Pori
- Raised hard white dots are usually milia; flat pale patches are a pigment change.
- Pale, slightly scaly patches on a child's cheeks are usually pityriasis alba; small round scaly spots that merge suggest tinea versicolor, a yeast overgrowth.
- Milky-white patches with sharp edges, often on both sides of the face or hands, suggest vitiligo, which responds better to early treatment.
- Pale spots show more on brown and black or tanned skin; sunscreen helps every cause, and a dermatologist can tell them apart with a Wood's lamp or skin scraping.
White spots on the face are usually milia, pityriasis alba, tinea versicolor, post-inflammatory hypopigmentation or vitiligo. Raised, hard white dots are milia. Flat, pale patches with fine scale on a child's cheeks are typically pityriasis alba, small round pale spots that merge and scale point to tinea versicolor, faded spots where a rash or pimple used to be are post-inflammatory hypopigmentation, and milky-white patches with sharp edges, often on both sides of the face, suggest vitiligo.
This guide shows what each looks like and compares them side by side. Pori does not diagnose skin conditions; its selfie scans and photo diary in Pori can help you keep dated, consistent photos to show a dermatologist and see whether treatment is working.
What causes white spots on the face?
White spots fall into two groups. Raised spots are usually milia, tiny cysts of trapped skin cells. Flat spots are a change in pigment: the skin has made less melanin (hypopigmentation) or has lost it completely (depigmentation). Pale spots of every kind stand out more on brown and black skin and on tanned skin, so many people first notice them in summer.
| Cause | Raised or flat | Color and edges | Scale or itch | Who and where |
|---|---|---|---|---|
| Milia | Raised, firm dots, 1 to 2 mm | Pearly white | No | Any age; eyelids, under the eyes, cheeks, nose |
| Pityriasis alba | Flat or very slightly raised patches | Pale, poorly defined edges | Fine scale, little or no itch | Mainly children and teens; cheeks and chin |
| Tinea versicolor | Flat spots that merge into patches | White, pink, salmon, tan or brown | Fine scale, sometimes itchy | Teens and adults in warm, humid weather; mainly trunk, neck and arms, sometimes face |
| Post-inflammatory hypopigmentation | Flat | Lighter than normal skin, shaped like the old rash or spot | No | Anyone, more visible on darker skin; wherever skin was inflamed or injured |
| Vitiligo | Flat | Milky white, sharp edges; hair in the patch may turn white | Usually no | Any age, often before 20; face, hands, feet, arms, often on both sides |
Are tiny raised white dots on my face milia?
If the white spots are raised, hard and pinhead-sized, they are most likely milia. Cleveland Clinic describes milia as small white bumps (cysts) under the surface of your skin, formed by trapped dead skin cells. They are common on the eyelids and under the eyes, and also show up on the cheeks, forehead and nose.
Milia are harmless and not contagious. Some clear in a few weeks; others last months. They can form after sun damage, burns or blisters, or as a reaction to a heavy skin cream. Do not try to squeeze them, which can scar. A dermatologist can remove them with a sterile needle. See our guide to milia under the eyes, and our guide to bumps on the face that are not acne for other raised bumps.
Why does my child have pale, dry patches on their cheeks?
That is the classic picture of pityriasis alba, a mild form of eczema. DermNet describes it as a low-grade type of eczema/dermatitis mainly seen in children, most often aged 3 to 16. It usually shows up as 1 to 20 round or oval patches, 0.5 to 5 cm across, mostly on the cheeks and chin, with fine scale and little or no itch.
DermNet notes that the pale color is more prominent in dark skin, is more noticeable in summer because the surrounding skin tans, and that the dryness shows more in winter. Patches often start slightly pink and scaly, turn pale, then fade. It often comes with dry skin or atopic dermatitis.
No treatment is needed for patches that do not bother your child. A fragrance-free moisturizer helps the dryness, and daily sunscreen keeps the surrounding skin from tanning, which makes the patches less obvious. DermNet says pityriasis alba clears after about a year on average, ranging from a few months to two or three years, and the color returns completely. A doctor may suggest a mild steroid or a non-steroid cream if there is redness or itch. Our guide to eczema on the face covers gentle skin care.
Could white spots on my face be a fungal infection?
They could be tinea versicolor, a common overgrowth of the yeast that lives on everyone's skin. The AAD says its spots can be white, pink, salmon, red, tan or brown, may be dry and scaly or itch, grow slowly and merge into patches, and become more noticeable when you tan because the yeast stops the skin from tanning. They often fade in cool weather and return when it turns warm and humid. It usually affects the trunk, neck and upper arms, but it can reach the face, especially the forehead.
A dermatologist can often tell by looking, or confirm it with a skin scraping or a Wood's lamp, under which affected skin glows yellowish green. The AAD lists treatments with selenium sulfide, ketoconazole or pyrithione zinc in shampoos, creams and cleansers, and antifungal pills for large or stubborn areas. The yeast dies quickly, but the skin can stay lighter for weeks or months before the color evens out. It often comes back in hot, humid weather, so a medicated wash once or twice a month can help prevent it. More in our tinea versicolor guide.
Why did a light spot appear where I had a pimple or rash?
That is post-inflammatory hypopigmentation: lighter skin left behind after inflammation or injury. A 2023 review in the Journal of Clinical Medicine describes it as a common acquired pigmentary disorder that is more prominent in skin of color, caused by skin inflammation, inflammatory or infectious skin conditions, or skin procedures. Among the causes the review lists are pityriasis alba and other inflammatory rashes, fungal infections, and treatments such as lasers and corticosteroids.
The shape is the clue: the light area matches the old rash, pimple, burn or treated spot, and there is no scale or itch now. The same review notes that most cases resolve on their own over time, though some cases persist for years. Treating the condition that caused it, being gentle with the skin and using sunscreen so the surrounding skin does not tan all help the spot blend in. The darker version, post-inflammatory hyperpigmentation, is more common; our guide on how to fade dark spots covers it.
How do I know if white patches on my face are vitiligo?
Vitiligo patches are usually milky white with sharp edges. Most other pale spots are only a shade lighter than the skin around them. The AAD says the skin may look lighter than your natural skin tone, white or even pink, and hair growing in a patch can turn white, including eyebrows and eyelashes. It is not contagious and does not harm your health, and the AAD notes it is most visible on darker skin or a tan.
Vitiligo is an autoimmune condition in which the immune system destroys the cells that make pigment. The National Institute of Arthritis and Musculoskeletal and Skin Diseases says anyone can get it at any age, though for many people patches begin before age 20. Patches usually appear on both sides of the body, often on the hands, feet, arms and face, and can involve the inside of the mouth or nose. The segmental type stays on one side, such as one side of the face, spreads for 6 to 12 months and then usually stops.
There is no cure, but treatment can restore color and slow spreading, and the AAD notes that treatment tends to work better when started early. Dermatologists use prescription creams, light therapy and newer medicines. Skin without pigment sunburns easily, so sunscreen matters. Our guide to early signs of vitiligo has more.
How can I tell these white spots apart?
- Can you feel it? A raised, hard dot is milia. All the others are flat.
- How white is it? Vitiligo is chalk or milky white. Pityriasis alba, tinea versicolor and post-inflammatory hypopigmentation are usually lighter than your skin but not fully white.
- Are the edges sharp? Sharp edges suggest vitiligo; blurry edges suggest pityriasis alba.
- Is there fine scale? Scale suggests pityriasis alba or tinea versicolor. Gently scraping a tinea versicolor spot often makes the scale more obvious.
- What came first? A spot that appeared after a rash, pimple, burn or treatment is likely post-inflammatory.
- Does it change with the season? Tinea versicolor and pityriasis alba show more after summer tanning; tinea versicolor often returns every warm season.
Tinea versicolor and vitiligo are easy to confuse, which the AAD points out, so a dermatologist may use a Wood's lamp or a skin scraping to tell them apart. Photos taken in the same light over a few weeks show whether a patch is spreading, fading or staying put, which helps the diagnosis. For other color changes, see uneven skin tone causes.
Should I protect white spots from the sun?
Yes. Pale and depigmented skin burns more easily, and tanning of the skin around a spot makes it stand out more. Daily broad-spectrum sunscreen on the face, reapplied when you are outdoors, helps with every cause in this guide. Our guides to sunscreen for your skin type and sunscreen for dark skin can help you pick one you will wear.
When should I see a doctor about white spots on my face?
See a doctor or dermatologist if:
- White patches are spreading, appearing in new places, or turning hair in the area white.
- Spots keep coming back after over-the-counter antifungal washes, or do not improve after a month of treatment.
- A child has patches that are not fading, or itch and crack.
- You are not sure whether it is vitiligo, because early treatment tends to work better.
A dermatologist can usually tell these apart in one visit. If you need one, find a dermatologist near you.
Frequently asked questions
What causes white spots on the face?
The most common causes are milia, pityriasis alba, tinea versicolor, post-inflammatory hypopigmentation after a rash or pimple, and vitiligo. Whether the spot is raised, how white it is and whether it scales help tell them apart.
What are white spots on my child's face?
Pale, slightly dry patches on a child's cheeks are most often pityriasis alba, a mild form of eczema. It is harmless, shows more after tanning and usually fades within about a year with moisturizer and sunscreen.
How do I know if white spots are fungal?
Tinea versicolor spots are small, round, slightly scaly and often merge, and they tend to appear or return in warm, humid weather. A dermatologist can confirm it with a skin scraping or a Wood's lamp.
How can I tell vitiligo from other white spots?
Vitiligo patches are usually fully milky white with sharp edges, have no scale, and often appear on both sides of the body, such as around both eyes. Hair in the patch may turn white.
Do white spots on the face go away?
Many do. Milia, pityriasis alba, tinea versicolor and post-inflammatory hypopigmentation usually fade with time or treatment, though color can take weeks to months to return. Vitiligo usually needs treatment to regain color.
Can sun exposure cause white spots on the face?
Tanning makes existing pale spots much more visible, and sun damage can contribute to milia. Sunscreen keeps the surrounding skin from darkening and protects pale skin, which burns easily.
Sources
- Cleveland Clinic: Milia
- DermNet: Pityriasis alba
- American Academy of Dermatology: Tinea versicolor: Signs and symptoms
- American Academy of Dermatology: Tinea versicolor: Diagnosis and treatment
- Post-inflammatory hypopigmentation: review of the etiology, clinical manifestations, and treatment options. J Clin Med, 2023 (PMC)
- American Academy of Dermatology: Vitiligo: FAQs
- NIAMS: Vitiligo
Pori is a wellness and skincare education app, not a medical device. This article is for general information and isn't medical advice. For anything that worries you, see a dermatologist.
