Tinea versicolor: the fungal cause of light patches

Not all light patches are pigment disorders in the usual sense. A frequent and very treatable cause of lighter (or sometimes darker) patches, especially on the chest, back, and shoulders of younger people, is tinea versicolor, an overgrowth of a yeast that normally lives on the skin, and one of several causes covered in our guide to hypopigmentation.

The yeast interferes with pigment production where it proliferates, leaving patches that are lighter than the surrounding skin and often more noticeable after sun exposure, since the affected areas do not tan. The patches may be faintly scaly and can itch mildly. It is favored by heat, humidity, and oily skin, which is why it is common in warm climates and tends to recur.

The good news is that it responds well to antifungal treatment, topical antifungal washes and creams for most cases, oral antifungals for widespread or stubborn ones. The important caveat patients should expect: even after the yeast is cleared, the color difference takes weeks to months to even out, because the pigment has to recover, so the patches do not vanish immediately after treatment. Recurrence is common, and periodic antifungal washes can prevent it. Recognizing this fungal cause, rather than mistaking it for a permanent pigment problem, leads straight to an effective, simple fix.

Related reading: Phototherapy: light treatment for repigmenting skin.