Pityriasis Alba: Causes, Symptoms, and Treatment Options

What is pityriasis alba?

Pityriasis alba is a benign skin condition that primarily affects children and adolescents. It is characterised by the appearance of round or oval hypopigmented (lighter than surrounding skin) patches, usually on the face, neck, and upper arms. These patches often begin as slightly red or pink areas that gradually fade to a pale colour over time.

Pityriasis alba is considered a mild form of eczema or dermatitis. While the exact cause is unknown, factors like dry skin, sun exposure, and skin irritation may play a role in its development. Although pityriasis alba can be cosmetically bothersome, it is not contagious or harmful.

Who gets pityriasis alba?

Pityriasis alba most commonly affects children between the ages of 3 and 16 years, with a peak incidence around 6-12 years old. Boys are slightly more prone to developing this condition than girls. Those with a history of eczema, hay fever, or asthma may be at higher risk. Pityriasis alba is more noticeable in individuals with darker skin tones due to the contrast between the lighter patches and the surrounding skin. It can occur in people of all races and ethnicities but is more frequently observed in regions with dry, sunny climates.

What causes pityriasis alba?

The pityriasis alba causes remains unknown, but several factors are believed to contribute to its development:

• Dry skin: Skin dryness can disrupt the skin barrier and trigger inflammation.
• Eczema or atopic dermatitis: Many people with pityriasis alba have a history of these conditions.
• Sun exposure: UV rays may affect pigment-producing cells in susceptible individuals.
• Skin irritants: Harsh soaps, detergents, or extreme weather can irritate sensitive skin.

However, pityriasis alba is not caused by an infection, poor hygiene, or nutritional deficiencies, as commonly believed.

Symptoms of pityriasis alba

The main symptom of pityriasis alba is the appearance of round or oval discoloured patches, ranging from 0.5 to 6 cm in size. These patches typically go through the following stages:

• Initially pink, red, or light brown and slightly scaly
• Gradually fading to a pale white or ivory colour
• Slowly regaining normal pigment over several months
• Mild itching or dryness in the affected areas
• Increased visibility of patches after sun exposure
• Flaky or rough texture of patches
• Patches may become more noticeable when the surrounding skin tans

Where will I have symptoms of pityriasis alba?

Pityriasis alba patches commonly appear on the cheeks, chin, upper lips, and sometimes around the eyes. They can also develop on the neck, shoulders, upper arms, and torso.

What triggers pityriasis alba?

Several factors can trigger or exacerbate pityriasis alba, including:

• Dry skin caused by low humidity, harsh winds, or excessive bathing
• Skin irritation from soaps, detergents, chlorine, or rough clothing
• Eczema flare-ups or chronic atopic dermatitis
• Excessive sun exposure without protection
• Sweating and friction in hot weather
• Emotional stress or seasonal changes that affect skin hydration

What are the risk factors for pityriasis alba?

Common risk factors for developing pityriasis alba include:

• Childhood or teenage years
• Personal or family history of eczema, asthma, or hay fever
• Living in a dry, sunny, or windy climate
• Having sensitive, dry, or eczema-prone skin

At what age is pityriasis alba most commonly seen?

Pityriasis alba has the highest incidence among preadolescent children, especially between 6-12 years of age. However, it can begin as early as age 3 and may occasionally persist into the late teens or adulthood.

What are the complications of pityriasis alba?

Pityriasis alba does not usually cause any serious health complications. The main concern is the cosmetic appearance of the patches, which can impact self-esteem in some children and teens. Rarely, the discolouration may persist for an extended period. However, pityriasis alba does not lead to skin infections, permanent pigment loss, or scarring.

How is pityriasis alba diagnosed?

Dermatologists can diagnose pityriasis alba by examining the characteristic skin patches and reviewing the patient's medical history. In most cases, no additional testing is needed. However, your doctor may recommend the following to rule out other conditions:

• KOH test to exclude fungal infections
• Wood's lamp exam to differentiate from vitiligo
• Skin biopsy if the diagnosis is uncertain

What tests diagnose pityriasis alba?

In typical cases, pityriasis alba can be confidently diagnosed based on a clinical skin examination and patient history alone. However, if the appearance is atypical or other skin disorders need to be excluded, your dermatologist may perform these tests:

• KOH (potassium hydroxide) preparation: A skin scraping is treated with KOH and viewed under a microscope to check for fungal elements. This helps rule out fungal infections like tinea versicolour.
• Wood's lamp examination: This special UV light is shone on the skin to observe how the patches fluoresce. Pityriasis alba lesions do not usually fluoresce, helping distinguish them from vitiligo and other pigmentary disorders.
• Skin biopsy: Rarely, a small skin sample may be taken for microscopic analysis if the diagnosis is uncertain or the lesions are not responding to treatment as expected. The biopsy can provide information on skin structure and rule out other conditions.

Treatment options for pityriasis alba

Although pityriasis alba usually resolves on its own within a few months, treatment can help alleviate symptoms and speed up repigmentation. Common pityriasis alba treatment approaches include:

• Moisturisers: Regular use of fragrance-free, non-comedogenic moisturisers helps hydrate dry skin and restore the skin barrier. Thicker ointments or creams are often most effective.
• Mild topical corticosteroids: Low-potency hydrocortisone 1% cream applied once or twice daily can reduce inflammation and itching in persistent cases. Stronger steroids are avoided on the face.
• Topical calcineurin inhibitors: Non-steroidal creams like pimecrolimus or tacrolimus may be prescribed to calm inflammation in sensitive areas.
• Sunscreen: Daily sun protection with a broad-spectrum SPF 30+ sunscreen prevents darkening of unaffected skin and reduces contrast.
• Camouflage makeup: Concealer or foundation can temporarily mask patches for better cosmetic appearance.

Importantly, pityriasis alba treatment at home should focus on gentle skincare, regular moisturising, and sun protection. Avoid scrubbing the patches or using harsh skincare products. If patches persist or worsen despite self-care measures, visit your dermatologist for an evaluation and personalised treatment plan.

Home remedies and lifestyle tips

Pityriasis alba treatment at home involves managing dry skin, which can worsen the condition.

• Regularly moisturising the affected areas with mild, fragrance-free emollient creams helps soothe dryness and reduce scaling.
• When bathing, use lukewarm water and limit bath time to prevent further skin dryness. Avoid harsh soaps that can irritate the skin.
• Sun protection is crucial in pityriasis alba treatment. The pale patches are more sensitive to sun damage and can become more noticeable when the surrounding skin tans. Apply a broad-spectrum sunscreen with SPF 50+ on exposed areas and wear protective clothing when outdoors.
• Maintaining a gentle skincare routine is essential. Avoid rough fabrics or excessive scrubbing, which can irritate the skin. If the patches are mildly itchy, over-the-counter moisturizing creams may provide relief.

Remember that pityriasis alba causes often resolve gradually over several months to years, so patience is key. If symptoms worsen or persist, consult a healthcare professional for further guidance.

What can I expect if my child has pityriasis alba?

If your child has pityriasis alba, you may notice round or oval, pale pink or light patches on their face, neck, and upper arms. These patches are usually dry, slightly scaly, and may cause mild itching. The condition is harmless and often associated with mild eczema or dry skin.

Pityriasis alba typically resolves on its own without scarring, but the lighter skin patches can persist for months or even years. The patches may become more noticeable in summer when the surrounding skin tans. Regular moisturising and sun protection can help manage the appearance of the condition.

When to see a doctor

Although pityriasis alba is benign, there are situations when you should consult a doctor:

• If the patches worsen, become increasingly itchy, or inflamed
• If new symptoms develop, such as pain or oozing
• If over-the-counter moisturizers and sun protection do not improve the patches
• If the condition causes significant cosmetic concern or psychological distress

A healthcare professional can confirm the diagnosis and rule out other skin conditions like vitiligo or fungal infections. In some cases, they may prescribe low-potency topical corticosteroids or other treatments to speed up healing and reduce symptoms.

Conclusion

Pityriasis alba is a harmless skin condition seen in children and young adults, often linked to dry skin. It causes pale, dry patches that usually fade over time. Regular moisturising, gentle skincare, and sun protection can improve symptoms. While it typically resolves on its own, persistent cases may need medical attention.

Metropolis Healthcare provides reliable diagnostic services and at-home sample collection across India, helping families manage skin concerns with accurate testing and personalised care.

FAQs

Is pityriasis alba a vitamin deficiency?

No, pityriasis alba is not caused by a vitamin deficiency. While some studies have explored the role of trace elements like serum copper, vitamin deficiencies are not considered a primary factor in the development of this condition. Pityriasis alba causes are often linked to dry skin, mild eczema, or atopic dermatitis.

How long does pityriasis alba last?

The patches of pityriasis alba typically last from a few weeks to several months. In some cases, especially in darker-skinned individuals, the pale discoloration can persist for years. However, the condition usually resolves on its own. Sun exposure can make the patches more noticeable during this time.

How to distinguish between pityriasis alba and vitiligo?

Pityriasis alba presents as pale, dry, slightly scaly patches, often with residual pinkness, primarily in children with a history of eczema. In contrast, vitiligo causes well-defined, completely depigmented (pure white) patches without scaling, which can appear anywhere on the body. Unlike pityriasis alba, vitiligo patches do not typically improve on their own. A dermatologist can differentiate these conditions through clinical examination and sometimes skin biopsy or other tests if necessary.