The spots appear when there is a loss ofskin pigmentor from trapped skin cells.
White spots on the skin are usually not skin cancer (benign) and typically need minimal treatment.
If you experience white spots, they may resolve on their own or with simple home treatments.
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These spots are typically small, about 1 to 3 millimeters in diameter.
No other symptoms, likeitchingor pain, are associated with the spots.
The exact cause of guttate hypomelanosis is not known but is likely due to sun exposure and genetics.
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Treatments may include medications such as topical steroids, tretinoin, or pimecrolimus.
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from DermNetdermnetnz.org2023.
Reproduced with permission from © DermNet and © Raimo Suhonendermnetnz.org2023.
Milia
Miliaare tiny white bumps often found on the eyelids, cheeks, and nose.
They are keratin-filled cysts that do not cause any pain or itching.
The skin continuously exfoliates itself.
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When skin cells do not properly exfoliate and get trapped under the skin, it can form milia.
Milia looks similar to whiteheads, which may make it tempting to pop or squeeze them.
However, this should be avoided because it can cause scarring.
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Milia don’t need to be treated, but if they bother you, there are a few options.
Some people have also tried exfoliators or facial peels, but these can actually make milia worse.
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Fungal Infections
Certain fungal infections may result in white spots on your skin.
One condition is calledtinea versicolororpityriasis versicolorwhich is a fungal or yeast skin rash.
Pityriasis versicolor pops up if there is an overgrowth of Malassezia yeast on the skin.
Skin patches develop as a result, but the patches can be either dark or light.
These spots also prevent tanning.
It is not contagious and it often resolves with treatment, although it may take a few months.
Sometimes the condition returns after treatment has ended.
The most common treatment for tinea versicolor is using antifungal or medicated dandruff shampoo on the skin.
It is recommended that you use the shampoo every day for at least four weeks.
In some cases, medication is prescribed such as an antifungal cream or oral antifungal medicine.
Your provider may also suggest using an over-the-counter miconazole or clotrimazole cream.
For example, it can happen during the sub-acute phase of an eczema flare.
White spots or light areas of the skin are not sparked by eczema treatments, such as steroid creams.
These creams cause blood cells to dilate, but they don’t change the color of the skin.
Usually, light spots resolve on their own, but it may take some time and prolonged treatment.
Treating your eczema and managing the symptoms is the best way to handle the white spots that appear.
Treating your eczema promptly can help minimize the overall damage.
Topical steroids are the most common treatment for hypo and hyperpigmentation that occurs with eczema.
You may need to continue using the medication after the flare-up has resolved if white spots remain.
It is typically seen on the cheeks and chin but can occur anywhere.
As the patches heal, they leave an area of hypopigmentation (skin lighter-colored than the surrounding skin).
Pityriasis alba has no known cause but tends to occur in people with dry skin and atopic dermatitis.
Most people with pityriasis alba will not need treatment.
However, a moisturizer can alleviate dryness.
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Vitiligo
Vitiligois anautoimmune conditionthat causes areas of the skin to lose pigmentation.
This causes milky-white areas on the skin that tend to be symmetrical with both sides of the body.
Vitiligo is most often seen on the hands, arms, face, and feet.
These white patches tend to start before the age of 20.
Treatments
Cosmetic solutions, including make-up and self-tanners, are often helpful for some people with vitiligo.
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Nutritional Deficiencies
A diet that lacks certain vitamins may cause pigment changes to your skin.
For example, there is some evidence that associates a vitamin B12 deficiency with vitiligo.
If medical treatments are advised, they generally include light or laser therapy treatments to the affected areas.
The patches start as red spots that gradually become white or yellow.
The patches may or may not become inflamed.
It’s possible for a person to have both morphea and lichen sclerosis at the same time.
In some cases, some patients also use a topical form of vitamin D called calcipotriene.
If you have morphea or any form of scleroderma, speak to your healthcare provider about personalized treatments.
Nevus Depigmentosus
Nevus depigmentosus is a whitish birthmark that forms within the first few months of life.
Nevus depigmentosus does not affect the hair.
Nevus depigmentosus can also be called non-pigmented naevus or achromic naevus.
The condition usually affects the trunk, although it can also affect other parts of the body.
Treatment is generally not needed for this skin condition.
If repigmentation is needed, dermatological options include laser treatments, phototherapy, or skin grafting.
Piebaldism
Piebaldismis a rare genetic condition that is usually diagnosed at birth.
The condition causes white patches of skin and white hair.
The primary characteristic of piebaldism is a white patch of hair near the forehead.
Eyelash and eyebrow hair can also be affected.
People with piebaldism need to be especially careful in the sun as the white patches can burn easily.
Sunscreen is highly recommended, and people with the condition are often advised to do regular skin cancer checks.
Cosmetic options are available to cover up white patches or white hair, including hair color or makeup.
Other treatments include dermabrasion or UV light therapy (often used in combination with other treatments).
Some clinicians may also suggest various skin grafting methods, such as suction epidermal grafting or full-thickness punch grafts.
Lastly, transplant procedures can also be used.
Treatment will vary based on the underlying cause.
See a dermatologist to evaluate the white spots to determine the best care plan.
American Osteopathic College of Dermatology.Idiopathic guttate hypomelanosis.
American Academy of Ophthalmology.What are milia?
University of South Florida.What Are Miliaand How Do You Get Rid of Them?
Cedars Sinai.Tinea Versicolor (Pityriasis Versicolor)
National Eczema Society.Skin pigmentation and eczema
American Osteopathic College of Dermatology.Pityriasis alba.
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Vitiligo.
Indiana University School of Medicine.
Dermatology.Understanding Segmental Vitiligo
NYU Langone Health.Topical medication for vitiligo.
Dutta RR, Kumar T, Ingole N.Diet and Vitiligo: The Story So Far.Cureus.
2022 Aug 28;14(8):e28516.
