Tinea versicolor (an-an): why white spots appear and how to treat them

An-an is the Filipino name for tinea versicolor, also called pityriasis versicolor. "Versicolor" means the patches can be lighter or darker than your skin.

The patches usually look like this:

• small round or oval spots with clear edges, which can join into larger areas
• lighter than the skin around them on most brown skin, but sometimes darker or pink
• flat, with a fine, powdery scale that shows more when you gently stretch the skin
• mostly on the chest, upper back, shoulders, neck and upper arms, and sometimes the tummy

Many people feel nothing. Some have a mild itch that is worse when they are hot and sweaty.

The patches do not tan. That is why an-an often seems to appear after a beach trip: the skin around the patches darkens in the sun, so the pale spots stand out.

In children, an-an sometimes shows up on the face, especially the forehead. But pale patches on a child's face are often something else. See White spots on skin that are not an-an.

An-an is caused by a yeast, a tiny kind of fungus, called Malassezia. It lives on almost everyone's skin and usually does no harm. Sometimes it grows more than usual in the top layer of the skin and disturbs the skin's normal coloring, which leaves the patches.

Things that make this more likely:

• hot, humid weather, which is why an-an is so common in the Philippines
• heavy sweating from outdoor work, sports or hot commutes
• oily skin, common in teenagers and young adults, who get an-an most
• oils or oily lotions on the skin, tight clothes that trap sweat, and long hours in a face mask
• pregnancy, birth control pills and steroid medicines
• diabetes, being overweight and a weak immune system
• family history

Most people with an-an are otherwise healthy. A national skin survey in the Philippines, published in 1999 and cited by Filipino dermatologists in a Cochrane research plan, found it in about 2 in every 100 people. An-an does not spread from person to person.

Many families have their own ideas about an-an. Here is what the medical sources say.

"Galing sa pasma." Some believe an-an comes from pasma, such as bathing while tired or sweaty. It is caused by a yeast, not by bathing. Washing off sweat and staying cool can actually help keep it away.

"Madumi kasi." An-an is not a sign of being dirty. People who bathe every day get it too. There is no reason to feel ashamed.

"Nakakahawa." It does not pass from one person to another. A child with an-an can go to school as usual.

"Bawal ang malansa." No special diet has been shown to help an-an, so there is no need to stop eating fish, eggs or chicken.

"Mawawala rin 'yan." An-an may fade in cooler months, but untreated it can last for years and usually returns in hot weather.

"Hindi gumana ang gamot, puti pa rin." Pale spots often stay for months after the yeast is gone. This does not mean the medicine failed. See Why the white spots stay after treatment.

Many problems cause white spots on skin, and some need very different care.

• Pityriasis alba: pale, slightly dry, round patches, most often on the face of children and teenagers. It is linked to eczema (dry, sensitive skin), is harmless, and fades on its own over many months. Many parents call this "an-an sa mukha", but antifungals do not treat it. A doctor may suggest a moisturizer, and sunscreen keeps the patches from burning.
• Vitiligo: milky-white patches with sharp edges and no scale. Hair in a patch may turn white.
• Psoriasis: raised, flaky patches, which the NHS lists among the look-alikes.
• Ringworm (buni): a red, often itchy rash shaped like a ring, which can spread to other people by touch. See our guide to ringworm (buni).
• Leprosy (Hansen disease): a pale or reddish patch where the skin has lost feeling, so a light touch is hard to feel. Leprosy is still found in the Philippines. It is curable, the World Health Organization supplies the medicines free, and early treatment prevents disability.

Check for numbness. If a pale or reddish patch feels numb, or your hands or feet are numb or weak, get checked soon at your health center. Do not treat it at home as an-an.

A nurse or doctor can often tell it is an-an by looking. To be sure, they may:

• do a KOH test: a little scale is scraped off, or lifted with clear tape, and checked under a microscope for the yeast. It is quick and usually painless.
• shine an ultraviolet Wood's lamp on the skin, which can make the patches glow yellow-green, though many patches do not glow

Tip: If you can, skip cream or medicated shampoo on the patches on the day of your check-up, and tell the health worker what you have already used. Recent treatment can hide the scale and make the tests harder to read.

Most an-an clears with medicine put on the skin, and several kinds are sold at pharmacies without a prescription.

Medicated shampoos used on the skin. Anti-dandruff shampoos with selenium sulfide or ketoconazole treat an-an well, and they are easier to spread over a large area than a cream. Lather the shampoo onto the patches in the shower, leave it on for as long as the label says (the NHS advises 10 to 15 minutes), then rinse well. Use it as often, and for as many days, as the label or your pharmacist says. Zinc pyrithione shampoos are also used.

Antifungal creams with clotrimazole, miconazole, ketoconazole or terbinafine suit smaller areas. Spread it over each patch and the skin just around it, as the label says.

These steps help the treatment work:

1. Treat your scalp too. The scalp is a main hiding place for the yeast, so doctors advise treating it as well, for example by washing your hair with the same shampoo.
2. Finish the course. Treatment lasts from a few days to 4 weeks, depending on the product. The scale and itch usually settle in 2 to 3 weeks.
3. Watch for irritation. Selenium sulfide especially can irritate the skin, and some people are allergic to a product. Stop and ask a pharmacist if your skin turns red, sore or blistered.
4. Ask a pharmacist first for a child, and check the label, since some products are not meant for young children.
5. If you are pregnant or breastfeeding, ask a doctor or pharmacist first. In pregnancy, an-an is treated on the skin only, and clotrimazole cream is one option found to be safe.

Tablets are a second choice. If an-an covers a large area, keeps coming back, or does not clear with shampoos and creams, a doctor may prescribe antifungal tablets. Never take tablets left over from someone else. Ketoconazole tablets are no longer recommended because of the risk of liver damage, and terbinafine tablets do not work for an-an.

Steroid creams do not treat an-an. Itch creams with a steroid, such as betamethasone, do not kill the yeast, and steroids can help it grow. Read the ingredients before you buy.

Medicine kills the yeast fairly quickly, but the skin needs time to make its usual color again.

• Expect a few months before the patches blend in. In one study, about 3 to 5 in every 10 people still had pale spots months or even years after the yeast was gone.
• No more scale and no more itch usually means the treatment worked, even if the spots are still pale.
• Sun makes the spots stand out, because the skin around them tans and the patches do not. Shade, sleeves and sunscreen help.
• New scaly patches, or patches that spread again, may mean an-an has come back. Old pale spots that are slowly fading are different.

For most people the skin slowly makes its normal pigment again and the contrast fades. If pale spots last a long time, a health worker can check that they are not something else.

Many Filipinos try a home remedy for an-an first. Here is what is known.

• Sulfur soap. Sulfur with salicylic acid helps shed the top layer of skin where the yeast lives, and medical reviews list it among the treatments used for an-an. Antifungal shampoos and creams have more research behind them.
• Akapulko or lemongrass. Researchers list these herbal preparations among treatments that have been tried, but we found no good studies showing they work for an-an.
• Kalamansi, lemon, garlic or vinegar. We found no studies showing these treat an-an, and strong juices can sting or irritate the skin.
• Scrubbing with a pumice stone or rough cloth. This has been used to remove scale, but there is little proof it clears an-an, and hard scrubbing can scrape the skin.

Stop any remedy that makes your skin red, sore or blistered. If the patches are still scaly or spreading after about 2 weeks, switch to a pharmacy shampoo or cream, or get checked.

You can start at a pharmacy. Tell the pharmacist where the patches are, how long you have had them, and if you are pregnant or treating a child.

For a check-up, go to your barangay health station, rural health unit (RHU) or city health center: find a health center near you. A skin doctor helps when an-an keeps coming back or the diagnosis is unclear: find a dermatologist.

With PhilHealth YAKAP, check-ups at your registered YAKAP clinic are free, though as of July 2025 a private YAKAP clinic may charge up to ₱900 per patient a year.

Free medicines through PhilHealth GAMOT. As of mid-2026, PhilHealth's GAMOT list includes ketoconazole shampoo, ketoconazole cream and clotrimazole cream, and PhilHealth's June 2026 circular names tinea versicolor among the conditions they are listed for. To get them:

• your YAKAP doctor prescribes them in the GAMOT app
• show the prescription or its code and a government ID at an accredited GAMOT pharmacy (look for the PhilHealth GAMOT sign outside)
• claim antifungals within 2 days of the prescription date, or you may have to pay
• as of July 2025, each member and each dependent can get up to ₱20,000 worth of medicines a year

The 21 medicines PhilHealth said in January 2026 are still given at YAKAP clinics do not include antifungals, so ask your clinic which GAMOT pharmacies near you are accredited. To sign up, see our PhilHealth YAKAP guide.

Not sure the patches are an-an? Ask our symptoms assistant or book a call with a nurse.

Because the yeast is a normal part of the skin, up to 8 in 10 people get an-an again, most often in hot, humid months. These steps lower the chance:

• Stay cool and dry. Bathe after heavy sweating, and change out of damp shirts.
• Wear loose, breathable clothes rather than tight clothes that trap sweat.
• Skip oily products such as body oils and heavy lotions on the chest and back.
• Wash and iron your clothes. A medical review notes that clothes can hold the yeast and bring it back to your skin.
• Use a medicated shampoo on your skin from time to time. If an-an keeps returning, health services suggest washing the skin with an anti-dandruff or antifungal shampoo about once a month, or every few weeks in the hot season.
• See a doctor if it returns many times a year. A doctor may suggest a preventive plan, sometimes with tablets.