Pityriasis Alba is a non-contagious skin disorder that commonly occurs among children and teenagers. It may appear on various parts of the body particularly the face, neck, shoulders, and arms. Though less common, it can appear on the legs or trunk (chest and back) of the body. It mostly affects the chin and cheek when it occurs on the face.
Pityriasis means scaly and alba means white. The condition starts out as a red patch or rash that leaves a light-colored patch (Hypopigmentation) after it heals. The lightened discoloration is due to a natural removal of melanin from the affected area of the skin.
People of all skin types can be affected by pityriasis alba, but people who have sensitive skin and spend a lot of time exposed to sunlight are more likely to develop the condition. In addition, the light-colored patches are more noticeable in persons with a darker skin tone. People with lighter skin tones typically see these patches after tanning.
This skin disorder seems to stop affecting children and teens once they become adults, and the patches eventually fade away as the skin regains its natural tone.
The symptoms of pityriasis alba are restricted to the skin and are easy to spot. This does not mean that anyone with the following symptoms has this skin disorder. The condition is best diagnosed by a doctor. These are the most common symptoms and they may vary from person to person:
The exact cause of pityriasis alba is not clearly known, scientifically. What is known is that it is not caused by a bacteria, fungus or yeast. However, it is believed to be closely linked to another skin condition known as atopic dermatitis or eczema. In fact, it is sometimes referred to as a mild form or eczema.
The exact cause of eczema is also not quite clear, but research suggests it is linked to the immune system’s overreaction to irritants. The red, itchy, and scaly inflamed patches visible on the skin in people with pityriasis alba are quite similar to that in people with eczema. People who suffer from eczema are also more likely to develop pityriasis alba.
It is not really necessary to treat this skin condition as it typically heals on its own and the pale patches disappear eventually.
If treatment is necessary, however, it will depend on a few factors such as how long you had it, the location of it, its severity and whether you tried other treatments that did not work.
There are other skin conditions that cause similar symptoms to that of pityriasis alba. For example, another non-contagious skin disorder known as Vitiligo causes depletion of skin pigmentation leaving patches of light-colored skin.
For an accurate diagnosis and appropriate treatment, speak with your doctor. Your doctor will do a visual examination of the skin. Tests such as a skin biopsy or KOH or potassium hydroxide staining may be done, if necessary, to rule out other skin conditions, before treating you accordingly.
Your doctor may recommend over-the-counter treatment or even prescribe medication. The following are common ways to treat this skin condition:
Skin moisturizers, such as creams, lotions, and ointments can be applied to soothe the affected skin and relieve dryness and scaling. They may include bland emollient creams and oil-in-water (aqueous) creams. Emollients are unscented, non-cosmetic moisturizers which are available as creams, lotions, and ointments and are especially good for treating the face.
Lotions with lanolin, petrolatum, cetyl alcohol, mineral oil, and glycerin are also effective. They are good for locking in moisture and softening the skin and work better when applied immediately after a bath or when the skin is still moist.
Ointments may be more effective to treat very dry, rough or scaly skin patches due to pityriasis alba. Each of these forms of moisturizers may work better when used at a certain time of the day. Your doctor will advise you on how to use it and may encourage you to continue using it to keep the symptoms under control.
While this skin disorder may disappear on its own, and while moisturizers may help reduce some of the symptoms, such as dryness and scaling, topical low-potent steroid medication may be needed, especially to help hasten re-pigmentation of the skin.
A topical, low-potent steroid medication such as hydrocortisone 1% is commonly prescribed to reduce inflammation and associated symptoms, such as redness and itching. Hydrocortisone also helps to speed up the return of the skin’s natural tone. Two other types of anti-inflammatory medicines, desonide 0.05% and fluocinolone 0.025%- 0.01%, are commonly used to suppress the symptoms of pityriasis alba.
Tacrolimus ointment and pimecrolimus cream have also been proven effective and reportedly promote skin pigmentation. Tacrolimus ointment is an immunosuppressant agent which, though effective, is a more expensive treatment. It is available in strengths of 0.03% and 0.1% and can be safely used in children as young 2 years of age. Pimecrolimus 1% is the recommended strength for this treatment option that helps to eliminate the skin lesions.
Despite its efficacy, the US Food and Drug Administration (FDA) advised that tacrolimus be used more as a last resort after other treatments have failed. The advisory was published following concerns that its use may be linked to cancer. Additionally, prolong use of non-steroid medications is not recommended especially on the face. Adverse effects of long-term use include thinning of the skin.
Psoralen plus ultraviolet light A (PUVA) photochemotherapy has been used to restore pigmentation in extensive cases of pityriasis alba. This is a combination treatment that uses a compound called psoralen plus exposure of the skin to UVA (longwave ultraviolet radiation). A major drawback of this treatment is a high rate of recurrence of the skin disorder once treatment has been stopped. This treatment is still in its experimental stages, so its long-term effectiveness and adverse effects have not been established.
Treatment with a special laser device, twice a week for approximately 12 weeks, has also been successfully used to treat pityriasis alba.
The cause of pityriasis alba is practically unknown even though researchers believe it may occur due to similar reasons eczema does. This makes it challenging to provide precise preventative measures. However, there are steps a patient can take to help protect the skin to promote healing during and after treatment.
It is important to note that pityriasis alba is a condition that may recur in some people. Avoiding lengthy exposure to the sun may help reduce the frequency of recurrence. Wearing a sunscreen agent with a SPF 15 or higher, protective clothing, a wide-brimmed hat or using an umbrella will also protect the skin. Children should also take warm instead of hot baths to prevent the occurrence of the condition.