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 I have a fungus. He thinks it’s contagious and wants me to see a dermatologist. Do you have 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.
Question: My middle child is 9 years old and recently got a wart on her hand. I heard that it is a virus infection. Do I need to worry that she is contagious to others? Are the over-the-counter medications any good?
Answer: Warts are caused by a virus, are generally harmless and can be on almost any part of the body. They can vary in size and number and can be painful, especially when located on the bottom of a foot or other sensitive area.
Since warts are caused by a virus, they are slightly contagious to people not immune to the wart virus, but only through direct skin contact. A person with a wart is obviously susceptible, and the warts may spread on their body. Scratching or picking at a wart, shaving or biting warts on fingers can lead to spreading.
There are no effective vaccines or oral medications for warts, despite anecdotal reports to the contrary. People have been trying to cure warts for thousands of years. The success of some anecdotal treatments for warts is due to the fact that warts often disappear by themselves, especially in young children. That means there is a spontaneous cure rate of some warts, but it is less common in adults.
There is no single, perfect treatment for warts. Treatment is directed at killing the virus with the hope that the destroyed virus will not only go away, but will stimulate an immune response to prevent the return of the wart. There are over-the-counter medications containing salicylic acid that can destroy warts. If over-the-counter medications fail, see a dermatologist for evaluation and treatment. The treatment used by the dermatologist will depend on the location of the wart, its size, and the age/skin type of the patient, as well as the person’s activity level.
Sometimes new warts will form while existing ones are being destroyed. New warts can be treated only when they become clinically apparent. Some warts can be stubborn, requiring different treatment modalities when a previous type of treatment has failed. Although frustrating, warts may return weeks or months after an apparent cure. There is no reason to be concerned if a wart recurs, but it will need to be treated again.
