Pityriasis alba is a skin condition that causes white spots on the face or other areas of the skin. It typically affects children. The white patches should go away on their own, but you can talk to your healthcare provider about using moisturizers or other topical treatments to ease symptoms.
The condition is named for its scaly appearance and white patches. The name pityriasis alba comes from the Latin words pityrus, meaning wheat, and alba, for white.
This article describes pityriasis alba, and how it differs from vitiligo and similar conditions. It presents information about the symptoms, causes, diagnosis, and treatment options.
Pityriasis Alba Symptoms
Pityriasis alba causes lightly colored or white spots on the skin. Most often, they are found on the cheeks. But they can also show up on the neck, chest, back, and upper arms. Symptoms include:
- Pink or red spots that fade to lighter than usual skinAffected areas ranging from a quarter-inch to an inch in sizeWhite spots in circle or oval shapeUndefined borders that gradually blend into normally pigmented skinFlaky and itchy patches of skin
The patches themselves are often raised and may be scaly. The scaliness is most noticeable during the winter months when the air is drier. During the summer, the spots can be easier to see when other skin is tanned.
The lesions aren’t painful, but they might be mildly itchy.
Pityriasis Alba Causes
Although an exact cause is still unknown, pityriasis alba may be related to other skin conditions. For example, it is thought that when a case of dermatitis (skin irritation) heals, it may leave behind a lighter patch of skin.
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It may also happen if you use too much topical corticosteroids when treating eczema. This can cause areas of patchy rash to lighten as they heal.
Some genetic disorders are also believed to cause cutaneous hypopigmentation (loss of skin color). This can happen when melanocytes, the cells that produce the skin pigment melanin, have lower activity. Melanin makes the skin darker.
Diagnosis
Usually, your healthcare provider can diagnose pityriasis alba by simply looking at the rash of white spots on the face, or other parts of the body, while reviewing your child’s symptoms and medical history.
About 5% of children in the U.S. will get pityriasis alba at some point in their early school years, according to a 2015 study in the Journal of Clinical Medicine.
Pityriasis alba is often confused with tinea versicolor, where an overgrowth of fungus on the skin causes patchy white lesions. However, there are several ways to distinguish between the two disorders:
- A Wood’s lamp examination uses a handheld ultraviolet (UV) light to highlight differences in skin color. It is usually used in a dermatologist’s office in a darkened room.
- Potassium hydroxide (KOH) can be used to diagnose fungal infections, like tinea versicolor or other fungal conditions such as tinea corporis (ringworm). For this test, the skin is lightly scraped to remove some skin cells, which are mixed with potassium hydroxide and examined under a microscope.
Pityriasis alba can also be confused with vitiligo, an autoimmune disease where pigment is lost in some patches of skin. However, vitiligo has very distinct borders, which will help your healthcare provider to distinguish between the two.
Vitiligo patches appear first on sun-exposed parts of the body. It can often occur after a triggering event such as a sunburn. It can then spread to the armpits, eyes, groin, genitals, naval, and rectal areas.
Softer, blurred borders
Patches are lighter than surrounding skin, but not completely depigmented
Smaller affected areas
Very distinct borders
Patches are typically stark-white in color (complete loss of pigmentation)
Larger affected areas
Pityriasis alba also develops in sun-exposed areas. However, it isn’t clear if sun exposure triggers the condition.
Treatment
Treatment of pityriasis alba is not always necessary. Most cases usually resolve on their own by adulthood. Still, many parents choose to treat it for cosmetic reasons, especially if their child is self-conscious about their skin.
Pityriasis alba can be confused with other skin conditions, like fungal skin infections or vitiligo. A physical exam and certain diagnostic tests can help to determine what kind of skin disorder affects your child.
Even with treatment, recovery can sometimes take several months. Your child should avoid tanning (natural or artificial) and consistently use sunscreen (at least 30 SPF) to speed healing.
Moisturizers
Moisturizers that contain petrolatum, mineral oil, squalane, or dimethicone can help soften the skin and reduce scaliness, especially on the face. Brands that are effective, inexpensive, and easy to find include:
- AquaphorAveeno CreamEucerin
You may also ask your physician for recommendations. Good skin hygiene, in general, can help the patches heal faster.
Over-the-Counter Hydrocortisone
You can use an over-the-counter (OTC) 1% hydrocortisone cream (topical steroid) sparingly if there is itchiness. However, care should be taken when using hydrocortisone on the face.
Do not apply around the eyes or on the eyelids. Don’t use OTC hydrocortisone for more than four weeks continuously unless you are following your healthcare provider’s advice.
Topical Calcineurin Inhibitors
Elidel (pimecrolimus) and Protopic (tacrolimus) are non-steroidal medications that may be prescribed to clear the rash. They aren’t often needed but are sometimes suggested in more severe cases.
Because children are more vulnerable to side effects, ask your healthcare provider before applying hydrocortisone on your child’s face and follow their recommendations.
Topical calcineurin inhibitors are most often used to treat eczema. They are used off-label for pityriasis alba. This means the Food and Drug Administration hasn’t approved them specifically for this purpose. Because they are not steroids, you can safely use them around the eyes.
Summary
Pityriasis alba is a condition in which patches of skin lose pigmentation and are lighter in color than surrounding skin. It most often affects elementary-age children. The affected areas of skin are small—usually no bigger than an inch in diameter.
A diagnosis of pityriasis alba is based on a physical exam and skin tests. Most often, the white spots on the skin heal on their own without treatment. But, if your child feels self-conscious, your healthcare provider may advise treating the patches with moisturizers or other topical medications to speed the healing process.
A Word From Verywell
Anytime your child has an unusual rash, you should make an appointment with their pediatrician. Pityriasis alba is a harmless condition, and there is no medical reason to treat it. But if doing so will make your child feel more confident, that’s a good enough reason to consider it. Remember that, in most cases, pityriasis alba fades by adulthood.
Frequently Asked Questions
- Does pityriasis alba ever go away?
- Yes, in most cases. The light-colored or white spots on the face of children usually go away on their own in a matter of months. Any treatment is meant to help make someone with pityriasis alba more comfortable. The skin disorder, which may be linked to atopic dermatitis, typically clears up entirely by adulthood.
- Learn More:
- How Atopic Dermatitis Is Treated
- Is Vaseline good for pityriasis alba?
- It may help as a moisturizer to relieve itching. However, if your condition is severe, your healthcare provider may recommend Protopic (tacrolimus) ointment as treatment.One study, comparing tacrolimus and two other ointments with Vaseline (petrolatum), found Vaseline offered no benefit in treating pityriasis abla redness and scaly patches compared with the other treatments.
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- The 10 Best Sunscreens of 2022
- What is pityriasis alba caused by?
- The answer is still unclear. Pityriasis alba may be linked to environmental exposure (like sun or wind), to virus or fungal exposure, or even to diet and skin hygiene. A study of 2,726 people with the condition found that incidence peaked during summer months, suggesting a link to environmental causes.
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- How Do Lifestyle Factors Impact Skin Conditions?
Yes, in most cases. The light-colored or white spots on the face of children usually go away on their own in a matter of months. Any treatment is meant to help make someone with pityriasis alba more comfortable. The skin disorder, which may be linked to atopic dermatitis, typically clears up entirely by adulthood.
It may help as a moisturizer to relieve itching. However, if your condition is severe, your healthcare provider may recommend Protopic (tacrolimus) ointment as treatment.
The answer is still unclear. Pityriasis alba may be linked to environmental exposure (like sun or wind), to virus or fungal exposure, or even to diet and skin hygiene. A study of 2,726 people with the condition found that incidence peaked during summer months, suggesting a link to environmental causes.