Both pityriasis alba and tinea versicolor can present with white patches on the skin. However, the treatment approach for each is different, so it is important to differentiate them.
In this article, we will discuss the causes, appearance, and treatment of both these skin conditions.
What are pityriasis alba and tinea versicolor?
Pityriasis alba is considered to be a mild type of eczema that leads to discolored patches on the skin, while tinea versicolor (also known as pityriasis versicolor) is a fungal infection of the skin that can lead to skin discoloration.
The word “pityriasis” in both terms refers to a fine, bran-like scale. The word “alba” in pityriasis alba refers to white or light-colored spots on the skin, while the word “versicolor” in tinea versicolor refers to the varied colors of the skin patches, which can be white, brown, or pink.
Causes
The exact cause of pityriasis alba is not known. However, it is often seen in individuals with atopic dermatitis and it is thought that these white patches may be due to post-inflammatory hypopigmentation.
On the other hand, tinea versicolor is a fungal infection that occurs due to an excess of Malassezia fungus. This fungus is part of the normal skin flora, but for some unknown reason, its levels increase in some individuals. Excessive oiliness of the skin, immunosuppression, and hormonal changes may be predisposing factors.
Pictures and symptoms
The appearance of both these conditions may help in identifying them.
Pityriasis alba is commonly seen in children on the face; other sites include the neck, upper arms, or trunk. It can occur in other age groups as well.
Tinea versicolor is commonly seen in young adults and typically involves the trunk, upper arms, and shoulders. In children, the patches may be seen on the face.
Pityriasis alba presents with pink patches which over time become white, while tinea versicolor presents with white, brown, or pink spots on the skin. Patches of both have fine scales on the surface.
Patches of pityriasis alba have ill-defined borders while patches of tinea versicolor have well-demarcated borders.
Both pityriasis alba and tinea versicolor are usually asymptomatic; however, some individuals may experience mild itching.
Diagnosis
In most cases, your doctor may be able to diagnose your skin condition based on the examination of the white spots on your skin. However, if needed, there are a few tests that may help in differentiating them.
- Skin scrapings: This involves scraping the skin cells from the affected area and examining them under a microscope for fungal elements. Patches of tinea versicolor will show fungal elements, while patches of pityriasis alba will not show any fungus.
- Wood’s Lamp examination: This involves the use of a special UV light to examine the affected area. In cases of pityriasis alba, there will be no fluorescence, while areas affected by tinea versicolor will show yellowish-orange fluorescence.
- Skin biopsy: A skin biopsy is rarely needed for these conditions.
Treatment
Treatment of pityriasis alba
Pityriasis alba does not necessarily require treatment, and the white patches may go away on their own over time. Moisturizers may help in reducing surface scaliness and dryness.
If there is a lot of inflammation or redness, your doctor may recommend low-strength steroids or, in some cases, calcineurin inhibitors.
Treatment of tinea versicolor
Tinea versicolor is a fungal skin rash and usually does not go away on its own. It is typically treated with topical creams or shampoos containing antifungal ingredients such as ketoconazole, found in Nizoral, or selenium sulfide, found in Selsun Blue.
The lather of shampoo should be left on the skin for 5 to 10 minutes to allow the ingredients to work on the fungus.
Preventive measures
While both pityriasis alba and tinea versicolor cannot be completely prevented, there are certain measures that may be beneficial.
Preventive measures for pityriasis alba
- Avoid long baths with hot water; instead, decrease the duration of the bath and use warm water.
- Avoid contact with irritants.
- Use skincare products meant for sensitive skin, which are free of fragrance and essential oils.
- Always wear sunscreen as it can prevent making the white patches more prominent.
Preventive measures for tinea versicolor
- Don’t use excessively oily skincare products.
- Take a bath after excessive sweating.
- Wear loose and breathable clothes.
- If you get recurrent outbreaks of tinea versicolor, use the maintenance treatment plan recommended by your doctor or an anti-dandruff shampoo a few times every month.
Similarities
- Both can present with white patches on the skin.
- These white patches can become more prominent after sun exposure or in the summer.
- Both these skin conditions are usually asymptomatic.
- Both skin conditions may leave behind discolored patches which may take months to a year to regain their original skin color.
- Both tinea versicolor and pityriasis alba are not contagious.
Key differentiating features
- Pityriasis alba is considered to be a type of eczema while tinea versicolor is a fungal infection of skin.
- White patches of tinea versicolor have well-defined borders while white patches of pityriasis alba have blurry or ill-defined edges.
- Moreover, the patches in pityriasis alba are initially pink and later pale or white, while tinea versicolor can present with patches of various shades – white, brown, or pink.
- Tinea versicolor requires treatment with antifungal topicals or oral pills while pityriasis alba may resolve on its own.
- Investigations or diagnostic tests like a Wood’s lamp examination or skin scrapings will show evidence of fungal elements in tinea versicolor but none in pityriasis alba.
Summary
Both pityriasis alba and tinea versicolor are harmless conditions and do not typically spread from one person to another.
However, both these skin conditions may leave behind discolored patches which may take several weeks or months to resolve. Sunscreen applications can prevent the patches from becoming more noticeable.
Disclaimer: This article is for information purposes only and does not replace medical advice.