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Therapeutic regimens for tinea versicolor (pityriasis versicolor)

Therapeutic regimens for tinea versicolor (pityriasis versicolor)
Drug Dose Duration
Topical therapies
Various azole antifungal preparations (including creams, solutions, lotions, foams, and gels)* Once- or twice-daily application Typically two weeks (range in clinical studies of one to four weeks)
Ketoconazole 2% shampoo One five-minute application daily Three consecutive days (a single application may be similarly effective)
Terbinafine 1% cream Twice-daily application One week
Ciclopirox 0.77% cream Twice-daily application Two weeks
Selenium sulfide 2.5% shampoo One ten-minute application daily One week
Zinc pyrithione 1 or 2% shampoo One five-minute application daily Two weeks
Oral therapies
Fluconazole 300 mg orally once weekly Two weeks
Itraconazole 200 mg orally once daily Five days

* Topical azole antifungals include: clotrimazole 1%, econazole 1%, efinaconazole 10%, ketoconazole 2%, luliconazole 1%, miconazole 2%, oxiconazole 1%, sertaconazole 2%, and sulconazole 1%. For additional detail on available formulations and frequency of application refer to the Lexicomp drug-specific monographs included with UpToDate.

¶ Oral therapy is reserved for patients with disease refractory to topical therapy or widespread disease that makes the application of topical therapy difficult. Oral terbinafine and griseofulvin are not effective; oral ketoconazole is not recommended (refer to topic discussion). Doses provided are for adults.
Prepared with data from: Hu SW, Bigby M. Pityriasis versicolor: a systematic review of interventions. Arch Dermatol 2010; 146:1132.
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