Springdale Mason Pediatrics

Pityriasis Alba

Definition

  • Small pale spots on the face
  • Called Pityriasis Alba (PA)

Call or Return If

  • After 2 weeks of treatment, dryness is not gone
  • After 6 months, normal skin color has not returned
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Small spots with less pigment than the normal skin.
  • The spots are flat. Most are oval shaped.
  • Their borders are vague and fade into the normal skin.
  • Pale spots are usually less than ½ inch (12 mm) across.
  • The face is always involved, but can also occur on the arms.
  • The spots may be covered with very fine scales.
  • Spots look worse (more pale) in the summer when the normal skin gets tan.
  • It rarely causes any itching.

Causes

  • A partial loss of skin pigment caused by skin irritation
  • The main irritants are soap and dry winter weather.
  • Soap removes the skin's natural protective oils. Once they are gone, the skin can't hold moisture.
  • Dry climates make it worse, as does winter weather. Reason: low humidity inside.
  • Can occur as early as 2 years
  • More common in children with eczema
  • Seen in up to 30% of children

Prevention of Recurrent Pityriasis Alba

  • Don't use soaps or bubble bath. Reason: It's made worse by soaps.
  • You may want to limit use of swimming pools or hot tubs. Reason: Pool chemicals are very drying.
  • Run a humidifier in the winter if the air is dry.

After Care Advice

Overview:
  • Pityriasis Alba (PA) is a common condition.
  • It will get better if you avoid soaps and other irritants on the face.
  • The normal pigment always returns, but it may take 6 months
  • PA has nothing to do with vitiligo. Vitiligo are spots with complete loss of pigment.
  • PA is harmless and can be treated at home.
  • Here is some care advice that should help.
Soap and Bathing:
  • Never use any soap on the areas with PA. This is very important.
  • Young children with PA should avoid all soaps. Soaps take the natural protective oils out of the skin. Bubble bath does the most damage.
  • For young children, the skin can be cleansed with warm water alone. Keep bathing to 10 minutes or less.
  • Most young children only need to bathe twice a week.
Moisturizing Cream:
  • Buy a large bottle of moisturizing cream. Avoid those with fragrances.
  • Put the cream on the PA areas 2 times per day.
  • After warm water baths or showers, trap the moisture in the skin. Do this by putting on the cream quickly. Use the cream within 3 minutes of completing the bath.
  • During the winter, apply the cream to all the skin. Do this every day to prevent dry skin.
Steroid Cream:
  • Usually PA is not itchy unless you scrub it with soap.
  • For very itchy spots, use 1% hydrocortisone cream. No prescription is needed.
  • Use up to 2 times per day as needed until the itching is better.
  • In time, the moisturizing cream will be all that you need for treating PA.
Prescription Creams:
  • There is no prescription cream that will help.
Humidifier:
  • If your winters are dry, protect your child's skin from the constant drying effect.
  • Do this by running a room humidifier full time.
What to Expect:
  • With treatment, the skin should feel softer within 1 week
  • The normal skin pigment will take up to 6 months to return. But, it always does.
  • May recur in young children, but goes away by the teen years.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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