Tanning, whether it’s done at the beach or in a tanning salon, remains an extremely popular thing to do in spite of all we’ve learned about the dangers of overexposure to UV rays. People head to the beach in droves during the warm weather and most tanning salons have long lists of clients who come in for regular sessions. The relative merits of tanning aside one thing some people notice after tanning is that their skin, instead of being an even brown, has developed white spots. While some take it in stride, most want to know what is causing these spots and whether they represent some type of real health hazard.
The Origin of Those Little White Spots
Some folks come in out of the sun or emerge from the tanning bed with white spots on the skin. This can be a disconcerting development but in most cases the spots themselves are not actually dangerous. There are an array of possible causes for these spots and if you drill down into the issue a bit you discover that many of these white spots were not actually created by tanning, they were already there and simply revealed by tanning. So what are they?
Tinea Versicolor or TV as it’s sometimes called is a type of fungal infection. This type of fungus interferes with melanogenesis, which is the process whereby melanin produces pigment for the hair, eyes and most notably, the skin. With Tinea Versicolor small white areas appear that can be itchy and may take on a scaly character, especially if scratched. TV usually manifests on the neck, chest and back and is most commonly seen on people between the ages of 15 and 30. The exact cause of tinea versicolor will vary from person to person and may include prolonged exposure to high humidity or a compromised immune system. People who tend to sweat excessively also seem to be more prone to TV than others. Treatment of tinea versicolor usually entails OTC antifungal creams although a dermatologist may recommend something stronger. Be mindful that it may take some months for the affected areas to blend back into the rest of your skin even after you’ve eradicated the fungus. And don’t worry, it’s not contagious.
PIH (Post-Inflammatory Hypopigmentation)
Any time the skin is inflamed (as it is after tanning) there’s a chance it may develop post-inflammatory hypopigmentation or PIH. PIH takes the form of white spots because the inflammation interferes with the process of melanogenesis, (similar to tinea versicolor as we saw). Sun exposure is hardly the only cause of PIH however. Psoriasis, eczema and various forms of dermatitis may result in hypopigmentation as can burns, scarring and infections such as chickenpox. It’s possible that there is a genetic predisposition to PIH although more research is necessary to determine a conclusive link. Because it’s not a fungus-like tinea versicolor PIH will often clear up on its own.
Vitiligo is a condition wherein the process of melanogenesis, or melanin production, is not just disrupted in some areas for a time; it is permanently eliminated. Areas of the skin that fall prey to vitiligo will not respond to treatment or return to their natural hue in time. The exact cause of vitiligo is not known although theories abound. Many believe it to be an autoimmune disorder while others believe genetics may play some role. Vitiligo typically occurs on the extremities such as the face, hands, elbows, knees and feet although it can appear anywhere. As of this writing, there is no cure for vitiligo but not tanning is certainly one way to avoid making the condition more obvious. Treatments may include depigmenting the surrounding skin to make it match better, the application of topical medications or tattooing the affected areas to match them with unaffected areas.
With lichen sclerosus, small white spots appear on the skin. You may first notice these spots in the genital or anal regions but they can also occur on other areas of your body including the arms and shoulders or the chest or back. The condition tends to be progressive and in time the white spots can become larger and more sensitive. It’s not unusual for painful cracks and/or blisters to appear or for affected areas to bleed. As of this writing, the exact cause of this condition is yet unknown. What is known however is that lichen sclerosus is not contagious and, despite some popular urban myths, is not spread through sexual contact. Some leading theories as to its origin include an imbalance in a person’s hormone levels, or an overactive immune system. Treatment is generally limited to corticosteroid creams.
Poikiloderma of Civatte
Poikiloderma of Civatte sounds like the name of a medieval knight but it’s actually a skin condition typically rooted in excessive exposure to the sun. PoC is a chronic condition that tends to manifest most commonly in fair-skinned adults where white patches appear on the upper body in the area of the chest and neck. In many cases, the white patches are subtle in appearance and may not produce any symptoms beyond the discoloration. As such many people with PoC are not even aware of it. Some people, however, may experience itching or a slight burning sensation in the affected area and these are often sufficient to sound the alarm bells. Continued exposure to the sun after the onset of poikiloderma of civatte can lead to a rapid worsening of the condition so protective clothing is recommended. There is no cure for this condition as of this writing although topic solutions are sometimes recommended.
The bottom line is that white spots are, as often as not, unrelated to tanning. The darkened skin produced by tanning simply accentuates the light spots that are already there. If you notice white spots on your skin it’s best to see a dermatologist and get an accurate diagnosis. They can recommend a treatment regime that will help you mitigate any symptoms.