White spots on the skin can be caused by a variety of factors, ranging from simple mycosis and white freckles to skin problems such as dermatitis, hypomelanosis or vitiligo.
When a spot appears on your skin you should take note of its size, where it is, when it appeared and if you have other symptoms, such as itching, dry skin or peeling. Then, make an appointment with a dermatologist so that the cause may be identified and to start the most appropriate treatment.
Some possible causes of white spots or patches on the skin and their treatment are:
1. Skin mycosis
One of the most common causes of small white spots on skin, which are very itchy and can spread through large areas of the body, are “beach” mycosis, also known as pityriasis versicolor or tinea versicolor.
Although it is known as “beach” mycosis, the person probably already had the mycosis, but only realized it after going to the beach, because the affected area wasn't tanned. The fungus that causes this mycosis naturally inhabits the skin, but due to some alteration, it becomes unpleasant, multiplying a lot, and forming typical spots that affect the neck, trunk or back.
What to do: apply an antifungal ointment indicated by a dermatologist, which may be Isoconazole, Ketoconazole or Miconazole. Shampoo, soaps and gels may also be indicated to supplement the treatment. To prevent other people in the house from being affected, each person should use their own bath towel and not share their clothes.
2. Blemishes caused by sun exposure
Sometimes people with light or olive skins get tanned when they go to the beach or pool and, after a few days, the skin peels, and small white patches appear, especially on the arms, chest and back.
What to do: It is important to moisturize your skin daily, and to always put sunscreen before going in the sun because the skin is thinner and more sensitive and has a higher risk of being sunburnt. Ideally, you should moisturize your skin very well about 10 days before going to the beach and eat foods high in vitamin A such as carrots, tomatoes, boiled eggs, papaya and mangos, because the more hydrated the skin is, the lower the risk of flaking and developing blemishes.
3. Atopic dermatitis/ atopic eczema
Atopic dermatitis is an inflammation of the skin that appears mostly in babies, but it can appear at any age. Dermatitis generally causes red patches, plaques or lumps, but when they disappear, they can make the area whiter.
What to do: The usual treatment is steroid medication prescribed by a dermatologist, such as Fenirax, twice a day. The skin should also be kept hydrated, and an antihistamine may also be needed to relieve itching.
4. White freckles
Light olive-skinned people can develop several small white freckles that may appear on the hands, arms or legs, especially over the age of 40. This usually happens in people who have fair skin or who have been exposed to the sun for many years without sunscreen.
What to do: It is recommended you protect your skin from the sun by always using sunscreen when you go to the beach or pool, or whenever you spend more than 15 minutes out in the sun. Wearing a hat and gloves can also be helpful in preventing the sun's rays from aggravating skin lesions.
This is a disease which causes the appearance of large white patches on the skin and that can also affect the inside of the mouth. Its cause isn’t fully known but is believed to occur due to a genetic change or an alteration in your immune system, when the body starts to fight against melanocytes.
What to do: The doctor can indicate treatments such as phototherapy or applying creams and ointments with corticosteroids and/or immunosuppressants. One of the drugs that may be indicated is Melagenina plus, which stimulates the production of melanocytes and melanin and evens out the tone of your skin.
This isn’t caused by any fungus, rather it’s a characteristic of the person and very common in Brazil. In these cases, there are some parts of the body that are lighter than the person's general skin tone, and although sun exposure improves contrast, the affected parts are always lighter than the rest of the body. This change in the skin is more common in people who have some type of allergy.
What to do: Although you don’t need any specific treatment, sun exposure early in the morning or late afternoon may be helpful in trying to even out your skin tone.
7. Tuberous sclerosis
Also known as Bourneville disease or Epiloia, it’s characterized by the appearance of white scattered patches that can affect any part of the body, although the trunk is the most common. They are often first identified in infants or children up to the age of 6, and there may only be 1 or more than 100 patches on the body.
What to do: You should see a dermatologist to confirm the diagnosis and start treatment to avoid complications, such as seizures or even kidney problems.
Can white spots be cancer?
Non-melanoma skin cancer can cause a spot with uneven edges to appear on whitish skin and this spot has different textures and colors. In that case, you should go to a dermatologist to be checked out and confirm if it is skin cancer and how to treat it.
Can white spots be caused by worms?
White spots on skin don’t always mean the presence of worms, however, associating this symptom with worms is normal, because when a person has worms, it is common for their body not to fully absorb the vitamins and food nutrients, and this deficiency in vitamins can cause white patches on the skin. The main vitamins that cause white patches on the skin are calcium, vitamin D and E, and these can be found in milk, sardines, butter and peanuts, for example.
If the cause of white spots on the skin is actually worms, these should be identified with a parasitological stool examination and treatment can be done with the use of worm medication.