Have you noticed white patches on the skin of a child’s face during the summer months?
The reason for white patches of skin on a kid’s face is one of the most common questions that I get asked, especially during the summer months. These patches appear more pronounced against the background of sun-kissed summer skin which draws a parent’s attention.
Discoloration on a child’s face immediately causes concern for parents. Often, caregivers are most anxious about vitiligo or other life-changing diagnoses.
However, the good news is that these white patches are rarely caused by a serious skin condition and often resolve on their own with time.
Causes of White Patches on Skin
Skin discoloration can have a wide range of causes. In children, pityriasis alba is by far and away the main reason for these white patches of skin.
A trained pediatrician can often look at a child and make this diagnosis easily.
Pityriasis Alba
Pityriasis alba is a common skin disorder that is characterized by fine scaly hypo-pigmented macules (white spots) or patches. The underlying cause of this condition is still unknown. The majority of children with these scaly patches, they have a history of dry skin. Some dermatologists even describe it as a “low-level” form of eczema in kids.
Around 5% of kids worldwide have this common condition and it usually affects boys and girls equally. White patches are more prominent in children with darker skin due to the difference in pigmentation.
This condition generally affects children before the adolescent years and is most common in younger age groups. Thankfully, even without specific treatment, the condition improves over time and the skin regains its normal pigment.
Atopic Dermatitis (Eczema)
Eczema is a skin condition that can lead to white spots on the skin.
Any time skin becomes inflamed, the dead skin cells take longer to regain pigment. Atopic dermatitis or eczema occurs in kids when their skin becomes easily inflamed and dry. It is best known as the “itch that scratches.”
This means that the skin is dry and itchy which leads the child to scratch and causes the symptoms of eczema. Skin inflammation leads to loss of pigmentation, especially in children with dark skin.
Skin moisturizers and topical steroids are the treatments of choice for this skin condition. For whitish patches on the face that are caused by eczema, sometimes a steroid-sparing medicated cream is required for treatment.
Fungal Infections, Such as Tinea Versicolor
Another skin condition that can present similarly to pityriasis alba is tinea versicolor (also called pityriasis versicolor).
This fungal infection leads to discolored patches of skin on the upper trunk, back, and face. Tinea versicolor is caused by yeast overgrowth on the skin. This particular yeast favors skin that is oily and/or in people with excessive sweating. It can affect anyone, but it is more common in adolescents due to their increased oil gland activity during puberty. This skin condition also favors people who live in tropical climates.
While it is not clear why some people experience yeast overgrowth and others do not, it is simple to treat this somewhat common condition. Medical treatment includes topical antifungal creams and/or oral antifungal medications.
Additionally, for mild cases, the use of an over-the-counter dandruff shampoo containing Selenium might do the trick.
Vitamin Deficiency or Nutritional Deficiencies
Several nutritional deficiencies can result in skin pigment changes in both kids and adults. The best way to prevent vitamin deficiency is to eat a healthy diet full of vitamin-packed fruits and vegetables.
Calcium as well as Vitamins D, E, and B12 are important factors in keeping your skin healthy. Vitamin deficiencies can lead to white spots or white patches of skin.
If you cannot maintain these nutrients through a healthy diet alone, you may need to supplement vitamins to maintain healthy skin. This is especially true for people who have malabsorption of vitamins such as Vitamin B12.
Other Possible Causes
Discolored skin can be caused by many other chronic skin conditions such as psoriasis, seborrheic dermatitis (dandruff) or other fungal skin infections.
Additionally, autoimmune diseases such as vitiligo can cause white patches of skin. With this skin issue, the immune system attacks the melanocytes which are the pigment cells that are responsible for the production of melanin or skin pigment.
In this type of skin condition, the white patches are well-demarcated or set apart from the normal skin. White patches in a person who has vitiligo are very different from kids who have lighter spots on the skin due to an inflammatory condition.
Treatment for White Patches of Skin
In order to remedy the white spots on your child’s skin, you need to know the cause of them. Treatment can range from eating a balanced diet to prevent nutritional deficiencies to topical steroids or topical antifungals to immune system modulators for autoimmune disorders.
However, no matter the underlying cause of the white patches of skin, one thing is true for all of these varieties of conditions. You must protect your child’s skin from sun damage as well as prevent the darkening of the surrounding skin which makes the white skin look more pronounced.
Daily use of broad-spectrum sunscreen is important for all kids, but especially those who have patches of discoloration on their skin. Sunscreen should be a part of everyone’s skincare routine in order to protect the skin against sun damage. Skin cancer doesn’t usually affect children, but prevention is important.
White Patches of Skin
Hopefully, this article sets your mind at ease to know that white spots on the skin are fairly common in childhood. The most common cause of these skin discolorations is a self-limiting condition known as pityriasis alba. If your child has a few white spots on their face, you can try a short course of topical steroids at home first to see if you can improve their condition.
However, steroids are not long-term treatments and can damage skin with prolonged use. Be sure to seek medical advice if your child’s condition is not improving or you are worried that they have a different type of skin condition.
If you would like to have a pediatrician that is on call for your family, 127 Pediatrics may be the right fit for you. Fill out a contact form to get scheduled for a free meet and greet at 127pediatrics.com
© 127 Pediatrics; July 2023
This article is for informational purposes only and should not be construed as medical advice.
Dr. Andrea Wadley is the owner, pediatrician, and breastfeeding medicine specialist for 127 Pediatrics. She has an established house-calls-only concierge pediatric practice in Colleyville, TX. She is also the owner and operator of the 127 Pediatrics Online Breastfeeding Medicine and Education Center.
