Why Does My Skin Have White Patches? Causes and Treatment Explained

White patches on skin can be caused by vitiligo, fungal infections like tinea versicolor, or eczema. See a dermatologist for diagnosis.

Common causes

• Vitiligo: loss of pigment; affects 1 to 2 percent of people, with smooth white patches, often symmetrical.
• Tinea versicolor: a fungal yeast with scaly light patches, especially in summer.
• Eczema, pityriasis alba: dry, pale patches in children.
• Post-inflammatory hypopigmentation after rash, burns or injury.
• Idiopathic guttate hypomelanosis: small white spots on sun-exposed skin, common over 40.

Treatment

Depends on the cause. Antifungals for tinea. Vitiligo: topical steroids, light therapy.

Sun protection

White patches burn easily, so use SPF 30 or higher.

See a dermatologist

If patches spread or don’t go away.

What white patches can mean

White patches on skin occur when pigment is lost (depigmentation) or reduced (hypopigmentation), or when scaly skin looks pale. The cause determines treatment, so a proper diagnosis matters.

Common causes

• Vitiligo: an autoimmune disease where melanocytes are destroyed, causing well defined, milky white patches that often start on the hands, face and around the eyes. It affects about 0.5% to 2% of people worldwide, and may start at any age, usually before 30.
• Pityriasis alba: pale, slightly scaly round patches on the face of children and teens, linked to dry skin and eczema.
• Tinea versicolor: a yeast infection (Malassezia) causing white, pink or tan patches on the chest, back and shoulders that become more visible in sun.
• Post-inflammatory hypopigmentation after eczema, psoriasis, burns or injuries.
• Idiopathic guttate hypomelanosis: small white spots on the shins and forearms of sun exposed skin in adults, common after age 40.
• Albinism and piebaldism: genetic conditions with lack of pigment from birth.
• Lichen sclerosus: white shiny patches, often in the genital area.
• Fungal infections, leprosy in endemic regions, and certain medications.

Treatment

• Vitiligo: topical corticosteroids, calcineurin inhibitors (tacrolimus), narrowband UVB phototherapy and, since 2022, ruxolitinib cream (Opzelura), the first FDA approved treatment that restores pigment in some patients. Camouflage makeup is an option. Surgery such as skin grafts is used for stable disease.
• Pityriasis alba: moisturizers and mild steroid creams, with fading over months to years.
• Tinea versicolor: antifungal shampoos (selenium sulfide, ketoconazole) or creams, and oral drugs for extensive cases. Pigment may take weeks to months to return.
• Post-inflammatory changes usually return gradually after the cause is treated.

Sun protection

White patches burn easily because they lack melanin. Use broad spectrum SPF 30 or higher sunscreen, cover the skin with clothing and avoid tanning, which makes the contrast stronger.

See a dermatologist

See a dermatologist if patches spread, are itchy, scaly, numb, or change in size, if they appear on the genitals, or if they occur with other symptoms such as fatigue or thyroid disease. Vitiligo is linked to autoimmune conditions such as thyroid disease, type 1 diabetes and alopecia areata, so screening may be advised. A dermatologist may use a Wood’s lamp or take a skin scraping.

Pigment loss versus fungal causes

White patches on skin can be vitiligo, which affects about 0.5 to 2 percent of the world’s population and results from loss of melanocytes. Pityriasis alba affects children with mild, scaly pale patches that often follow eczema. Tinea versicolor is a yeast infection causing pale or dark patches on the chest and back, treated with antifungal shampoos or creams. Post-inflammatory hypopigmentation appears after skin injury. Idiopathic guttate hypomelanosis causes small white spots on sun-exposed skin in older adults. Doctors may use a Wood’s lamp, skin scrapings or biopsy for diagnosis. Use SPF 30 or higher, since depigmented skin burns easily. Vitiligo treatments include topical ruxolitinib cream (approved in 2022), steroids and phototherapy.

Based on data from the American Academy of Dermatology and the FDA