We understand, white spots on the face can be irritating! Be it the patches of discoloration, the small bumps or all the different forms they come in.
The good news is that these spots have effective treatments. Read on to know more about them.
Milia are small, white, raised, painless, fluid-filled bumps that develop on the surface of your skin. Usually seen in babies, milia are also found in adults. (1).
Milia are 1–4 mm wide and usually appear around the eyes, cheeks and nose. They are generally white or yellow in color, often painless, and are not harmful. For some people, however, they may cause discomfort.
Milia can be categorized as either primary or secondary. While Primary milia occurs when keratin gets trapped under your skin and forms a fluid-filled sac, secondary milia develops from trauma like dermabrasion, tissue damage, skin inflammation, etc. Secondary milia can also occur due to side effects of some medications.
Milk spots on face are formed when keratin (a protein in the upper layer of the skin) and dead skin cells get trapped below the skin surface. Milia can manifest due to an allergic reaction to a harsh skincare product or due to sun exposure.
In some cases, people may develop a rare condition known as milia en plaque. In this condition, milia are surrounded by areas of raised, red, scaly, itchy skin. Researchers aren’t sure of any known cause behind this, but believe it to be a sign of discoid lupus erythematosus, a chronic skin condition of sores with inflammation and scarring on the face, scalp, and ears (2).
Doctors suggest retinoid creams and ointments, especially those with 0.1 percent tretinoin, as the primary treatment method. Others include:
Extraction of keratin:A certified dermatologist will use a medical grade needle to extract the keratin.
Retinoid cream: This can be used on areas other than those surrounding the eyes.
Microdermabrasion: Upper layers of the affected area are removed.
Cryotherapy: In this treatment, liquid nitrogen is used to freeze the milia for removal.
Curettage: Your doctor numbs the area, removes the milia, then seals the skin with a hot wire.
2. Pityriasis Alba
Pityriasis Alba (latin: scaly patches) is a non-cancerous skin condition that causes flaky, scaly, itchy red patches of discolored skin that turns into pale white spots over time when healed. The skin condition usually affects the face. However, it can impact areas like the neck, shoulders, and arms.
According to a research study on Pityriasis Alba-Common Disease, Pityriasis Alba (PA) tends to develop in children between the ages of 3 and 16. It affects between 1.9% and 5.25% adolescent children (3). It’s also common in children with atopic dermatitis.
PA often occurs in children who take hot baths frequently or those who are exposed to the sun without any protection. However, there is no strong evidence to prove if these factors cause it.
Pityriasis alba is non-contagious (4) and in most cases goes away by early adulthood.
In some instances, pityriasis alba can be confused with vitiligo. The patches are not completely depigmented in pityriasis alba whereas in vitiligo the patches are typically white in color which means there is complete loss of pigmentation. A doctor can help you differentiate between the two.
Researchers are not sure about the exact cause of PA, but they suppose it to be a mild form of eczema which is caused by an overactive immune system responding aggressively to irritants (5).
Thinking about how to get rid of pityriasis alba? Pityriasis Alba clears on its own and does not require medical attention. Your doctor may suggest applying moisturizer and topical steroid like hydrocortisone to reduce the itchiness, if any. (6)
In some cases, your doctor may also ask to use a nonsteroid cream like pimecrolimus to relieve scaling, dryness, and tacrolimus ointment, calcineurin inhibitors to restore your skin’s color (7) (8). However, if you think that the spots are persistent or itchy, consult your doctor for a topical prescription medication to reduce the inflammation.
To minimize the appearance of white patches on the skin, you can resort to home remedies using natural ingredients such as aloe vera, neem oil, honey, apple cider vinegar, basil, etc. You can apply freshly extracted aloe vera on the white patches or honey on the white spots. Neem oil too can help in managing white patches on your skin.
Despite these treatment methods, there are chances that these patches recur. So make sure you use the prescribed creams and consult your doctor for further diagnosis.
Vitiligo is a skin condition that causes loss of your skin color in patches. It occurs when melanocytes (specialized skin cells) stop making melanin (9) (10). Melanin is the pigment that gives color to your skin, hair, and eyes. Without melanin, white patches form.
The patches appear in places where the melanocytes that make skin pigment are destroyed. These milky white patches usually develop above your eyes, neck or hands and can even affect the inside of your mouth, scalp. They may grow in size or spread to other parts of your body over time (11). This condition however is neither painful nor itchy.
American Osteopathic College of Dermatology states that vitiligo affects an estimated 1% of the world's population. It affects both male and females, but is more commonly noticed in people with darker skin tones. However, since the affected areas of the skin lack pigment, it may be noticed even in fair-skinned people. Most people first notice skin vitiligo in their 20s. (12)
Researchers are not sure about the causes of vitiligo. A study by Karger suggests this condition may be the result of an autoimmune disorder that causes the body’s immune system to mistakenly attack the healthy cells. People who have other autoimmune diseases, such as hypothyroidism or alopecia areata, may have an increased risk of developing vitiligo, and people with vitiligo may have an increased risk of developing another autoimmune disease (13).
Doctors believe that vitiligo on cheeks forms when antibodies that destroy melanin are produced in the body. People with a family history of vitiligo have a high chance of getting it.
The choice of treatment completely depends on your age, how much skin is involved and where, the pace in which the condition is progressing, and its severity.
Medications and light-based therapies can help restore your skin color or even out skin tone, however, the results vary. Some treatments can have serious side effects too which is why it’s important to consult your dermatologist first.
Some of the treatments include:
There are no drugs that can stop the process of vitiligo. But some of them can help restore your skin tone. Applying a corticosteroid cream to the affected skin might return the color. This is most effective when vitiligo is still in its early stages.
Doctors may prescribe milder forms of the drug especially for children and people who have large areas of discolored skin.
For people whose condition shows rapid progress, corticosteroid pills or injections can be an option. On the other hand, people who have small areas of depigmentation might be given calcineurin inhibitor ointments, such as tacrolimus (Protopic) or pimecrolimus (Elidel) (14).
A. Light therapy: Phototherapy with narrow band ultraviolet B (UVB) has been shown to slow down the progression of active vitiligo (15). This is more effective when used with corticosteroids or calcineurin inhibitors. You might need to do this therapy two to three times a week. You may start noticing the change between the first and the third month.
B. Combining oral psoralen and light therapy: This treatment is aimed at treating large areas of skin with vitiligo. It works best for people with vitiligo in the areas of the head, neck, upper arms and legs.
Skin grafting: Here, the doctor transfers small sections of your healthy, pigmented skin to areas that have lost pigment. This procedure is sometimes used if you have small patches of vitiligo.
Micropigmentation: A type of tattooing that is usually applied to the lips of people affected by vitiligo.
It is advised that people with vitiligo always wear sunscreen as direct sun rays will cause damage and burn the affected skin.
4. Tinea Versicolor
Tinea versicolor is a condition in which white and shades of brown, pink spots appear on the skin that form lighter or darker patches.
They occur due to a kind of fungus on the skin and is not contagious in most cases (16).
These patches are commonly noticed on darker skin and may get larger over time. They mostly appear on the arms, chest, neck, or back. You may also experience dry, itchy, and scaly skin along with changes in your skin color.
Tinea versicolor is widespread and its symptoms are more noticeable in warm, humid environments. As per a study by Journal of Microbial & Biochemical Technology, this condition becomes more noticeable with a suntan and is more common in teenagers and young adults than in older people. However, children are not excluded from suffering this fungal infection.
Tinea versicolor occurs when a type of yeast from the Malassezia family causes an infection or suppresses your immune system (17).In some cases, it can lead to a rash.
This condition happens when the yeast grows rapidly on the surface of your skin. While doctors aren’t sure about the exact cause of this, they believe the growth of the yeast on your skin might be influenced by factors like humid weather, excessive sweating, hormonal changes, a weakened immune system, etc.
Over-the-counter (OTC) antifungal medications can help you get rid of the discolored patches of skin. However, you should contact your doctor if this doesn't help.
Dermatologists recommend anti fungal creams, shampoos, soaps, etc. to treat Tinea versicolor. Antifungal medication like fluconazole can also be used to stop and prevent this condition.(18)
Some of the OTC medications that can be used to treat tinea versicolor include clotrimazole (Lotrimin AF, Mycelex), miconazole (Monistat, M-Zole), selenium sulfide, etc. (19)
Your doctor may also prescribe topical creams such as ciclopirox (Loprox, Penlac) (20) ketoconazole (Extina, Nizoral), etc. These creams can be applied directly to your skin.
Your doctor may also prescribe pills such as itraconazole (Onmel, Sporanox) to treat tinea versicolor (21).
Tinea versicolor may occur in pregnant women, but the condition is restored after the hormone levels are back to normal.
5. Idiopathic Guttate Hypomelanosis
Idiopathic guttate hypomelanosis (IGH) is often called sunspots which present as white, small spots on your skin that receive more exposure to the sunlight. This includes legs, arms, upper back, and face. These spots range from 1–10 mm in size, are usually painless, benign, and don't cause any symptoms.
Did You Know?
IGH usually affects women older than 40, but can happen to anyone with increasing age. (22).
A study by the National Center for Biotechnology Information stated that IGH more commonly occurs in fair-skinned, elderly people. However, it may happen in women at younger ages than it does in men.
While too much exposure to the sun without protection can contribute to the risk of skin cancer, sunspots in themselves do not indicate the development of cancer.
Although researchers aren't sure as to what causes Idiopathic guttate hypomelanosis it is believed to be related to prolonged UV exposure. Genetics may also play a role.
There are only a few options that you can resort to for treating sun spots after they appear. However, if you wish to minimize their appearance, talk to your doctor about laser treatments.
Most white spots are harmless and you can stop wondering what they are. But consider making a visit to your dermatologist when the spots begin to grow in size or spread.
When To See A Doctor?
White spots in general are not a cause of concern and mostly go away on their own. You can follow the doctor-prescribed medicines, ointments, or creams to treat them.
However, if you are not sure about the symptoms, notice any changes in the appearance of the spots, or experience pain or severe itching, see your doctor immediately to diagnose and prevent any possible underlying conditions.
Frequently Asked Questions About Spots On The Face
1. Which vitamin deficiency causes white spots on the face?
Small white spots on the skin can indicate a deficiency of vitamin B12 in the body. This deficiency can lead to low levels of melatonin, contributing to the white spots on your skin including your face.
Other than this, deficiencies in vitamins D and vitamin E can also cause white patches on the skin.
2. Does lack of calcium cause white spots on the face?
Yes, calcium deficiency can lead to white spots on the face. Doctors recommend eating a healthy diet for boosting the immune system. It is believed that a strong immune system can prevent the spread of the depigmentation.
3. How long does it take for white spots on your face to go away?
In most cases, white spots on the skin do not require medical treatment and they go away on their own. However, the time taken to treat them entirely depends on what causes them, their severity. It’s best to consult your doctor to determine the best treatment.
White spots on the skin may occur when skin proteins get trapped under the skin’s surface, develop as a result of depigmentation, or due to the loss of skin color, and a variety of health conditions. They are usually harmless and can be treated easil at home. However, it’s important that you get them checked by a dermatologist to find out the exact cause and best ways to treat them.
1. Milia (2021)
2. Cutaneous Lupus Erythematosus: Diagnosis and treatment (2013)
3. Infantile pityriasis alba and comorbid disorders (2009)
4. Pityriasis Alba-Common Disease, Enigmatic Entity: Up-to-Date Review of the Literature (2015)
5. Pityriasis Alba (2021)
6. Pityriasis Alba (2021)
7. Tacrolimus ointment 0.1% in pityriasis alba: An open-label, randomized, placebo-controlled study (2006)
8. An exploratory study to determine the efficacy of 1% pimecrolimus cream in the treatment of pityriasis alba (2005)
9. Vitiligo (2021)
10. Melanocytes and Their Diseases (2014)
11. Vitiligo: More than skin deep (2019)
12. Adult Onset Vitiligo: Multivariate Analysis Suggests the Need for a Thyroid Screening (2016)
13. Vitiligo and Autoimmune Thyroid Disorders (2017)
14. Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo (2019)
15. What Is New in Narrow-Band Ultraviolet-B Therapy for Vitiligo? (2019)
16. Treatment of pityriasis versicolor in the United States (2004)
17. Malassezia—Can it be Ignored? (2015)
18. Tinea versicolor: Overview (2014)
19. Topical Treatment of Common Superficial Tinea Infections (2002)
20. Treatment of tinea versicolor with a new antifungal agent, ciclopirox olamine cream 1% (1985)
21. Itraconazole in tinea versicolor: a review (1985)
22. A clinical study of idiopathic guttate hypomelanosis and its association with diabetes mellitus (2021)
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