Many of us take great pains to make sure our skin is clear and pristine. (At Byrdie HQ, we've got the robust skincare regimens to prove it.) So, anytime something out of the ordinary pops up that we don't automatically know how to deal with, things can reach panic mode pretty quickly.
For example, age spots. And we're not just talking about dark sunspots; we've got a pretty good handle on those. We're talking little white spots, which can look a bit like confetti or white freckles. "It is a little-known fact that sun damage causes not only brown spots, but also white spots," says Dr. Anna Guanche, board-certified dermatologist and celebrity beauty expert at Bella Skin Institute. "I liken them to 'gray hairs' in the skin."
More than likely, these are a result of a harmless condition called Idiopathic Guttate Hypomelanosis (IGH). "IGH is a skin condition characterized by multiple round [or] oval white spots that are usually flat. It is very commonly found on the arms and legs of patients over 50," says Dr. Marla Diakow of Schweiger Dermatology Group in Garden City, NY. "[It's] a completely benign entity, but often one of cosmetic concern to patients."
These white spots occur due to localized loss of pigmentation of the skin. Read on to get the full scoop on this condition and how it can be treated.
Causes of IGH
Unfortunately, doctors don't have a straightforward answer for what causes IGH; in fact, the term idiopathic means that the cause is unknown. (Guttate means "resembling teardrops" and hypomelanosis refers to the light color of the affected areas. The macules—a medical term for flat skin spots—are generally small, flat, and either circular or angular in shape.)
The most likely culprits? "Sun and UV exposure are thought to be predisposing factors, as is advancing age," Diakow says. IGH may be an inevitable part of the natural aging process, as the skin loses pigment through a gradual reduction in melanocytes, much like hair loses color as we get older and turns gray or white. Diakow adds, "Other theories suggest trauma or genetic factors may play a role."
IGH most commonly affects women in their 40s and older, but both men and women can develop it earlier in life, too. "The incidence of IGH increases with age, and it affects the majority of the population over age 70," Diakow says.
Like most conditions, you may be more susceptible to acquiring IGH if it runs in your family. If you've been a sun worshipper your whole life, you're also more likely to get it than those who stay out of the sun or are very diligent about wearing sunscreen.
How to Treat IGH
If you begin to notice unexplained white spots, you should visit your dermatologist ASAP to rule out other conditions that have similar characteristics. If it turns out to be IGH, your derm will definitely advise you get better about sun protection. "The use of broad-spectrum sunscreens and photo-protective clothing are recommended for prevention [of IGH]," Diakow says.
The key word is prevention. "Once spots have formed, there are no universally effective treatments," Diakow says. "However, several modalities have been reported with limited success, including cryotherapy, intralesional steroid injections, topical retinoids, chemical peels, and lasers."
Guanche says, "For fairer skin types with sun damage and freckling [or] brown spots, photo facials or laser treatments to remove the surrounding excess pigmentation can make the white spots look less noticeable, due to less contrast."
Many of these treatments use therapeutic wounding of the lesions to stimulate melanocytes and thereby add pigment back to the spots. However, some of these therapies, such as chemicals peels, can cause post-inflammatory hyperpigmentation, so it's crucial that you consult your dermatologist first to determine what solution will work best for you.
The same goes for any home remedies, including topical application of fresh ginger, cabbage juice, or lime juice, and eating antioxidant-rich figs and walnuts. "There are no large-scale scientific studies showing that any of these ingredients are effective treatments. In particular, patients should avoid putting many of these, especially lime juice, on any sun-exposed areas of the skin to prevent worsening of pigmentation and irritation of the skin."
It's likely that no extreme measures need to be taken to treat IGH since the spots are benign. But Diakow advises, "If the lesions have any associated symptoms such as itching or pain, if they seem to be growing or spreading, or if they are raised and flaky, they should be evaluated by a dermatologist," Diakow says. "Light areas of skin on the face, back, or abdomen, and in a younger patient would be less likely to be IGH."
If It's Not IGH, Then What Could It Be?
"Other possible causes of white spots on the skin include fungal infection, autoimmune conditions, and post-inflammatory hypopigmentation," Diakow says. Though unrelated to IGH, some common issues that are also associated with white spots include the following:
- Vitiligo: Loss of color in patches of skin
- Pityriasis alba: Scaly patches of light pink or red skin, most common in children and young adults, and associated with eczema
- Tinea versicolor: A fungal infection that results in patches of lighter or darker skin
Guanche says, "If white macules or spots are developing in non-sun-exposed areas, it would be important to be seen and get a definitive diagnosis."
The bottom line: White age spots on your skin are probably not any more concerning than your typical sunspots, but get to a dermatologist to make absolutely sure. And don't forget to slather on some sunscreen before you head out.