What is Pityriasis Alba?

Last updated: October 2019

Pityriasis alba is a common skin condition seen most often among children aged 3 to 16. The name comes from the Greek words pityriasis meaning “scaly,” and alba meaning “white.”

Pityriasis alba is not a dangerous condition, and most cases resolve on their own after age 16 or by the time people reach adulthood. It affects approximately 2 to 5 percent of children. There is wide variation in how long individual flare-ups of pityriasis alba can last, ranging from one month to 10 years. However, most cases clear up in a few months to a year.1

The lightened skin patches characteristic of the condition can be more noticeable in the summer when the surrounding skin tans. Lightened patches can be more noticeable on darker skin tones, as well.

What are the symptoms of pityriasis alba?

Pityriasis alba is characterized by the presence of ill-defined, often rounded or oval, sometimes scaly, mildly red, pink, or regular-colored patches on the skin. The patches eventually resolve, leaving slightly faded areas on the skin.2 These patches can sometimes present similar to the skin lesions or plaques that are typical with plaque psoriasis.

  • The patches occur most often on the face, particularly on the cheeks.
  • 50% of people with pityriasis alba experience symptoms only on their cheeks.
  • Other areas are the upper arms, neck, or shoulders. Fewer than 20% of children experience symptoms on their upper body.
  • Patches are less common on the legs or trunk.
  • The patches are usually 1-4 cm. in diameter.
  • They are usually found in groups of 4 or 5 to 20 or more.1

How is pityriasis alba diagnosed?

Diagnosis of pityriasis alba is made based on clinical signs and symptoms.3 Skin lightening (also known as hypopigmentation) is common after an episode of swelling, for example, and it can sometimes result from the use of topical steroidal creams or other beauty products.

Lightened patches can also be caused by certain autoimmune conditions and fungal infections, among other things. In seeking to make a diagnosis, a doctor might conduct a few tests to rule out other possible conditions that can cause similar symptoms. Psoriasis plaques and other types of inflammation may leave behind hyperpigmentation (dark patches) or hypopigmentation (light spots), which can be more noticeable on darker skin. Sometimes light therapy (phototherapy) can emphasize the contrast.

These include:

  • Scrapings to rule out fungal infection
  • Examination under a special lamp called a “wood lamp”
  • Skin biopsy1

What causes pityriasis alba?

The exact cause of pityriasis alba is not fully understood, but dermatologists think it is a mild manifestation of atopic dermatitis, a more severe form of the skin condition known as eczema. Psoriasis and atopic dermatitis are both conditions that affect the skin, however, there are differences between the two conditions, and proper diagnosis is important to receive the right treatment and manage symptoms. It is possible for an individual to have both psoriasis and atopic eczema, and in some cases, a person may be diagnosed with psoriasiform dermatitis, a type of inflamed skin condition that resembles psoriasis.1 It is possible that those with psoriasis experiencing hyperpigmentation or hypopigmentation may be experiencing pityriasis alba.

How is pityriasis alba treated?

Pityriasis alba is not a serious ailment, and it generally resolves on its own. It is not contagious, and it is not caused by any kind of germ or fungus.1 Most cases are gone by adulthood. There are a few treatments that can help reduce symptoms or encourage healing, if needed.1

  • Regular use of over-the-counter creams or lotions to help the skin retain moisture
  • Use of an over-the-counter low-dose topical corticosteroid cream (like hydrocortisone) to reduce redness and itching
  • Use of a prescription non-steroidal topical cream that reduces redness and itching (There are two currently available: Protopic and Elidel.)

For more persistent cases, UV light treatment, laser treatment, and other prescription creams may also be effective.1 If you are experiencing hypopigmentation or hyperpigmentation, talk with your dermatologist who can discuss with you what treatment options are possibe.

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