Tis the season. . . as summer rolls around I’ve again started getting questions almost daily from parents worried about scattered white spots that are appearing on their child’s face. Parents often worry that these skin changes are a sign of vitamin deficiency or some sort of infection, but they are most often due to a very common but somewhat mysterious skin condition called pityriasis alba.
We don’t understand exactly what causes pityriasis alba, but we do know that it is not dangerous and is not related to a more serious condition inside your child’s body. It is thought to be a type of dermatitis (non-specific inflammation of the skin) that leads to “post-inflammatory hypopigmentation”. This means that the skin is dry or irritated in some way and the skin is left injured. The affected areas appear lighter that other areas of the skin, especially after sun exposure. This is why parents start to notice and ask about this condition in the late spring and early summer- the contrast between affected skin and healthy skin is more obvious after kids start playing outside more.
Protecting your child’s skin from the sun with broad-spectrum sunscreen is the best way to prevent this condition from becoming more noticeable (and is also really important for other reasons). Your pediatrician may also recommend frequent use of emollients (moisturizer) year-round, as this helps to stop progression of the problem and diminish the dry skin and scaling that are sometimes associated with pityriasis. Even with treatment, pityriasis alba may take months to a year to completely resolve.
There are other skin conditions that cause patchy or more generalized whitening of the skin, such as vitiligo, psoriasis, atopic dermatitis, or tinea versicolor. If you think your child may have one of these conditions, talk with your child’s health care provider.