Pityriasis alba vs Vitiligo I Dermatologist Guide

“Doctor, My daughter is getting white dry patches on the skin of her face. Does she have Pityriasis alba or leukoderma?”

A white patch on the skin of a child on even an adult is a matter of concern. The first thing that comes to mind is leucoderma or vitiligo. However, it can be Pityriasis alba (P. alba), vitiligo, or post-inflammatory hypopigmentation (PIH). These 3 can be easily differentiated by dermatologists.

In this article, we will discuss Pityriasis alba, along with other causes of white patches on the skin.

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What is Pityriasis Alba?

Pityriasis Alba is characterised by the development of a few to many small patches of dry and pale skin on the face of your child. Rarely, such patches might appear on the neck, arms and shoulders. Initially, the patches are slightly red and then they turn pale with scaling. These patches appear more prominent in summers because of tanning of the surrounding skin, but they rarely itch or pain.

Pityriasis Alba versus Vitiligo

There are three major causes for getting the white patch on the face in children. I have tabulated the differences below:

	P. Alba	Vitiligo	PIH
Color	light coloured	white	white
Borders	Not well defined	Well defined	Well defined
Scales	Present	Not present	Can be present earlier
Evolution	Start as slight scaly patch and later scale disaapear	remain as white patch without scales throughout	Begin as red rash with or without scales that heals with white color.

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Reason for getting P. Alba

As commonly thought of, neither nutritional deficiency nor worm infestation is the causes of this condition. It is low-grade eczema often associated with dry skin, atopic dermatitis and asthma in the family.

Treatment

Few patches that are barely visible should be left alone; a good moisturiser in the case of dry skin is recommended. However, if the spots are visible from a distance, then your dermatologist might prescribe you either pimecrolimus or tacrolimus, which can help in re-pigmentation of patches. Steroid creams are used if there is redness, but at best they should be avoided.

Precautions

Pityriasis Alba is sometimes chronic; the patches might come and go for several years until the child reaches adolescence. In such cases, we recommend you use a fragrance-free non-foaming face wash followed by moisturiser regularly. You should always apply child-safe sunscreen before your child goes out in bright sunlight.