils and cells in the area between your neck and waist better than people who do not have this superficial fungal infection.
The spots on the skin represent the organism’s ability to impair normal tanning and pigment formation. The scaly skin can be scraped and the fungus identified under a microscope. Tinea versicolor does not influence your general health. Although it may itch, the major concern is its appearance.
Tinea versicolor can be treated with daily showers followed by the daily application of an over-the-counter antifungal cream such as miconazole or clotrimazole. The pigmentation will persist for some time after eradication of the fungus, at least until the pigment cells have recovered and are able to produce normal pigmentation in the skin. It is best to use the antifungal cream daily until the skin pigment has returned to normal.
Widespread cases of tinea versicolor can be treated with oral and topical medication under the direction of a dermatologist. Tinea versicolor is similar to other infections. That is, once it is cured you can get it again and it does have a tendency to recur. Should this happen, repeat the treatment program.