White spots and patches on skin: pictures and possible causes

White spots or patches are often areas of skin that are missing pigment. Causes that Cleveland Clinic lists among the most common are white sun spots (idiopathic guttate hypomelanosis), tinea versicolor, vitiligo, pityriasis alba and milia. Pictures and descriptions cannot tell you which one you have, so have new or changing spots checked by a doctor. Source: Cleveland Clinic — White spots on your skin.

That depends on the cause. Flat spots 2 to 5 mm across on sun-exposed arms and legs can be white sun spots. Raised white or yellowish bumps about 1 to 2 mm across can be milia. Other small pale or skin-coloured bumps on this page are closed comedones, molluscum contagiosum and lichen nitidus. See a doctor if you are not sure what the spots are. Sources: DermNet — Idiopathic guttate hypomelanosis, the atlas articles in the cards above.

Cleveland Clinic says white spots aren’t typically dangerous, but some rare causes can be. The atlas describes older areas of basal cell carcinoma that may appear white, and melanomas can include white among several colours. Lichen sclerosus raises the risk of some genital and anal cancers, though the risk is low. Rarely, a blood cancer called cutaneous T-cell lymphoma can cause itchy, discoloured skin, and one uncommon form causes pale patches. Our atlas says vitiligo does not turn into skin cancer, but Cleveland Clinic advises people with pigment problems to watch closely for any changes to their skin and to protect it from the sun. See a doctor about a new or changing mole, or a mole that is painful, itchy, inflamed, bleeding or crusty — don’t wait 4 weeks for these. Also see a doctor about a growth that is getting bigger or has changed colour or texture, or a growth or area of skin that hurts, itches, bleeds, crusts or scabs for more than 4 weeks. Sources: Cleveland Clinic — White spots on your skin, NHS — Lichen sclerosus, Rao et al., J Clin Med 2023 — Post-inflammatory hypopigmentation, NHS — melanoma symptoms, NHS — skin cancer symptoms, Atlas — Basal cell carcinoma, Atlas — Melanoma, Atlas — Vitiligo.

White sun spots is a common name for idiopathic guttate hypomelanosis: small, flat, pale or white spots on sun-exposed skin such as the forearms and shins. Sun exposure over time and ageing are thought to play a part. They are harmless and usually need no treatment, but they do not regain their colour on their own. Sun protection is recommended. If they bother you, a dermatologist can explain the options. Sources: DermNet — Idiopathic guttate hypomelanosis, Schweiger Dermatology — White spots on skin, Cleveland Clinic — White spots on your skin.

You cannot be sure without a medical check. Our atlas describes vitiligo as milky-white patches with a sharp border, typically not itchy, scaly or thickened, though itch can occur. It describes tinea versicolor as pale or fawn patches with fine scale, pityriasis alba as faint pale patches with fine scale, usually on the cheeks of children, and pale marks after inflammation as having an indistinct border. A doctor can examine the skin, and may use a special lamp (Wood’s lamp) to see how much pigment has been lost. Sources: atlas article on vitiligo, NHS — Vitiligo.

Yes. Tinea versicolor (pityriasis versicolor) is a common skin infection caused by a fungus that normally lives on the skin. On brown or black skin the patches tend to be paler than the skin around them; on white skin they are usually pink, red or pale brown and may not tan. It does not spread from person to person. The NHS advises not to diagnose it yourself and to see a GP or pharmacist if you are worried. It can take a few months for the colour to return after treatment, and the patches can come back. Source: NHS — Pityriasis versicolor.

Among the causes on this page, pityriasis alba has fine scale and looks drier in winter, tinea versicolor patches may feel scaly, and psoriasis has thick white or silvery scales on raised patches. Other conditions can look similar, so see a doctor if you are not sure what the patches are. Sources: DermNet — Pityriasis alba, NHS — Pityriasis versicolor, the atlas article on psoriasis.

Among the causes on this page are milia, closed comedones (whiteheads), molluscum contagiosum and lichen nitidus. Forcing milia out can damage the skin, according to our atlas, and molluscum contagiosum can spread through contact. See a doctor if a growth is getting bigger or has changed colour or texture. Sources: the atlas articles in the cards above, NHS — skin cancer symptoms.

Possible causes on this page include pityriasis alba, which mainly affects children and teenagers, molluscum contagiosum, and milia, which are common in newborns and disappear within a few months. Vitiligo and lichen sclerosus can also affect children. Ask a doctor about white patches on a child if you are not sure what they are, and always about itchy white patches on the genitals. Sources: DermNet — Pityriasis alba, NHS — Vitiligo, NHS — Lichen sclerosus, the atlas articles in the cards above.

Treatment depends on the cause, so find out what the spots are first. White sun spots usually need no treatment. Pityriasis alba usually clears over time. Tinea versicolor is treated with antifungal medicines, and the colour can take months to return. The white patches of vitiligo are usually permanent, though treatments can reduce how they look. Our atlas advises seeing a clinician when pale patches appear, particularly if they are spreading, because recently lost colour tends to return more readily, though this is not guaranteed. Do not squeeze, pick, cut or try to extract spots or bumps yourself. Sun protection matters, because skin without pigment burns more easily. Sources: DermNet — Idiopathic guttate hypomelanosis, DermNet — Pityriasis alba, NHS — Pityriasis versicolor, NHS — Vitiligo, Atlas — Vitiligo, Atlas — Milia (milium cysts), Atlas — Closed comedones, Atlas — Molluscum contagiosum.

See a doctor about a pale or reddish patch that feels numb or where you have lost feeling, an itchy white patch on your genitals or skin, a new area of skin that is hard, thick and shiny, or a new or changing spot. See a doctor about a new or changing mole, or a mole that is painful, itchy, inflamed, bleeding or crusty — don’t wait 4 weeks for these. Also see a doctor about a growth that is getting bigger or has changed colour or texture, or a growth or area of skin that hurts, itches, bleeds, crusts or scabs for more than 4 weeks. Sources: WHO — Leprosy, NHS — Lichen sclerosus, DermNet — Morphoea, Cleveland Clinic — White spots on your skin, NHS — melanoma symptoms, NHS — skin cancer symptoms.