What does it look like
First, a slightly pinkish spot with fine flaking appears on the skin, which parents often mistake for irritation. After a few weeks, the inflammation subsides and the area becomes lighter than the surrounding skin, maintaining a slight roughness. The size of the spots is from one to four centimeters, the boundaries are blurred, there can be from several to a dozen of them. Itching is mild or absent. In summer, the contrast increases because healthy skin tans, but the affected areas do not, and this is when parents most often consult a doctor.
- Light spots with blurred boundaries
- Fine pityriasis-like peeling
- Localization on the cheeks, shoulders, back
- Spots are more visible on tanned skin
- Little or no itching
Why does it occur
The exact mechanism is unknown, but the condition is considered a mild form of eczema. Inflammation in the skin disrupts the transfer of pigment from the pigment cells to the cells of the superficial layer, causing the area to become lighter. Dry skin, frequent washing with hot water and soap, swimming in chlorinated water, wind and sun contribute to this. Children and adolescents with atopic dermatitis or a tendency to dry, sensitive skin are more often affected. Hygiene and nutrition have nothing to do with it, and parents don’t need to blame themselves.
- Association with atopic dermatitis
- Dryness and disruption of the skin's protective barrier
- Frequent washing with soap
- Sun and wind
- Childhood and adolescence
- Not associated with infection and hygiene
How is it different from fungus and vitiligo?
Pityriasis versicolor also produces light spots, but more often on the back and chest, in adolescents and adults, peeling intensifies when scraped, and a fungus is found in the scraping. Vitiligo produces milky white patches with clear boundaries, without peeling, often around the mouth, eyes and hands; the hair in the fire may turn white. Lichen alba is characterized by blurred borders, slight peeling and previous redness. If in doubt, the doctor examines the skin under a Wood's lamp and takes a scraping.
- Pityriasis versicolor is a fungus found in scrapings
- Vitiligo - distinct milky white patches
- Post-infectious depigmentation after inflammation
- Lichen alba - blurred boundaries and peeling
- Wood's lamp helps distinguish between conditions
Care and treatment
No specific treatment is required, the task is to restore the skin barrier and protect the skin from the sun. The basis of care is emollients, that is, moisturizing and softening creams that are applied daily, or preferably twice a day, especially after bathing. Soap is replaced with mild detergents, water is made warm, not hot. If there is noticeable redness and peeling, the doctor may prescribe a short course of weak external anti-inflammatory drugs. In summer, sunscreen is a must: it reduces the contrast between spots and tanned skin.
- Daily emollients, especially after swimming
- Mild detergents instead of soap
- Warm water and short water procedures
- Sunscreen during the warm season
- External anti-inflammatory agents as prescribed by a doctor
- Refusal of bleaching and aggressive products
How long does it last and what's next?
The spots disappear slowly: it usually takes several months to a year for the pigment to recover, sometimes longer, and in some children the episodes are repeated in the spring and summer. This is a normal course, and the process cannot be significantly accelerated - attempts to “even out the tone” with aggressive means only increase irritation. Lichen alba does not leave scars or permanent changes; by adolescence or young adulthood, manifestations usually stop. If the spots do not change for more than a year, increase in size, or look atypical, a repeat examination is needed.
- Pigment restoration in months
- Possible repeated episodes in spring and summer
- No scars or traces remain
- It is impossible to speed up the process by aggressive means
- Repeated examination for an atypical picture
- Ongoing care for atopic dermatitis