Pityriasis alba is a common, benign skin condition characterized by light-colored patches that frequently appear on the face and arms. While generally harmless and often resolving on its own, its appearance can be a cosmetic concern. This article provides practical information on managing and reducing the appearance of these patches.
Understanding Pityriasis Alba
Pityriasis alba presents as lighter, often oval or round, skin patches, sometimes with a fine scale. They commonly appear on the face (especially cheeks), neck, and upper arms. It primarily affects children and adolescents (ages 3-16), but can also appear in adults.
The exact cause is not fully understood. It is often linked to mild forms of eczema or atopic dermatitis and dry skin. Sun exposure can make the patches more noticeable because the surrounding skin may tan while affected areas do not. It is not contagious and usually fades spontaneously over several months to a few years as normal skin pigmentation gradually returns.
Home Care and Over-the-Counter Options
Consistent moisturizing is a primary step, improving skin barrier function and reducing dryness or scaling. Apply emollients, such as thick, fragrance-free creams or petroleum jelly, at least twice daily, especially after bathing, to retain skin moisture.
Gentle skin cleansing is also important; using mild, soap-free, and fragrance-free cleansers can prevent further irritation and dryness. Sun protection is also important. Use a broad-spectrum sunscreen with SPF 30+ daily to prevent surrounding skin from tanning, which makes patches more prominent. Sun-protective clothing, like long-sleeved shirts and wide-brimmed hats, offers additional protection.
For mild inflammation or redness, a low-potency over-the-counter hydrocortisone cream (0.5% or 1%) may be used for a short period, typically one to two weeks. This reduces associated itchiness or discoloration. However, such creams should be used sparingly and as directed, especially on the face.
Medical Treatments and When to Seek Professional Help
For more persistent or widespread cases, a healthcare provider may prescribe stronger topical corticosteroids, such as hydrocortisone 2.5% or fluticasone propionate. Used under medical supervision, these have potential side effects with prolonged use, including skin thinning. Prescription corticosteroids are typically applied for limited durations to manage inflammation and encourage repigmentation.
Topical calcineurin inhibitors, such as tacrolimus ointment (0.1%) or pimecrolimus cream (1%), offer an alternative, particularly for facial involvement, as they do not cause skin thinning. Tacrolimus 0.1% ointment effectively resolves hypopigmentation, often applied twice daily for several weeks. While these medications can be effective, they may be more costly than corticosteroids.
Phototherapy, specifically narrowband UVB, may be considered for severe or extensive cases that do not respond to topical treatments. A dermatologist administers this treatment. Seek professional medical advice if patches are widespread, persistent, cause significant cosmetic concern, or if home care and over-the-counter remedies do not show improvement after several weeks. A healthcare provider can accurately diagnose and recommend the most appropriate course of action.
Managing and Preventing Recurrence
Adherence to good skincare habits remains important even after patches fade, helping prevent new ones from forming. Daily moisturizing and consistent sun protection are ongoing practices. Avoiding skin irritants, such as harsh soaps or cleansers, also supports skin health.
Patience is necessary, as the condition can take several months to a few years for complete resolution, and the process of repigmentation is gradual. Managing any underlying dry skin or eczema is also beneficial for long-term skin health. While pityriasis alba often resolves on its own, maintaining these practices supports skin recovery and can reduce the likelihood of recurrence.