Light patches on a child’s face or body can be worrying. Two common causes are pityriasis alba and vitiligo. Here’s how to tell them apart and what to do.
Pityriasis Alba (PA)
- Who: School-age kids, often with dry skin or eczema.
- Look:
- Faint, round/oval pale patches, most often on cheeks, sometimes arms.
- Mild dry scale; edges are soft, not sharply defined.
- More noticeable after sun exposure because surrounding skin tans.
- Feel: Usually not itchy or only mildly so.
- Why: Low-grade eczema leads to temporary uneven pigment and dryness.
- Home care:
- Daily gentle moisturizer or sensitive-skin face cream.
- Sunscreen SPF 30+ to reduce contrast in summer.
- If slightly inflamed, a brief course of mild hydrocortisone 1% may help (ask clinician).
- Course: Harmless; color gradually returns over months.
Vitiligo
- Who: Can begin in childhood; sometimes family history of autoimmunity.
- Look:
- Chalk-white patches with sharp, well-defined edges; may be around eyes/mouth, on hands/feet, or in body folds.
- Hairs in the patch can turn white (poliosis).
- No scale; contrast is high on darker skin tones.
- Feel: Not itchy; purely pigment loss.
- Why: Autoimmune loss of melanocytes (pigment cells).
- Care:
- See a clinician/dermatologist for diagnosis and treatment plan.
- Options include topical steroids or calcineurin inhibitors, narrowband UVB light, and, in select cases, newer repigmentation therapies.
- Sunscreen to protect depigmented skin and reduce contrast; cosmetic cover-ups if desired.
- Course: Variable—can spread or stabilize; early treatment may help repigmentation.
When to see a clinician
- If patches are pure white, sharply bordered, spreading, or involve eyelids/lips/hands/feet.
- If you’re unsure between PA and vitiligo, or if there’s significant worry.
Quick tip
- Scale and fuzzy borders suggest pityriasis alba; no scale and sharp borders suggest vitiligo.