Everything You Need to Know About Pityriasis Alba
Key takeaways:
Pityriasis alba is a skin condition that causes spots of skin to look lighter.
Children and teenagers are more likely to develop pityriasis alba.
Pityriasis alba will go away on its own, but this can take months. Treatment with topical steroids can help.
You might have pityriasis alba if you’ve recently noticed that you have some flat, light patches on your face, upper chest, or arms. Pityriasis alba is a skin condition that makes patches of skin look lighter (hypopigmentation) than the rest of your skin. Children and teenagers tend to develop it more often.
Many people notice pityriasis alba during warmer months, as they spend more time outdoors and get more sun exposure. This makes pityriasis alba stand out more. While pityriasis alba isn’t a dangerous condition, it can make some people feel self-conscious. So if you’ve noticed some lighter spots on your skin, here’s what you can do to get them to fade back to your usual skin tone.
What causes pityriasis alba?
Experts aren’t sure why some people develop pityriasis alba or why it’s more common in younger people. Research shows that infection does not cause pityriasis alba, and it’s not contagious. It doesn't seem to be related to diet or vitamin and mineral deficiencies.
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There’s some research that people who have eczema might be more likely to develop pityriasis alba. There’s also research showing that people who tan (instead of burn) in response to sun exposure report get pityriasis alba more often. This is probably because it makes the spots stand out more for these people.
How do you diagnose pityriasis alba?
A healthcare provider can usually diagnose pityriasis alba just by looking at it. Your provider might ask you some questions to find out when you noticed the spots and if they’ve changed over time. Some people notice that the spots start off slightly red and scaly or dry before turning into a lighter patch. And some notice mild itching.
Your provider might also examine your rash under a Wood lamp, which contains a special light and a magnifying glass. This can help your provider rule out other things that might cause your skin to have lighter spots, like:
What’s the difference between pityriasis alba and vitiligo?
Many people worry that the skin changes from pityriasis alba can be from vitiligo. But these are two completely different conditions. Vitiligo is an autoimmune condition that can affect skin all over the body.
Pityriasis alba is not an autoimmune condition. It usually only affects skin on the face, arms, and upper chest. Pityriasis alba doesn’t increase your chance of developing vitiligo.
Both conditions cause skin to look lighter, but the patches of pigment loss look different. Skin changes from pityriasis alba usually have a faded border, so you notice a more gradual transition of skin color. But changes from vitiligo have very sharp borders, and the change in skin color looks more abrupt.
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Is there treatment for pityriasis alba?
Pityriasis alba will improve on its own, but this can take months — and in some cases, years. Pityriasis alba can cause spots of skin loss that can be up to 1 inch in size. It’s no surprise that many people are interested in ways to speed up the healing process and get their skin back to its usual even tone.
Treatments for pityriasis alba include the following.
Topical steroids
Low-strength steroid creams can help calm dryness and scaling. Steroids can also speed up repigmentation, returning your skin to its usual tone faster. You’ll apply steroids to pityriasis alba twice a day for anywhere between 4 and 12 weeks. Many people start to see improvement within 3 weeks.
Topical steroids don’t work for everyone, but many people report success. Because you need to use steroids for a long time, it’s best to work with a healthcare provider instead of using over-the-counter creams. A healthcare provider can make sure you’re not developing side effects or complications from steroids.
Calcineurin inhibitors
New research shows that medications like low-dose tacrolimus ointment speed up repigmentation faster than topical steroids. In one study, people reported pityriasis alba spots had resolved in as little as 3 weeks.
Moisturizers
There’s not a lot of evidence that moisturizers can speed up repigmentation. But moisturizers can help with scaling, dryness, and flakiness. And that can make your pityriasis alba spots less noticeable while you’re using other treatments. Moisturizers can also help relieve itching.
Sunscreen
Wearing sunscreen is important for your skin health for many reasons. It helps protect you from skin cancer and signs of skin aging. For pityriasis alba, using sunscreen helps make skin changes less noticeable.
Light therapy
There are small studies showing that medical-grade light therapy may help resolve pityriasis alba. But right now it’s reserved for people who aren’t having success with other treatments.
Bottom line
Pityriasis alba is a skin condition that causes light spots on the face, upper chest and back, and arms. It becomes more noticeable when you spend more time outdoors. Pityriasis alba will go away on its own over time, but medications — like steroid creams and tacrolimus ointment — can speed up healing.
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References
Abdel-Wahab, H., et al. (2021). Pityriasis alba: Toward an effective treatment. Journal of Dermatology Treatment.
Al-Mutairi, N., et al. (2012). Efficacy of 308-nm xenon chloride excimer laser in pityriasis alba. Dermatologic Surgery.
American Osteopathic College of Dermatology. (n.d.). Pityriasis alba.
British Association of Dermatologists. (2018). Pityriasis alba.
Oakley, A. (2020). Pityriasis alba (dry white patches). DermNet NZ.
Givler, D. N., et al. (2021). Pityriasis alba. StatPearls.
Miazek, N., et al. (2015). Pityriasis alba--Common disease, enigmatic entity: Up-to-date review of the literature. Pediatric Dermatology.
Plensdorf, S., et al. (2017). Pigmentation disorders: Diagnosis and management. American Family Physician.
Rigopoulos, D., et al. (2006). Tacrolimus ointment 0.1% in pityriasis alba: An open-label, randomized, placebo-controlled study. British Journal of Dermatology.
Weber, M. B., et al. (2002). Pityriasis alba: A study of pathogenic factors. Journal of the European Academy of Dermatology and Venereology.
