Skin Health Eczema & Dermatitis An Overview of Pityriasis Alba Lightened Skin Lesions Seen Mostly in Young Children By Heather L. Brannon, MD Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years. Learn about our editorial process Heather L. Brannon, MD Medically reviewed by Medically reviewed by Casey Gallagher, MD on May 12, 2020 Casey Gallagher, MD, is board-certified in dermatology. He is a clinical professor at the University of Colorado in Denver, and co-founder and practicing dermatologist at the Boulder Valley Center for Dermatology in Colorado. His research has been published in the New England Journal of Medicine. Learn about our Medical Review Board Casey Gallagher, MD on May 12, 2020 Print Table of Contents View All Symptoms Causes Diagnosis Treatment Pityriasis alba is a common, benign skin disorder that typically affects children ages 6 to 12. This condition is characterized by raised, rounded patches of lighter skin that are mainly on the face, although other areas of the body are sometimes involved. Pityriasis alba is so named for its scaly appearance (derived from the Latin word pityrus, meaning bran) and characteristic white patches (alba, for white). Symptoms Pityriasis alba causes discolored lesions to develop on the skin. Most often, they are found on the cheeks, but they can also develop on the neck, chest, back, and upper arms. The spots typically start as pink or red patches that gradually fade into abnormally light patches of skin. The lesions typically range from a quarter of an inch to an inch in size, with a circular or oval shape. The borders of the lesions are not clearly defined and gradually blend into normally pigmented skin. The lesions themselves are often raised and may be covered by very fine skin flakes. The scaly appearance is most noticeable during the winter months as a result of drier air. During the summer, the lesions can appear more prominent when other skin is tanned. The lesions aren't painful, but there may be some mild itching. This photo contains content that some people may find graphic or disturbing. See Photo Pityriasis alba. DermNet / CC BY-NC-ND Causes Although an exact cause is still unknown, pityriasis alba is thought to be caused when an acute case of dermatitis heals and leaves behind a lighter patch of skin. It may also result from the overuse of topical corticosteroids when treating eczema; this can cause areas of patchy rash to lighten as they heal. Certain genetic disorders are also believed to cause cutaneous hypopigmentation (loss of skin color) due to the reduced activity of melanocytes, the cells that produce the pigment melanin. It is estimated that 5% of children in the U.S. will get pityriasis alba at some point in their early school years, according to a 2015 study in the Journal of Clinical Medicine. Diagnosis Generally, pityriasis alba can be diagnosed with a visual examination and review of your child's symptoms and medical history. Pityriasis alba is often confused with tinea versicolor in which the overgrowth of fungus on the skin causes patchy white lesions. There are several ways a doctor can distinguish between the two disorders: A wood light examination involves the use of a handheld ultraviolet (UV) lamp to highlight differences in skin color. It is usually performed in a dermatologist's office in a darkened room.Potassium hydroxide (KOH) can be used to treat a light scraping of the skin. When examined under a microscope, any evidence of fungus will be visibly highlighted, confirming tinea versicolor or other fungal conditions such as tinea corporis (ringworm). Pityriasis alba can also be confused with vitiligo, a disease caused by the destruction of the melanocytes in the affected skin. Affected skin borders can distinguish the two. Pityriasis Alba Softer, indistinct borders Patches are lighter than surrounding skin, but not completely depigmented Smaller affected areas Vitiligo Very distinct borders Patches are typically stark-white in color (complete loss of pigmentation in affected areas) Larger affected areas Vitiligo patches initially appear on sun-exposed parts of the body, often after a triggering event such as a sunburn, but can progress to other areas such as the armpits, eyes, groin, genitals, naval, and rectal area. Pityriasis alba also develops on sun-exposed areas, but it isn't clear if sun exposure triggers its development. Treatment Treatment of pityriasis alba is not always necessary. Most cases resolve on their own without it, usually by adulthood. Still, many parents choose to have it treated for cosmetic reasons, especially if their child is self-conscious about their skin. Even with treatment, recovery can sometimes take several months. The avoidance of tanning (natural or artificial) and the consistent use of sunscreen (minimum 30 SPF) can also help. Moisturizers Moisturizers that contain emollient ingredients such as petrolatum, mineral oil, squalane, or dimethicone, can help soften the skin and reduce scaliness, especially on the face. Brands that are effective, inexpensive, and easily found include: AquaphorAveeno CreamEucerin You may also ask your physician for recommendations. Good skin hygiene, in general, can help speed the healing of lesions. Over-the-Counter Hydrocortisone An over-the-counter (OTC) 1% hydrocortisone cream can be used sparingly if there is itchiness. However, care should be taken when using hydrocortisone on the face. Do not apply around the eyes or on the eyelids. OTC hydrocortisone shouldn't be used for more than four weeks continuously unless under the advice of a doctor. Because children are more vulnerable to side effects, you should ask your child's doctor before applying hydrocortisone on your child's face and follow their recommendations. Topical Calcineurin Inhibitors Topical calcineurin inhibitors Elidel (pimecrolimus) and Protopic (tacrolimus) are non-steroidal medications that may also be prescribed to clear the rash. They aren't often needed but are sometimes suggested in more severe cases. Topical calcineurin inhibitors are used off-label for pityriasis alba. Because they are not steroids, they can safely be used in the eye area. A Word From Verywell Anytime your child has an unidentified rash, you should make an appointment with their pediatrician. Pityriasis alba is a harmless condition, and there is no medical reason to treat it. But if doing so will make your child feel more confident, that's a good enough reason to consider it. Remember that, in most cases, pityriasis alba fades by adulthood. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Siegfried E, Herbert A. Diagnosis of atopic dermatitis: mimics, overlaps, and complications. J Clin Med. 2015; 4(5): 884-917. doi:10.3390/jcm4050884 Plensdorf S, Livieratos M, Dada N. Pigmentation disorders: diagnosis and management. Am Fam Physician. 2017 Dec 15;96(12):797-804. Miazek N, Michalek I, Pawlowska-Kisiel M, Olszewska M, Rudnicka L. Pityriasis alba--common disease, enigmatic entity: up-to-date review of the literature. Pediatr Dermatol. 2015 Nov-Dec;32(6):786-91. doi:10.1111/pde.12683 Givler DN, Basit H, Givler A. Pityriasis Alba. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019-. 2019 May 13.