"What are these white spots on my body?" concerned patients often ask me. That's the summer souvenir you get for all the time spent in the heat and the sun. The medical term for 'liver spots' is pityriasis versicolor (PV). PV is caused by a yeast-like fungus called Malassezia furfur. These are harmless fungi that live on the skin without causing any problem. Hot and humid weather conditions cause increased perspiration and high sebum (oil) production by the skin, thereby creating the perfect environment for the fungi to multiply and spread.
The other conditions that also promote the multiplication of fungi are
a) wearing synthetic clothing for prolonged periods when playing sports
b) poor personal hygiene.
PV is found throughout the world and has no racial or sexual preference. In addition, PV thrives in hot and humid weather, which is why the condition is prevalent in Jamaica.
When the aforementioned conditions exist, the fungi multiply quickly, leaving behind a mild, itchy and scaly rash. The term versicolor refers to the fact that the fungi cause the affected skin to change colour and become either darker or lighter. Typically, the rash starts as small, round, pale patches on the areas of the skin exposed to the sun, i.e. arms and face. The rash may also appear as scaly brown patches. The patches may merge together and form a large continuous area of discoloration. Sometimes it is difficult to tell which area is the unaffected skin. PV is commonly seen on the neck, arm, chest and back. In the more severe cases the entire body may be affected.
PV patches that are brown or reddish- brown usually go away immediately after treatment. The lighter areas may take six weeks to three months to regain colour. This is because the fungi produce a chemical which inhibits the normal production of pigment in the affected skin, resulting in areas of paler skin tone. The uneven skin tone is unsightly and may cause the affected individual to avoid social gatherings.
This condition is not serious or contagious. People seek treatment because they are very self-conscious, especially in the summer months, when the skin is more exposed. Sometimes people mistake PV for the other dreaded hypopigmented condition — vitiligo! The difference between the two conditions is that vitiligo patches are usually stark white and totally devoid of pigment.
Prevention is better than cure as recurrence is very common.
• Bathe more often when the weather is hot and humid in order to cool down the body and remove the troublesome fungi.
• As soon as you finish exercising, you should change into clean dry clothing. Avoid wearing wet synthetic clothing which encourages the fungi to multiply.
• Apply non-prescription products such as Whitfield ointment, sodium thiosulfate solution, Head and Shoulder shampoo, Selsun blue shampoo and ariSulfur bar to the affected area daily for one to four weeks.
If the rash covers a large area of your skin and has not cleared after the above treatments, seek the advice of your doctor/ dermatologist who will prescribe a course of tablets to clear the condition.
Next week I will discuss ‘ringworm’ of the scalp. It's back to school! Look out for this contagious infection of the scalp.
Dr Patricia Yap is a dermatologist at Apex Skin Care and Laser Center.