What is melanin?
Melanin is the substance that gives skin its color or pigment. When the skin cells that produce melanin, also called melanocytes, reduce their production, the resulting condition is known as hypopigmentation. Hypopigmentation is also known as skin depigmentation or loss of skin color. In situations where hypopigmentation is the result of skin inflammation or damage, the condition may be referred to as post-inflammatory hypopigmentation, or PIH.
What are white spots on skin?
Hypopigmentation is a condition in which the skin is lighter in color than normal. It occurs due to the absence of normal amounts of melanin caused by disease, injury, burns, or other trauma to the skin. Hypopigmentation can affect a small area of the skin, or it can be widespread.
Main symptoms of white spots on skin
It usually appears as lighter than normal colored patches on the skin or as areas on the skin that appear white.
Main causes of white spots on skin
Hypopigmentation may be caused by injury, inflammation, or infection of the skin. It can also be caused by some medical conditions or certain medicines. The most common cause of hypopigmentation is damage or trauma to the skin. Burns, infections, pimples, blisters, scrapes, and any injuries that result in scarring can all lead to skin discoloration. Improperly administered skin resurfacing treatments, such as photofacials (IPL), laser peels, or chemical peels can also cause skin damage that results in hypopigmentation.
Other causes may include:
- Albinism is a condition characterized by colorless skin, hair, and eyes that occur because skin cells produce little or no melanin.
- Vitiligo is a skin condition that causes your skin to lose its natural color. People who have this condition will notice patches of lighter skin appear. While some people develop a few patches, others may lose much more skin color. In other cases, vitiligo will affect other parts of your body. It can also cause your hair to turn white or discolor parts of the mouth or eyes.
- Tinea versicolor is a condition that occurs when a natural yeast found on the skin called Pityrosporum ovale grows out of control and begins to change the pigmentation of the skin. When this occurs, patches of skin may become lighter or darker.
- Pityriasis alba is a skin disorder commonly found in children and young adults that causes pale pink or red, scaly patches to form on the skin. When these patches clear up, the skin is left discolored, with smooth light patches taking their place.
Diagnosis and tests for white spots on skin
Your doctor will examine your skin to know what your loss of pigmentation is caused by. Since more than one condition may be necessary for your symptoms, there may be a need for more tests. In this case, your doctor may perform a skin biopsy. This is a procedure in which a doctor cuts and removes a small sample of skin to have it tested. This test will help you and your doctor tell the difference between missing melanocytes and melanocytes that are malfunctioning for another reason.
The doctor may also be interested in knowing whether you have been diagnosed with autoimmune diseases like type 1 diabetes or hypothyroidism or if any of your family members have similar symptoms.
Treatments for white spots on skin
Treating hypopigmentation may involve the use of topical corticosteroids or tars, light or laser treatment, or surgical skin grafting.
There are topical medications that sometimes help with white spots on the skin. Some of the medications used to treat hypopigmentation include topical steroids that come as a cream or ointment which you apply to your skin. They may restore some of your original skin color and stop the spread of the white patches.
Your doctor may prescribe a topical steroid if:
- You have non-segmental hypopigmentation on less than 10% of your body.
- You want further treatment like sun protection and camouflage creams.
- You are not pregnant.
- You understand and accept the risk of side effects.
Before you consider using a topical steroid on your face, consult a dermatologist.
Some of the steroids that your doctor may prescribe include:
- Fluticasone propionate
- Betamethasone valerate
- Hydrocortisone butyrate
When your skin is exposed to sunlight, it produces melanin to help protect it from ultraviolet (UV) light. However, if you have hypopigmentation there may not be enough melanin in your skin to be protected. As a result, it is advisable that you apply sunscreen with a sun protection factor (SPF) of 30 or above. It will protect your skin from sunburn and long-term damage especially if you have fair skin.
Side effects of treatments
Some people may experience side effects of topical steroids. These include:
- Streaks or lines in your skin
- Atrophy — thinning of your skin
- Telangiectasia — visible blood vessels appearing
- Hypertrichosis — excess hair growth
- Contact dermatitis — inflammation of your skin
Health Solutions From Our Sponsors
American Academy of Dermatology Association: "VITILIGO DISCOMFORT STOPS WITH SUNSCREEN USE."
American Academy of Family Physicians: "Choosing Topical Corticosteroids."
American Academy of Family Physicians: "Common Pigmentation Disorders."
Indian Dermatology Online Journal: "Side-effects of topical steroids: A long overdue revisit."
National Health Service: "Treatment-Vitiligo."
NYU Langone Health: "Diagnosing Vitiligo."
Solihull Medical Cosmetic Clinic: "What is hypopigmentation?"
StatPearls [Internet]: "Hypopigmented Macules."
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