eMedicine Specialties > Emergency Medicine > Dermatology

Pityriasis Alba: Treatment & Medication

Author: Rashid M Rashid, MD, PhD, Post-Graduate Year 2 and House Staff Resident, Department of Dermatology, MD Anderson Cancer Center, University of Texas and The Morzak Center
Coauthor(s): Andrew C Miller, MD, Chief Resident and Clinical Assistant Instructor, Departments of Emergency Medicine and Internal Medicine, State University of New York Downstate Medical Center, Kings County Hospital Center; Mark A Silverberg, MD, FACEP, MMB, Assistant Professor, Assistant Residency Director, Department of Emergency Medicine, State University of New York Downstate College of Medicine; Consulting Staff, Department of Emergency Medicine, Staten Island University Hospital, Kings County Hospital, University Hospital, State University of New York Downstate at Brooklyn
Contributor Information and Disclosures

Updated: Jun 11, 2009

Treatment

Emergency Department Care

No specific management is indicated or necessary in the ED.

Consultations

  • Consultation with a dermatologist usually is unnecessary in simple cases. The patient's primary care provider typically provides follow-up care.
  • Extensive pityriasis alba may warrant a referral to a dermatologist.

Medication

Because the disease usually is self-limited and asymptomatic, medical therapy is often unnecessary. Pityriasis alba has no medical consequences, and the side effects of the medications may outweigh the cosmetic benefit of intervention. The most commonly used remedies (eg, emollients, topical steroids, psoralen plus ultraviolet light A photochemotherapy [PUVA]) appear to have limited efficacy.

Emollients are used to reduce the scaling of the lesions, especially on the face.

Topical steroids may help with erythema and pruritus during the initial lesions and may accelerate repigmentation of existing lesions. Use should be limited, with frequent breaks from use, to avoid long-term skin atrophy and steroid changes.

Psoralen plus ultraviolet light A photochemotherapy (PUVA) may be used to help with repigmentation in extensive cases, although the recurrence rate is high after treatment is stopped.

Pimecrolimus 1% has also been proposed as an option over a 3-month period.3

Corticosteroids, topical

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body's immune response to diverse stimuli.


Hydrocortisone (Cortaid, Cortizone-10)

An adrenocorticosteroid derivative suitable for application to skin or external mucous membranes. Has mineralocorticoid and glucocorticoid effects, resulting in anti-inflammatory activity.

Adult

Apply sparingly to affected areas bid/qid

Pediatric

Apply as in adults

Documented hypersensitivity; not for use as monotherapy in primary bacterial infections (eg, cellulitis, angular cheilitis, impetigo, erysipelas, and paronychia); not for use in rosacea, perioral dermatitis, or acne; not for use on face, groin, or axilla

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Prolonged use, application over large surface areas, application of potent steroids, and use of occlusive dressings may increase systemic absorption of corticosteroids and may cause Cushing syndrome, reversible HPA axis suppression, hyperglycemia, and glycosuria

More on Pityriasis Alba

Overview: Pityriasis Alba
Differential Diagnoses & Workup: Pityriasis Alba
Treatment & Medication: Pityriasis Alba
Follow-up: Pityriasis Alba
Multimedia: Pityriasis Alba
References
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References

  1. Vinod S, Singh G, Dash K, Grover S. Clinico epidemiological study of pityriasis alba. Indian J Dermatol Venereol Leprol. Nov-Dec 2002;68(6):338-40. [Medline].

  2. In SI, Yi SW, Kang HY, Lee ES, Sohn S, Kim YC. Clinical and histopathological characteristics of pityriasis alba. Clin Exp Dermatol. Jul 2009;34(5):591-7. [Medline].

  3. Fujita WH, McCormick CL, Parneix-Spake A. An exploratory study to evaluate the efficacy of pimecrolimus cream 1% for the treatment of pityriasis alba. Int J Dermatol. Jul 2007;46(7):700-5. [Medline].

  4. Lin RL, Janniger CK. Pityriasis alba. Cutis. Jul 2005;76(1):21-4. [Medline].

  5. Ortonne JP, Passeron T. Melanin pigmentary disorders: treatment update. Dermatol Clin. Apr 2005;23(2):209-26. [Medline].

  6. Rakel RE, Bope ET. Conn's Current Therapy 2005. 57th ed. St Louis: WB Saunders; 2005:999.

  7. Sams WM. Principles and Practice of Dermatology. New York: Churchill; 1990:369.

  8. Vargas-Ocampo F. Pityriasis alba: a histologic study. Int J Dermatol. Dec 1993;32(12):870-3. [Medline].

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Further Reading

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Keywords

pityriasis alba, extensive pityriasis alba, hypopigmentation, hypopigmented dermatitis, scaly skin, white skin, atopic dermatitis, atopy, atopic disease, tinea versicolor 

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Contributor Information and Disclosures

Author

Rashid M Rashid, MD, PhD, Post-Graduate Year 2 and House Staff Resident, Department of Dermatology, MD Anderson Cancer Center, University of Texas and The Morzak Center
Rashid M Rashid, MD, PhD is a member of the following medical societies: American Academy of Dermatology, Council for Nail Disorders, Houston Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Andrew C Miller, MD, Chief Resident and Clinical Assistant Instructor, Departments of Emergency Medicine and Internal Medicine, State University of New York Downstate Medical Center, Kings County Hospital Center
Andrew C Miller, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Physicians, American Medical Association, Emergency Medicine Residents Association, Islamic Medical Association of North America, Medical Society of the State of New York, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Mark A Silverberg, MD, FACEP, MMB, Assistant Professor, Assistant Residency Director, Department of Emergency Medicine, State University of New York Downstate College of Medicine; Consulting Staff, Department of Emergency Medicine, Staten Island University Hospital, Kings County Hospital, University Hospital, State University of New York Downstate at Brooklyn
Mark A Silverberg, MD, FACEP, MMB is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

David A Peak, MD, Assistant Residency Director of Harvard Affiliated Emergency Medicine Residency, Attending Physician, Massachusetts General Hospital; Consulting Staff, Department of Hyperbaric Medicine, Massachusetts Eye and Ear Infirmary
David A Peak, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark W Fourre, MD, Program Director, Department of Emergency Medicine, Maine Medical Center; Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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