Sunday, October 18

Treatment of pityriasis alba - white spots/patches on children

Pityriasis alba > Causes > Diagnosis > Treatment
Treatment for pityriasis alba focuses primarily on healthy skin care efforts, understanding its benign, non-infectious and self-limited nature and educating the affected children about its universality and its resolution after some time.

Rule out other conditions and infections
For treatment of pityriasis alba it is very important for the parents to first rule out other conditions and infections like tinea versicolor, vitiligo and psoriasis.

Build the self-confidence of the affected child
The condition of pityriasis alba will resolve by itself after some time without treatment.
However the repigmentation process takes longer time. Self-assurance and confidence building measures should be undertaken as the affected children may face psychological stress due to the reactions of the school-mates and staff.

Avoid factors likely to trigger pityriasis alba
To reduce the lesion and to help in its resolution harsh soaps, solvents and detergents should be avoided.
Kids contact with allergy causing factors like dust, dust mites, molds, wool, dander from pets and pollen must be avoided.
Exposure to dry cold wind and sudden change of temperature and humidity should be avoided as as part of treatment.

Moisturize pityriasis alba affected area
As a treatment for pityriasis alba, to reduce and stop scaling, moisturising creams, cold creams and emollient lotions can be used.
For the treatment to be more effective it is advised to apply them within three minutes of washing the affected area to lock in moisture in the skin.

Possibility of pityriasis alba resolution with good balanced nutrition
The children food habits are to be monitored for any malnutrition.
A balanced food rich in proteins, vitamins and minerals should be given as part of the treatment.
Sufficient milk and milk products may be included in their diet.
Best part of the treatment for this non infective ailment is to find out whether the children are allergic to any food product and to stop use of such products.
Treatment of Pityriasis alba affected children for possible intestinal worms and parasites may resolve the condition.

Use of topical corticosteroid applications in pityriasis alba treatment
Treatment with mild nonprescription topical corticosteroids and hydrocortisone may be done.
The ointment may be applied for a week or two and stopped.
After sufficient gap of time it may be applied again for a week or two.
The treatment with corticosteroid topical ointments reduces scaling, inflamed appearance and pruritus if present.
Please note that prolonged use of corticosteroids must be avoided as this may give side effects like thinning of the skin.

Use of topical tacrolimus and pimecrolimus in pityriasis alba treatment
Topical Tacrolimus and pimecrolimus are approved medications to treat atopic dermatitis like pityriasis alba. They belong to calcineurin inhibitors and modulate the immune response.
They do not produce the side effects of long term use of corticosteroids like thinning of skin and decrease of effectiveness. However these ointments are very expensive.

Treatment of chronic and extensive pityriasis alba
Dermatologist's advice must be taken if the lesions are extensive.
He may consider oral psoralen and phototherapy.
Psoralen increases the sensitivity of the skin to ultraviolet light and sunlight.
Ultraviolet A light photochemotherapy may give improvement in the condition.
Depending on the extent of the lesions the dermatologist may consider prescribing cyclosporine A, a potent immunosuppressant as the last resort.

Sun protection for pityriasis alba affected children
Adequate sun protection should be given to pityriasis alba affected children.
Affected areas do not tan when compared to the surrounding normal areas and the differential tanning can worsen the cosmetic look of the children.
Taking the precautions and suggested treatments may resolve pityriasis alba early.

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