White Patches on Skin: What to Know About Vitiligo

White patches on skin are types of depigmented skin lesions. They can occur with an infection, allergy, or autoimmune disorder. Rarely, skin cancers and precancerous changes can cause white patches.  White patches are usually not serious. However, consult your doctor to determine the exact cause of your white patches.

This article explains the common causes of white patches on the skin and their treatment options.

Small white patches on the skin are areas of hypopigmentation or decreased skin color. Hypopigmentation occurs when there is a reduced amount of melanin in the area. Melanin is the molecule that gives skin its color or pigment.

The more melanin you have, the darker your skin will be. Conversely, skin with less melanin is lighter. When an area loses melanin for some reason, it will appear lighter than the surrounding skin.

There are various causes of white skin patches or white scaly patches on skin, such as vitiligo and eczema. White spots are common and rarely a cause for concern.

However, losing skin color can cause stress and feel upsetting. Finding the cause is an important step in resolving the issue, if possible. Contact your doctor about white patches that are persistent or cause you concern.

White patches may accompany other symptoms, which vary depending on the underlying disease, disorder, or condition.

White patches may accompany other symptoms, including:

• asthma and allergies
• tenderness or burning
• changes in the feel of your skin, especially on or around the white patches
• dryness of the skin, especially around the white patches
• itchy skin
• scaly or peeling skin
• redness, discoloration, warmth, or swelling

Possible causes of white patches on skin include:

One potential cause of white patches on the skin is vitiligo. This autoimmune disorder leads to the destruction of melanocytes, the cells that make melanin. The body’s immune system mistakenly targets melanocytes as a foreign substance. Their destruction leads to the lack of skin pigment, which causes white patches. 

White patches from vitiligo may come and go, or they may be permanent. Vitiligo is commonly only a cosmetic issue. A variety of medications and some procedures can help to minimize the appearance of the white patches.

Eczema is an inflammatory skin condition from hypersensitivity or allergy. It is common in children. It usually results in itchy scaling skin, sometimes the skin may begin oozing or peeling. However, it can also lead to the formation of white dry patches on the skin.

idiopathic guttate hypomelanosis are areas of small, circular, lightened pigment in adults that may develop on areas of skin that experienced chronic sun exposure. The reason this harmless skin condition occurs is unclear. However, doctors observe that it tends to run in families.

Tinea versicolor is a fungal infection of the skin. The infection can sometimes cause other symptoms, such as itching or dryness on or around the white patches. It is not contagious and usually responds to antifungal medications. 

The white areas usually return to their usual color within a few months of treatment. In some cases, it can take longer.

Other possible causes include:

• chemicals, such as skin bleaches
• congenital conditions, such as various forms of albinism
• nutritional deficiencies, such as lack of protein, vitamin B12, copper, or iron
• skin cancer
• vascular differences, such as Bier’s spots

To diagnose your condition, your doctor will ask you several questions related to your white patches, including:

• When did you first notice the white patches?
• Did they start suddenly or gradually?
• Do the white patches come and go, or are they constant?
• Do you have any other skin lesions?
• Do you have any other symptoms, such as itching or burning?
• Have the white patches changed in size, shape, or color?
• Have you had similar lesions before?
• Have you tried any medications or other measures for your white patches?

Your doctor may also examine your skin with special scopes or take a skin scraping or biopsy.

Treatment of white skin patches depends on the underlying cause. The goal is to address any underlying cause and return pigment to the skin, if possible.

Repigmentation is often possible with timely diagnosis and treatment. Congenital conditions that cause hypopigmentation are less likely to respond to treatment.

Potential treatments include:

• Depigmentation: This involves lightening the surrounding skin to make the spots less noticeable. This may be an option for people with vitiligo on more than half of their skin surface.
• Medications: These include antifungals, corticosteroids, immunomodulators, and vitamin A derivatives.
• Phototherapy: This involves aiming ultraviolet rays at the white patches to help darken the skin. 
• Surgical procedures: One example is skin grafting with pieces of skin that have a usual pigmentation.

White patches result from a variety of causes, but they are typically mild and have a good outlook. However, complications are possible, including:

• complications from any underlying systemic disease or condition
• increased risk of skin cancer due to lack of melanin, which protects you from ultraviolet light damage
• mental health stress from cosmetic effects causing anxiety or depression

Here are some questions people often ask about white patches on skin.

Skin cancer is a potential cause of white skin patches. For example, basal cell carcinoma can appear as flat, white, scar-like lesions. Amelanotic melanoma, also called nodular melanoma, sometimes lacks pigment. This type can also appear red, pink, or purple spots.

Contact your dermatologist about any new or concerning skin spots. Wear daily sunscreen to protect your skin year-round.

There are several nutritional deficiencies that can cause white spots on skin. Of the vitamins, vitamin B12 deficiency is a possible cause. Copper, iron, and protein deficiencies can also cause white skin spots.

It is important to know the underlying cause to help the skin regain pigment. Contact your doctor to get a proper diagnosis. Among other treatments, your doctor may suggest protecting your skin from sun exposure and wearing daily sunscreen.

Vitamin D is an important role in skin pigmentation. It increases melanogenesis, which is the production of melanin. Vitamin D also helps your body absorb calcium for your bones.

In general, white spots do not spread in a contagious way. However, if an underlying cause can affect different body parts, you may see white spots in several areas.

White skin spots, or areas of hypopigmentation, are common and usually harmless. There are several possible causes, including the autoimmune disorder vitiligo.

Finding the cause is important because it helps determine whether treatment is necessary. In some cases, repigmentation is possible. Other times, lightening the surrounding skin or using skin grafts can even out skin tone.