What causes small white spots on the body, what’s the best treatment?

Monday October 21 2019

 

By Dr Vincent Karuhanga

Dr have you ever heard of getting small white spots on the body because your aunt is pregnant? I have those small body spots everywhere. I am 75-years-old and have no aunt. A pharmacist gave me candiderm, betaderm, and Canesten creams, but am putting them in places which are visible to people because I cannot put all over the body.Is there better treatment because there is hardly any improvement? Muzeeyi Maliko.

Dear Muzeeyi Maliko,
Nearly all our skin is covered by hair except the palms, soles of the feet, lips, glans of the penis and inside labia. The skin has thick visible hair (especially on the head, face, pubis, armpits) but in other areas where we think there is no hair there is almost invisible hair (vellus hair). Both thick and vellus hair turn grey but at different times as we age.

Hair has a shaft and a root which root under the skin is surrounded by a tube called the hair follicle. The hair follicle has cells (melanocytes) that give hair melanin the black pigment to make hair black. Hair turns grey because the cells which give it pigment either stop functioning properly or die off.

Hair and nails are actually modified types of skin and not surprisingly when the follicle cells die or malfunction and hair turns grey, the surrounding skin areas also “grey” hence showing little brown areas that you see.

Using steroid creams (betaderm) on the small brown areas can make the whole skin brown without eliminating the problem but only causing skin and other side effects. Fungal treatment (Canesten cream) will also only work if the cause is fungal.

Pityriasis versicolor a skin condition caused by a fungus (Malassezia) that usually lives harmlessly on the skin. Under certain conditions including an oily skin, malnutrition, over-sweating and a weakened immune system, the fungus can infect the skin leading to light skin patches erroneously blamed on an aunt being pregnant.

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This because it affects, mainly adolescent or teenage children, the trunk, neck, and/or arms and is uncommon on other parts of the body is unlikely to be pityriasis versicolor erroneously said to affect those whose unties may be pregnant.

Pityriasis versicolor can be treated with special antifungals but can be worsened by using steroid creams. There could be other reasons why one may get brown patches including vitiligo requiring that you visit a doctor especially a skin specialist for the best intervention.

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