Pityriasis alba

A skin condition better known as “Khaid” in my mother tongue : Khasi.

Pityriasis alba is a common skin condition mostly seen in children & adolescents between 3-16 years of age

Pityriasis” refers to the fine scales and “Alba” refers to the pale hypo-pigmented patches.

These pale patches are mostly seen on the cheeks, arms, chest, or back.

What causes P.alba?

The aetiology is still unknown. However there are some factors that have been implicated in the development of P.alba:

How does P.alba present?

P. alba evolves through different stages:

  • First stage : Starts as areas of mildly erythematous (red) patches on the cheeks or chin, or arms. It may be itchy at this stage. This stage is commonly more noticeable in fair skin individuals and often missed in darker skin individuals.
  • Second stage : The erythematous patches subsides leaving behind pale hypo-pigmented patches with the fine scaling on the surface. This is more prominent in darker skin tones and it is usually at this stage that parents seeks medical attention for the patches.
  • Third stage: The pale patches spontaneously subsides in a few months to years leaving no scars

Variants of P.alba

Should I be worried that my child has P.alba?

No, P.alba is a benign self resolving condition. The patches subside spontaneously within a few months or years for some without any sequelae.

It is important to remember that it may take years to complete resolution of the patches of P.alba in few patients.

Why do you need to see a dermatologist?

P. alba can mimic many other skin conditions, therefore getting an expert to examine the skin lesions for a proper diagnosis is of utmost imporatance.

You dermatologist can help conduct certain bedside test on the skin to help rule out the above mentioned conditions.

Once the diagnosis of P. alba is ascertain, the dermatologist will advised on your skin care and treatment accordingly depending on the stage of the condition.

How is P. Alba treated?

What one can do to help improve the appearance of the skin lesions:

  • Avoid excessive bathing and excessive washing and scrubbing of face
  • Use moisturisers, it helps improve the appearance of the dry scaly patches
  • Always use a broad spectrum sunscreen which will help prevent further tanning and darkening of the surrounding skin, thus minimising the contrast between the pale patches and the neighbouring tanned skin.

What your dermatologist may prescibe?

  • A Short course of mild topical steroids especially during the first stage of the disease when the rash erythematous and itchy.
  • Topical calineurin inhibitors such as tacrolimus or pimecrolimus during the second stage.