What are white skin spots?

White skin spots are small white spots that appear on your skin. They may cause itchiness or feel tender, but they can also be painless. While their appearance can worry people, they are usually nothing serious. 

The term ‘white spots’ describes a variety of different spots. When there are other symptoms alongside the white spots, it can help you to work out what type of skin condition you have.

Different types of white spots:

• tiny white bumps on the surface of the skin
• larger areas of skin that are lighter than your natural skin colour
• white lumps of skin

White spots may cause itchiness or be tender, but they can also be painless. Depending on your skin tone, white skin spots may look different from what you expect. Studies of skin conditions have not always included non-white skin tones, so speak to a doctor or specialist skin doctor (dermatologist) to identify your skin condition.

Common causes of white skin spots

White skin spots can have several different causes depending on why you have them. You may have an underlying condition that’s causing them, or they could be due to getting too much sun. By understanding the different types of white spots and what causes them, you can build a clearer picture of why you’ve got them. 

Sunspots/white freckles

• These are small white spots on areas of skin that are more exposed to sunlight, such as legs, arms and face. 
• The medical name is Idiopathic guttate hypomelanosis (IGH).
• Doctors can prescribe topical steroids to reduce the spots, but getting rid of them is hard. Laser treatment is also an option.
• There is no link between sunspots and cancer, but see your doctor if you notice changes or experience pain or itching with the spots.

Milia or ‘milk spots’

• Milia are tiny white raised bumps usually found around the eyes, nose, forehead and cheeks. They form when a small cyst gets trapped under the skin.
• They are known as milk spots because they are so common in newborn babies, but adults can get them too.
• In babies, milia clear up by themselves. In adults, doctors may use a topical retinoid cream or a sterile procedure to remove the cyst material from the skin. If you try to remove them by yourself, they may leave a scar.
• A milium (singular) is not contagious.

Whiteheads/acne

• Whiteheads are small white spots often found on the face, back, shoulders and upper arms.
• They are a mild form of acne and are not the same as pustules (pimples) which have pus at their tips and can look white.
• You get whiteheads and blackheads when excess sebum oil or dead skin cells block a pore. A blackhead is when the pore is open (so the contents change colour when they meet oxygen), whereas a whitehead has a closed pore. 
• Many acne treatments are available, including over-the-counter face washes and prescription medicines.

Warts & verrucae

• These are non-cancerous hard skin growths that can look white in appearance.
• Warts are commonly found on hands and feet, whereas you can only get verrucae on the feet.
• Both warts and verrucae are very contagious, so good hygiene is essential to avoid passing them on to other people.
• Treatment includes over-the-counter medications from the pharmacist. If these don’t work, a doctor may be able to  remove them for you. 

Pityriasis alba

• Pityriasis alba starts as oval or irregular-shaped patches of rough skin that fade to leave areas with reduced pigment, which can be more evident on darker skin tones. 
• The patches can be itchy and dry, and the change of skin colour is often more noticeable after exposure to the sun as the areas don’t tan as usual. 
• Pityriasis usually clears up, although it can come and go for a few years. If the patches are uncomfortable, a doctor can prescribe a steroid cream. Using sun cream can stop the rest of the skin from changing colour and make the patches less obvious.
• Pityriasis alba is a mild form of atopic dermatitis (eczema) and is common in children.

Pityriasis versicolour 

• Also called tinea versicolour, these patches are a different colour from the usual skin tone. The patches look paler on darker skin tones but can look red or brown on white skin tones.
• A fungal infection causes pityriasis versicolour, so the treatment is antifungal creams or medications.
• It is not contagious but usually only goes away when treated. Your skin should return to its usual colour.

Vitiligo

• A lack of melanin means that pale patches on the skin are lighter than the natural skin tone.
• Vitiligo is most common on the face, neck and skin creases.
• The pale patches are more vulnerable to sunlight, so it’s essential to wear high-factor sun cream or keep them covered up.
• Vitiligo is thought to be an auto-immune condition and is not contagious.
• The patches are usually permanent, but there are treatments to temporarily reduce the difference in colour, such as steroid creams to restore the pigment or light treatment.

Lichen sclerosus

• Itchy white patches often on the genitals, which can easily bleed if rubbed.
• More common in women over 50, it is not contagious or caused by poor personal hygiene.
• Doctors can prescribe a steroid cream to treat lichen sclerosus. Home care includes using a barrier cream, washing with an emollient soap, and wearing loose-fitting clothes.
• Over time lichen sclerosus can cause scarring and tightness, making erections painful and shrinking the vulva. It can also increase your risk of cancer on your vulva, penis or anus. Check for lumps, change in skin tissue or an ulcer on your genitals that doesn’t go away.

Tuberous sclerosis 

• A rare genetic condition, tuberous sclerosis can cause several symptoms, including skin abnormalities like patches of lighter-coloured or thickened skin.
• The condition causes benign tumours to grow in different parts of the body, often the kidneys, heart, brain, lungs, eyes and skin. These tumours can lead to health problems such as epilepsy, breathing issues and kidneys not working correctly.
• Doctors treat tuberous sclerosis by focusing on the different issues caused by the condition. They may use lasers or prescription medicines to treat skin abnormalities.

Mycosis fungoides

• Mycosis fungoides is a very rare and slow-growing form of skin cancer that starts with irregularly-shaped dry patches on areas of the skin that don’t usually see the sun. 
• The patches can look lighter than the usual skin colour on darker skin tones. On white skin, they are often red.
• A skin biopsy is needed to confirm a diagnosis of mycosis fungoides. There is no known cure, but early diagnosis and treatment can control the disease.

Should I see a doctor about white spots?

Talk to your doctor if you develop white spots and are not sure of the cause. In most cases, white spots are nothing to worry about, but a doctor should check changes to your skin to rule out anything serious.

If you have white spots caused by acne, eczema or warts and they are impacting your daily life, talk to your doctor. They can recommend treatments to deal with them.

How do I know what’s causing my white skin spots?

It can be hard to identify what is causing white skin spots. You can also use Superdrug’s Online Skin Diagnosis service or your doctor or a dermatologist will be able to help you.

Sources

• Lichen Sclerosus NHS [accessed 4 October 2022]
• Milia Skinsight.com [accessed 4 October 2022]
• Mycosis Fungoides Bad.org [accessed 4 October 2022]
• Pityriasis Versicolor NHS [accessed 4 October 2022]
• Pityriasis Alba Bad.org [accessed 4 October 2022]
• Pityriasis Alba NCBI [accessed 4 October 2022]
• Tuberous Sclerosis NHS [accessed 4 October 2022]
• Vitiligo NHS [accessed 4 October 2022]
• White spots Sknclinics [accessed 4 October 2022]