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Light patches on a child’s face can be alarming, especially when families worry about vitiligo.
Pityriasis alba is a common eczema-related condition that can leave pale, slightly dry patches, especially after sun exposure makes the surrounding skin look darker.
We examine the pattern and texture to distinguish it from vitiligo, fungal infection, and other causes and explain simple skin care or treatment when needed.
What Is Pityriasis Alba?
Pityriasis alba is a mild form of dermatitis or eczema that occurs most often in children and teenagers. It commonly affects children with dry, sensitive or eczema-prone skin.
The inflammation can be subtle. A patch may initially be slightly dry, rough or pink and then become lighter than the surrounding skin as the inflammation improves.
The cheeks and face are most commonly affected, although patches can also occur on the neck, shoulders and upper arms.
How Is Pityriasis Alba Related to Eczema?
Pityriasis alba is closely associated with eczema and atopic skin. In some children, there may be very little redness or itching—the main thing parents notice is the lighter color left behind by mild inflammation.
Moisturizing the skin, treating active inflammation when needed and protecting the skin from excessive sun exposure can help. The surrounding normal skin may tan while a pityriasis alba patch does not, making the difference in color look much more dramatic during or after the summer.
Learn more about eczema and atopic dermatitis.
Pityriasis Alba vs. Vitiligo
Pityriasis alba is commonly confused with vitiligo, particularly when it appears on the face.
Pityriasis alba usually causes:
- Lighter rather than completely white skin
- Soft or poorly defined borders
- Mild dryness or fine scale
- Patches commonly on the cheeks
- An association with dry skin or eczema
Vitiligo more often causes:
- More complete loss of pigment
- White patches with clearer borders
- Smooth skin without scale
- Patches that may occur around the eyes, mouth, hands or other areas
- Areas that may enlarge or develop in additional locations
Appearance alone does not always tell the whole story. When the diagnosis is uncertain, a dermatologic examination and sometimes a Wood’s lamp examination can help distinguish different causes of light or white skin.
Pityriasis Alba in Brown and Darker Skin
Pityriasis alba can occur in any skin tone, but it can look much more noticeable in melanin-rich skin because of the contrast between the lighter patch and surrounding skin.
Pigment changes after eczema and other inflammatory skin conditions can also last longer than the original rash. Correctly identifying the underlying condition matters so that a harmless pigment change is not mistaken for vitiligo, a fungal infection or another disorder.
Explore Skin of Color Dermatology.
Does Pityriasis Alba Go Away?
Usually, yes. Pityriasis alba is harmless and the normal skin color generally returns gradually, although repigmentation may take several months and sometimes longer.
Treatment may include:
- Gentle, regular moisturization
- Mild cleansers and skin care
- Daily sun protection to reduce contrast
- Treatment of associated eczema or inflammation
- Prescription anti-inflammatory treatment when appropriate
When Should My Child Be Evaluated?
Consider an evaluation when a light patch is spreading, becoming distinctly white, developing in several areas, persisting despite good skin care or simply does not look like your child’s usual eczema.
Parents frequently come in worried about vitiligo. Often the first and most important step is simply determining why the skin is lighter.
Related Care: Pediatric Dermatology · Skin of Color Dermatology · Eczema · Vitiligo