White Spots on Your Skin: What Are They?

White spots, white patches or discoloration can happen for a variety of reasons — but are they ever a cause for concern? Depending on their appearance and where these pigment changes pop up, they could be signs of different skin conditions that may or may not need treatment.

Dermatology resident Angela Wei, MD, shares details behind some of these white spots and when you should get them checked out.

What can cause white spots on your skin?

White spots or patches are areas of your skin that, for some reason, are missing their pigment. To understand how this happens, it helps to know that one inch of your skin has about 19 million skin cells and 60,000 melanocytes. Melanocytes are the cells that make melanin, or skin pigment.

The amount of melanin you have determines the color or pigmentation of your skin. So, when there’s a lack of pigment or a loss of melanocytes, white spots or patches can pop up. These affected areas are very different from acne or sunburns.

Here are some of the most common conditions associated with white spots or patches:

Idiopathic guttate hypomelanosis

Idiopathic guttate hypomelanosis is a benign condition that looks like little rain drops or white dots on your skin. These spots can appear anywhere on your body that’s been exposed to the sun, but you tend to see them more on your:

• Arms
• Legs
• Lower half of your body

“While we don’t know exactly why it happens, it’s thought to be related to sun exposure over time,” says Dr. Wei. “Since it could be a marker of sun damage, sun protection is very important.”

Tinea versicolor

Tinea versicolor is a common fungal skin infection that often shows up in white patches. It can also appear as dark or pink spots. It’s not harmful or contagious, but it can be itchy. Caused by an overproduction of yeast, you’ll often find these white patches on your:

• Chest
• Back
• Face

The yeast removes pigment from the skin, and that lack of pigment is what causes the white patches. If you have darker skin, these patches may show up as a faint, light brown color.

“The yeast organisms thrive in warm and humid environments, so this condition can become more pronounced and spread if you sweat excessively,” notes Dr. Wei. “Typically, this condition can be treated with antifungal body wash, cream or oral medication. It could take months for pigmentation to return.”

Vitiligo

Vitiligo is a chronic autoimmune condition that happens when inflammatory cells target and kill the melanocytes that create pigment in your skin. It appears as large, smooth patches of white or lighter skin and can grow over time if left untreated.

It’s not painful, but lighter areas of your skin can be more vulnerable to severe sunburn because they don’t contain pigment.

Vitiligo typically starts around your:

• Mouth
• Eyes
• Nose
• Hands and feet
• Elbows and knees
• Genitals
• Belly button

“Treatment usually starts with topical steroids, but since it’s a chronic condition and we can’t use topical steroids forever, there are often other treatments we use longer term,” says Dr. Wei.

Most often, treatment relies on nonsteroidal topical creams like tacrolimus. In some cases, light treatments can be used to target and activate pigmented cells.

If treatment doesn’t work, you might experience vitiligo all over your body. If you prefer a more uniform skin tone, doctors may suggest removing pigment completely with the help of oral medications or skin therapy treatments.

Pityriasis alba and eczema

Pityriasis alba causes raised, round or oval itchy patches of lighter skin that mostly affects children. The lightening of pigment is thought to occur because of inflammation associated with eczema. When your surrounding skin gets darker as a result of sun exposure, the areas affected by eczema can also appear whiter and more noticeable.

“This condition causes lighter, wider patches on the cheeks of kids who often have eczema,” says Dr. Wei. “People with eczema have a very active immune response. Their skin is very sensitive and very itchy.”

Often this condition will improve on its own over time. To help manage the inflammation associated with pityriasis alba and speed up the recovery process, healthcare providers will recommend topical steroids or nonsteroidal topical creams.

“Just like eczema, the most important thing with this condition is to keep your skin moisturized to prevent your skin from drying up and becoming itchy,” explains Dr. Wei.

Milia

Milia, or milk spots, are small, raised, white cysts that develop just under the surface of your skin. Although harmless and painless, they’re commonly confused for whiteheads or pimples. They most often pop up on your:

• Eyelids
• Cheeks
• Forehead
• Genitals

These white cysts are caused by dead skin cells that get trapped and harden under the surface of your skin. Because they’re not harmful, they don’t require treatment. But if their appearance concerns you, a dermatologist can recommend over-the-counter and medicated creams or surgical treatments to help remove them.

Other causes of white spots on skin

There are other reasons why you might have white patches or spots on your skin. Many of these are rare (and some potentially dangerous) including:

• Lichen sclerosus causes wrinkly, itchy, parchment-like white plaques to appear on your genitals. Untreated, this can increase your chances of developing skin cancer.
• Morphea and scleroderma are caused by an overproduction of collagen. These white patches of skin tend to be unusually thick and hard.
• Discoid lupus erythematosus is an autoimmune disease that causes round, coin-shaped lesions on your face and scalp. They may appear pink or red at first, but leave behind white spots or patches of scarred skin as they heal. If it’s on the scalp, it can lead to hair loss. It usually doesn’t progress to systemic lupus.
• Cutaneous T-cell lymphoma is a rare group of blood cancers that causes itchiness and discoloration. It’s often confused for other skin conditions like psoriasis or eczema, and some forms are more aggressive or dangerous than others.

“While these conditions are typically rare, it is important to see your doctor or dermatologist to have new or changing spots on your skin evaluated to make sure there is nothing more serious going on,” advises Dr. Wei.

When to see a doctor

While white spots on your skin are typically not dangerous, if you notice any changes in your skin tone, consider making an appointment with a dermatologist just to be safe. Additionally, pay close attention to any changes in moles, birthmarks, pimples or bruises on your body. Annual skin cancer screenings are also recommended for anyone with a history of:

• Melanoma
• Using tanning beds
• Blistering sunburns
• Significant regular sun exposure
• Organ transplants
• Medical conditions or medications that suppress your immune system

And if you ever experience other symptoms like painful, bleeding or itchy skin, it’s good to get that looked at, too.

“Areas without pigment cells are more vulnerable to the development of skin cancers,” adds Dr. Wei, “So, I stress to everyone, particularly those with pigmentary problems, to be hyper-vigilant about any changes to their skin and to prioritize sun protection.”