column (e.g. in newspaper)
2025.09.18
Tinea versicolor can sometimes appear as spots.
As an Assistant Professor, Associate Ward Director, and Chief of Dermatopathology at the university hospital dermatology department, I deepened my expertise through academic presentations and paper publications both domestically and internationally. I have handled a wide range of treatments, from birthmark therapy in children to adult pigmentation concerns, utilizing various lasers and injection therapies, while also contributing to community healthcare. Through encountering numerous cases, I strongly felt the potential and necessity of aesthetic medicine, resolving to pursue further expertise. Building upon my solid dermatological knowledge and meticulous diagnostic skills, I value treatments that gently support each individual's skin while bringing out its inherent beauty.
While providing insurance-covered medical care, I occasionally see patients with pityriasis versicolor, so I thought I'd jot this down.
Today's insurance tip.
I am Dr. Aya Hayama, a board-certified dermatologist.
Brown spots that appear to be blemishes at first glance.
A characteristic feature is the appearance of fine scales when rubbed, but diagnosis is straightforward as microscopic examination reveals short hyphae.
Some patients occasionally visit our cosmetic dermatology clinic primarily concerned about dark spots, but since laser treatment isn't necessary and topical medication is used instead, diagnosis really is important, isn't it? 😊
Tinea versicolor
Tinea versicolor (or pityriasis versicolor) is a skin condition caused by an overgrowth of Malassezia, a type of fungus that is a normal part of the skin's flora.
Malassezia is normally present on everyone's skin. However, when it proliferates excessively due to factors like sweat and sebum-rich environments, humidity, heat, fatigue, or a weakened immune system, it affects the skin's pigment cells and disrupts pigment balance. This results in the characteristic appearance of pale or brownish spots on the skin, often accompanied by fine, dandruff-like scales. Itching is usually mild, but may be absent.
Common areas include the chest, back, shoulders, neck, and face—places with many sebaceous glands that tend to sweat easily. It often becomes more noticeable in summer, and for some people, it becomes less noticeable in winter.
Treatment primarily involves topical antifungal medications (such as ketoconazole or miconazole), and oral medication may be used for extensive cases. However, since the fungus itself is always present, recurrence is common. To prevent recurrence, maintaining lifestyle habits that prevent the buildup of sweat and sebum, along with seasonal care, is essential.
To prevent Malassezia from multiplying
To prevent Malassezia overgrowth, daily cleansing habits are crucial. Thoroughly removing sweat and sebum through daily showers and face washing is fundamental. However, scrubbing can damage the skin barrier, actually making it easier for bacteria to multiply, so gentle washing with your hands is important. Pay special attention to washing sebum-prone areas like the scalp, facial T-zone, chest, and back.
Next is moisturizing. Since Malassezia thrives on oil, it's best to use lighter moisturizers like gels or lotions rather than heavy creams. Choosing products labeled non-comedogenic or oil-free provides added peace of mind.
Clothing and lifestyle habits also play a role. Choosing moisture-wicking fabrics helps prevent sweat buildup, and showering or changing clothes promptly after exercise or on hot days can curb bacterial growth. Additionally, maintaining a balanced diet and consistent sleep patterns stabilizes sebum production, ultimately creating an environment less conducive to Malassezia proliferation.
If you suspect your skin discoloration might be pityriasis versicolor, we would be delighted if you could come in for an examination.
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