- Excessive sun exposure can create white spots on various areas of the body.
- While ultraviolet radiation (UV) is typically believed to be responsible for these spots, their exact cause is unknown.
- These spots are not dangerous and do not require treatment, however some may wish to reduce their appearance for aesthetic reasons.
- Proper sun protection can help reduce UV damage, which may prevent these spots from forming.
White sunspots, or iIdiopathic guttate hypomelanosis (IGH) are a form of hypopigmentation, a condition that occurs due to a lack of melanin in an area of skin. While there are several theories as to why IGH occurs, spots on skin from the sun is widely believed to be due to this decline in melanin production.
There are several treatments available that may reduce the appearance of white spots, however fully erasing these spots can be difficult, particularly when using at-home treatments alone.
What Is Idiopathic Guttate Hypomelanosis (IGH)?
Idiopathic guttate hypomelanosis (IGH) is the medical term for white spots on the skin. The name is descriptive, referring to the cause and appearance of these spots: idiopathic means the cause is unknown, guttate refers to their teardrop shape and hypomelanosis, the lighter-colored skin.
IGH spots appear gradually on the skin over time and tend to be small – commonly between 2–6 mm. Most are smooth to the touch, but some can feel scaly.
While the factors that lead to IGH are still disputed and a definitive cause has yet to be established, the most commonly accepted explanation is that the melanin production process is disrupted by accumulated ultraviolet (UV) damage as a result of years of sun exposure.
This link to sun exposure is partially based on the fact that the spots most often appear on areas exposed to the sun such as the arms, legs, face and back.
Although sun damage is one explanation for these spots, others believe they are part of the natural aging process. Genetics may also predispose some to IGH as the condition seems to run in families.
Who does it affect?
IGH typically occurs in people with lighter skin tones over the age of 40, and becomes increasingly common with age. Although the exact number of people with IGH is unknown, one study found that more than 85% of people over the age of 40 had some level of white sunspots. Women are also more prone to IGH than men, however this condition can affect anyone.
Sun damage, which is believed by some to trigger IGH, accumulates over time. This may explain why IGH is more common with age as the effects of sun damage compound over years of exposure.
Additionally, those with lighter skin tones are subjected to more UV damage over the course of a lifetime than those with darker skin due to lighter skin’s lower levels of melanin, a natural defense against UV damage. This increased amount of UV damage may explain why lighter- skinned people are more likely to develop IGH.
Should you be concerned if you are affected?
IGH are harmless and there is no evidence to link them to skin cancer or any other health concerns.
With that said, similar appearing white spots can be a sign of more harmful conditions, such as fungal infections, which require medical attention. A dermatologist can give an accurate assessment of your skin and provide treatment.
Treatments for White Sunspots
Some people may opt to treat sunspots on aesthetic grounds by one of two ways: over-the-counter (OTC) creams and professional treatments.
Unfortunately, treating IGH is particularly difficult. At-home treatments are limited to topicals which require months of regular application to achieve even minor results. Professional treatments offer quicker and typically more superior results, however, even the best available options will not fully fade spots.
Over the Counter Treatments for White Sunspots
There are two OTC topical options available to address white sunspots: steroid creams and retinoid creams. While both these creams may help to reduce the appearance of white spots, their effectiveness is questionable and neither can be considered a reliable treatment method.
Topical steroid creams
Although these creams are typically used to reduce inflammation and treat conditions such as eczema, creams that contain corticosteroids—which mimics cortisol, a naturally occurring hormone—may help to reduce white sunspots.
Corticosteroid creams are available in different strengths. Milder ones such as hydrocortisone can be purchased OTC, while stronger formulations will usually require a prescription.
Although topical corticosteroid creams are prescribed to those with white sunspots, there is no conclusive evidence to support their ability to fade these spots. Caution is also advised as long-term use of these creams can result in unwanted side effects, including further skin tone changes.
Topical retinoid creams
Retinoid creams assist with cell turnover and regeneration which can aid in reducing skin discoloration. Retinol and tretinoin—both concentrated forms of vitamin A—are two of the most commonly used types.
While one study found that daily tretinoin use over a four-month period significantly improved skin pigmentation, the extent of repigmentation will vary from one person to the next; additional research into this treatment is required.
Professional Treatments for White Sunspots
White sunspot treatments carried out by a professional use more potent solutions that tend to have a greater impact on IGH by treating deeper layers of skin than OTC methods.
While full repigmentation is still unlikely, the various tools and procedures utilized in these treatments—including lasers, dermabrasion, chemical peels and cryotherapy—can improve the localized lack of melanin that causes white sunspots.
Laser treatment can help to reduce the appearance of white sunspots. Excimer lasers, which use ultraviolet light to create pigment-producing cells, led to a significant increase in pigmentation in one small study of people with IGH. As only affected areas of skin are treated with UV radiation, the risk of side effects is relatively low.
Fractional lasers can also effectively fade spots by stimulating the melanin production process and eliminating defective melanocytes, which are melanin-producing cells.
This exfoliating procedure physically removes the skin’s outer layers using a specialized abrasive tool to reveal the new skin beneath. When used to treat IGH, dermabrasion causes white spots to crust over and triggers the body’s melanin production process.
A study of people with IGH found that dermabrasion achieved significant repigmentation in roughly 80% of cases, by helping to increase the formation of new melanocytes. However, following treatment, patients have experienced significant skin redness that can last for up to 6 months.
Dermabrasion is also not suitable for people with acne or a history of keloid scarring as these conditions increase the risk of side effects associated with the procedure.
Chemical peels remove the top layer of skin and therapeutically damage the skin to trigger the body’s natural healing response, which can help trigger repigmentation.
The peel technique can provide a noticeable improvement in skin tone, but may also cause redness or scarring. In some cases, chemical peels can worsen white spots or lead to hyperpigmentation.
Cryotherapy involves applying liquid nitrogen with a cotton-tipped applicator to a sunspot for 5–10 seconds to freeze the skin. This is thought to improve the production of melanocytes, however additional research into this process is still needed to confirm the exact cause of repigmentation.
One study found that the procedure substantially reduced the visibility of sunspots within 4 months of treatment.
Home Remedies for White Sunspots
Several natural treatments purportedly address IGH by using common ingredients such as:
- Cabbage juice
- Lime juice
- Onion juice
- Fresh ginger
- Green tea
While some anecdotal evidence supports their use, there is no scientific proof that any natural home remedies can effectively fade white spots. If you choose to apply a natural treatment, it is important to exert a degree of caution. While most are safe, some can cause skin irritation and disrupt your skin’s natural pH balance.
Preventing White Sunspots
To prevent white sunspots, limit direct sun exposure and protect skin from the sun. There are several ways to achieve this::
- Wear a broad-spectrum, water-resistant sunscreen with a minimum SPF of 30; reapply every 2 hours when outside and immediately after swimming
- Stay in the shade during the hottest parts of the day, usually between 10 a.m. and 2 p.m.
- Cover as much exposed skin as possible by wearing sunglasses, a hat and long-sleeved shirts and pants
- Avoid tanning beds
Other Causes of White Spots on Skin
Aside from IGH, white spots on the skin can also be associated with other skin conditions or be symptoms of other health issues. While most of these white spots are larger in size than IGH, they may at times be confused with the white sunspots.
A lack of vitamin B12 can lead to the formation of skin lesions which can take the form of white spots on skin. These spots often show up on the outside of the forearm and can grow whiter over time.
A vitamin D deficiency can also result in the formation of white spots, as low vitamin D levels are associated with psoriasis, a common skin disorder that speeds up the life cycle of skin cells. While not all forms of psoriasis cause white spots, the condition can cause spots that resemble IGH.
Also known as tinea versicolor, this common fungal infection is caused by a buildup of yeast on the skin. Humid environments and moist, oily skin can trigger the discoloration of small skin patches. They may be white, pink or brown, and can be itchy or scaly.
A lack of melanin results in vitiligo’s characteristic white patches. Commonly seen on the face, neck and hands as well as creases in the skin, the patches can appear symmetrically on both sides of the body. With time, they may change in shape and size, but they’re usually permanent.
Pink or red scaly patches are an initial symptom of pityriasis alba, a condition mainly seen on the faces of children and young people. In later years, these round or oval-shaped areas fade to leave white spots on the skin. Usually, pigmentation gradually returns. Pityriasis alba’s cause is unknown.
White sunspots are a very common skin concern, particularly for those over the age of 40. Although there is no scientific consensus on the specific factors that lead to IGH, sun exposure is believed by many to inhibit the production of melanin and contribute to the formation of white spots on the skin.
As sunspots cause no health threat, removing them isn’t medically necessary, however, some may prefer treatment for aesthetic reasons. When addressing IGH, it is important to keep in mind that while fading the spots is possible, the complete elimination of these spots is an unlikely outcome even when undergoing professional treatment.
There are several methods that may help reduce the appearance of white sunspots including OTC options such as topical steroid and retinoid creams, as well as professional treatments such as lasers, dermabrasion, chemical peels and cryotherapy.
Wearing sunscreen daily and limiting sun exposure whenever possible can also serve to minimize UV damage and may prevent sunspots from forming.
If you’re unsure of the cause of white spots on your skin, seek the advice of a board-certified dermatologist.
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