What is Pityriasis Alba?
The term Pityriasis Alba derives from the Latin language and in literal meaning stands for “scaly white” skin.
The skin disorder is characterized by colorless, dry, white, pale oval or round patches with fine scales. The patches most often appear on the cheeks and forehead area, however, in certain cases can also spread on neck,fore arm and chest area. This skin order first appears in the form of scaly red patches which later on becomes hypo-pigmented i.e. a shade lighter than the normal skin color.
Usually, these scaly dry patches can be treated with regular applications of moisturizer and sunscreens and often fades away on their own once the child reaches puberty. The condition often gets worse in the dry winter weather and in summers when the skin is exposed to sunlight making it further darker or tanned.
Who is at risk?
Pityriasis Alba is generally observed in children between age groups 3 and 16 years. Children having other ailments like asthma, hay-fever, eczema or dry skin are found to be at greater risk. It is found in common amongst all races equally, however, observed more prevalent in dark skinned people than with a light tone and occurs more commonly in males than in females.
What Causes Pityriasis Alba?
The exact cause of Pityriasis Alba is still not known. This disorder often occurs in patients suffering from dermatitis or eczema. In case of eczema patients the immune system becomes hypersensitive and responds aggressively to the foreign antigens. However, sometimes the immune cells may often start attacking normal body cells, causing irritation and inflammation in skin cells.
Also, the occurrence of white and pale patches is often found as a result of the use of corticosteroids in treating patients with eczema or dermatitis. Hypopigmentation may be caused due to the reduced activity of melanocyte cells, which are responsible for pigmentation and skin color.
Often external factors like excessive exposure to sunlight, chemical soaps or creams having artificial fragrance, humidity which makes the skin drier, stress, laundry detergent, etc. are also found to be responsible actors to trigger Pityriasis Alba. Any of the conditions or factors that may be harmful to the skin can trigger the symptoms of Pityriasis Alba.
General Symptoms of Pityriasis Alba
Clinical symptoms of Pityriasis Alba lesions are often referred to as the occurrence of round or oval shaped, white or pale colored, dry, flaky patches on the face, neck or chest area and sometimes in the armpits and hands. Erythrema or red lesions may be the primary or early signs of Pityriasis Alba which is often followed by hypopigmentation of the area leading to white or pale patches.
The patches may be concentrated in one place or may be widely widespread. The characteristic features of the lesions found in Pityriasis Alba may be summed up as below:
- White, pale, red, pink or skin colored flaky dry patches in oval, round or irregular shape having an indistinct margin with lamellar scaling.
- The patches may be 3 to 4 or as many as 20 or more in numbers with an average size of 2-4 cm in diameter.
- In most of the cases the patches may be restricted to facial region, however, very often they may spread on to neck, shoulder, forearms, legs and trunk area.
Pityriasis Alba has some uncommon variants based on the different characteristics of lesions, which are as below:
- Extensive Pityriasis Alba: The extensive Pityriasis Alba differs from the classic form in being, more widespread and symmetrical in nature; absence of initial inflammatory phase and spongiosis. These kind of lesions is more commonly found in the trunk region than face and in females as compared to the male population.
- Pigmenting Pityriasis: These lesions are found to be associated with dermatophyte infection and have characteristic bluish color in the core surrounded by pale and scaly skin of variable size. These patches are mostly found in the facial region.
Pityriasis Alba Diagnosis
Pityriasis Alba can be generally diagnosed on the basis of physical examination only. However, in certain patient specific tests may be included to rule out any fungal infections or other disorders similar in appearance and symptoms.
- Skin Biopsy or Scraping: Sometimes the physician may scrap few flaky scales for microscopic examination for assessment of any fungal or microbial infections. Similarly, the small skin section may be used for examining the possibilities of any associated Cancer.
- KOH or potassium hydroxide staining: Scraps may be used for staining with potassium hydroxide to rule out the possibility of tenia versicolor or tenia corporis.
- Wood’s light examination: This is used when there is a possibility of vitiligo. The skin lesions are studied under the wooden lamp to differentiate between the lesions. The vitiligo patches glow more brightly with sharp boundaries under the light as compared to lesions in Pityriasis.
Pityriasis Alba Treatment
In most of the cases, Pityriasis Alba resolves spontaneously and no medical treatment is required. In certain patients medical therapy may be required if the problem persist for a long time or recurs again or is extensively spread. In such conditions, the most common treatment therapies applied to Pityriasis Alba patients are as below:
- Moisturizers: A good moisturizer helps in treating the scaly skin. Few examples which are often found to give good results in Pityriasis Alba patients are: Lac-Hydrin cream; Cordan cream containing 2% Zetar and Pragmatar ointment.
- Topical Steroid Cream: Low potency steroid cream is often used to reduce the red itchy patches. 1% hydrocortisone or 0.05% of Desonide may help to heal the initial lesions and increase the rate of repigmentation in the affected area.
- PUVA (Psoralen with Ultra Violet rays): This is a kind of photochemotherapy procedure which may be beneficial in repigmentation of extensively affected areas. However, chances of recurrence are quite common.
Apart from above mentioned therapies Laser treatment, Tar Paste, Tacrolimus 0.1% topical cream and 1% of pimecrolimus cream are often found to be effective treatment options.
Natural Home Remedies For Pityriasis Alba
The best and the most easy way to treat Pityriasis Alba is through simple home remedies and following certain general precautions which are very convenient to follow. As discussed above, most of the time Pityriasis Alba does not require any medical treatment and resolves on its own.
Some simple home remedies which are often very helpful in preventing the recurrence or treatment of the disorder are as below:
- Use of a good moisturizer to keep the skin moist is very important. Children’s skin is often very sensitive, so its always better to check with your physician first before using any cream or ointment.A good Vaseline or petroleum jelly without any artificial fragrance is the best option.
- Olive oil and coconut oil serves the best moisturizers easily available in your kitchen.
- A good amount of sunscreen shall be applied before going out in the sun.
- A good moisturizing soap shall be used for bathing instead of the soaps that leave the skin dry.
Pityriasis Alba Pictures