Why do white patches appear on the skin?

Why do white patches appear on the skin?
Photo source: Getty images

The skin protects us from the external environment. It is our protective covering. Changes on its surface are immediately visible. The loss of pigment, but also other changes in colour alert us that something is wrong. In addition to diseases related to the skin itself, it also alerts us to other diseases that may have skin manifestations.

White patches on the skin are also referred to as depigmentation and appear on a person's skin anywhere on the body. A flat discoloration of the skin is also called macula. It is caused by a change in blood supply or pigment

Most often they occur on the hands, face, but also on the back. These are clearly distinguishable and circumscribed paler spots and blotches. These spots may or may not indicate a more serious disease.

These spots are caused by the destruction of pigment cells in a given part of the skin, causing depigmentation of a permanent nature. According to theories, the cause may be, for example, an autoimmune reaction or the death of pigment cells due to the effect of neurochemical mediators.

There are several diseases that are manifested by white and pale patches on the skin, such as vitiligo, Pityriasis versicolor, hyperthyroidism or other diseases of the endocrine system.

Many times they are the result of an injury or vaccination. If they occur without an obvious previous and external cause, they are a symptom of a disease. It is important to watch for other accompanying symptoms in addition to loss of pigmentation.


A very common disease with the manifestation of white spots is vitiligo. It is characterised by the appearance of a number of white spots, especially on the face, upper limbs or hair.

These are smaller spots that can be either specifically localized or generalized, universal or mixed. The disease affects both men and women and its development starts quite early, around the age of 20.

The disease is caused by the death of melanocytes and is non-transmissible. During the summer period, a person with this disease should not be exposed to sunlight. White spots on the skin itch after sunbathing.

The disease can be cured, but the results are highly variable. Treatment with glucocorticoids, local PUVA therapy, modern laser therapy or application of topical preparations are used. If no other treatment works, microsurgery in the form of skin grafts is also an option.

Pityriasis versicolor

Another of the diseases is Pityriasis versicolor

This disease is of fungal origin and the pale spots are caused by the fungus Malassezia furfur. The disease manifests itself in the form of grey and white patches on the back or neck, sometimes as white dots on the skin.

mycosis causing pityriasis versicolo
Malassezia furfur, a species of yeast. Source: Getty Images

The following factors contribute synergistically to the development of the disease:

  • oily skin
  • increased sweating
  • reduced body defences
  • high ambient temperature
  • high environmental humidity

The disease is partially transmissible. Treatment consists in the application of antifungal agents. However, the treatment is prescribed by a specialist, a dermatologist, who will determine the best possible way to remove these spots and spots.

White spots in hyperthyroidism

Hyperthyroidism is a disease that is characterized by excessive hormone production in the thyroid gland. It is an autoimmune disorder of the body. One of the symptoms of the disease is the existence of white and pale spots on the skin due to the failure of pigment cells and their dysfunction.


young man albino, white hair, wearing a jacket
A young man with albinism. Source: Getty Images

Albinism is a rare inherited disease that can take many forms. One is total albinism or oculocutaneous albinism, where it affects the skin, hair and eyes. The ocular form affects the colour of the eyes.

The third form is partial albinism. The latter is characterized by depigmentation affecting only some parts of the body. The depigmentation is caused by a defect in the enzyme tyrosinase.

Total albinism is characterized as follows:

  • white skin and hair
  • light blue to red eyes
  • sensitivity to UV radiation
  • higher risk of skin diseases
  • faster skin ageing

White patches on the skin and other diseases

In addition, spots of a similar type also occur as part of the symptoms of other diseases. Examples of these are diabetes, pernicious anaemia or Addison's disease.

Another type of pigment loss is leucoderma. This disease involves a focal loss of pigment. Unlike Vitiligo, the spots are without edges.

Destruction of pigment structures occurs as a result of another disease. Leucoderma occurs in syphilis, psoriasis, but also as a result of skin infections or even after healing of burns.

Leprosy is an example of other diseases, and the formation of spots also occurs in liver diseases, kidney dysfunction, or pituitary dysfunction. Another example is Lichen sclerosus, which is a chronic dermatosis. Its cause is not precisely known.

White patches on the skin in children

White spots in children can occur after injuries, burns. But also as a result of inflammations of the skin and other diseases mentioned above. Therefore, an early professional examination is important.

young boy sitting alone on a bench, sad, experiencing negative emotions, playground, grass, swing
Children often experience negative emotions. Source: Getty Images

As in adults, pigment disorders can also arise in children. Albinism occurs as a congenital pigmentation disorder. Hereditary predisposition also contributes to the occurrence of vitiligo.

Children's difference often takes its toll. Children with pigmentation disorders suffer from reduced self-esteem, and other emotional disorders. Therefore, support is needed from parents and loved ones.

A child with vitiligo cannot hide and avoid other people. He has to participate in group activities. Support is needed and, in the case of psychological difficulties such as depression and anxiety, a professional examination.

Understanding Vitiligo - Causes & Theories

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Interesting resources

  • Ezzedine, K; Eleftheriadou, V; Whitton, M; van Geel, N (4 July 2015). "Vitiligo". Lancet386 (9988): 74–84. 
  • Whitton, M; Pinart, M; Batchelor, JM; et al. (May 2016). "Evidence-based management of vitiligo: summary of a Cochrane systematic review". The British Journal of Dermatology174 (5): 962–69. 
  • Chopra, Parul; Niyogi, Rageshree; Katyal, Gauri (2009). Skin and Hair Care: Your Questions Answered. Byword Books Private Limited. p. 2. ISBN 978-8181930378.
  • Krüger C; Schallreuter KU (October 2012). "A review of the worldwide prevalence of vitiligo in children/adolescents and adults". Int J Dermatol51 (10): 1206–12
  • Rapini, Ronald P; Bolognia, Jean L.; Jorizzo, Joseph L (2007). Dermatology: 2-Volume Set. St Louis: Mosby. pp. Chapter 76. ISBN 978-1-4160-2999-1.
  • Morishita N; Sei Y. (December 2006). "Microreview of pityriasis versicolor and Malassezia species". Mycopathologia162 (6): 373–76. 
  • Prohic A; Ozegovic L. (January 2007). "Malassezia species isolated from lesional and non-lesional skin in patients with pityriasis versicolor". Mycoses50 (1): 58–63
  • "Hyperthyroidism". www.niddk.nih.gov
  • Devereaux D, Tewelde SZ (May 2014). "Hyperthyroidism and thyrotoxicosis". Emergency Medicine Clinics of North America32 (2): 277–292. 
  • Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. (June 2011). "Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists". Thyroid21 (6): 593–646
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