Vitiligo starts out as a pale spot

White spots on the skin - what can you do?

Question: My friend (19) has had white spots on his skin for about half a year. Because of his darker skin color, you can see the spots quite clearly. He has the very light spots on his forehead, on his cheek and on his back. At the back of the head he has a 3 cm large circular area where instead of his black hair only white hair grows. My friend suffers a lot from it, but his doctor says there is nothing that can be done about it. Why do you get light spots on the skin? And what could be done about these white spots?

Answer: There are several skin conditions that show up as light spots on the skin. The most common of the diseases in question include:

  • a certain fungal disease (pityriasis) in which the affected areas of the skin - especially after exposure to the sun - appear lighter than healthy skin and
  • the so-called white spot disease (Vitiligo), in which the pigment-forming cells in a certain skin area and also in the hair roots perish.

Vitiligo usually begins in the first stage of adulthood. In circumscribed areas, sharply delimited white spots often appear symmetrically - especially often on the back of the hand and face. If the hair roots are also affected, which is noticeable by individual white tufts, it is called poliosis.

The cause of Vitiligo has not yet been adequately clarified. It is assumed, however, that the body forms defense substances against its own pigment cells and that these perish as a result. The diagnosis can only be made unequivocally through a tissue examination.

What can be done about white spots on the skin? Is white spot disease dangerous?

Vitiligo is a harmless disease in itself, but it can be cosmetically very disturbing. Unfortunately, the treatment is mostly unsatisfactory; in the initial stage it is occasionally possible to stop further progression by administering cortisone preparations. In later stages one can try to encourage a "re-immigration" of pigment cells into the affected areas, which is mainly possible through special irradiation. Taking beta-carotene can also lead to cosmetic improvement.

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Sufficient sun protection is important, as the light areas of the skin do not have any natural sun protection from pigments and severe sunburn can develop there very quickly.

Furthermore, pityriasis can generally be treated quickly and easily.

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Dr. Brigitte Rous, general practitioner