What Are White Freckles?

Small spots on the skin’s surface that have no pigmentation are called white freckles. The altered skin appearance occurs with mild eczema, photo-aging, and a topical fungal skin infection. The skin lightening can also occur as the result of a benign condition known as vitiligo. Treating white freckles largely depends on the underlying cause.

Pityriasis alba is a type of mild eczema that commonly produces white, freckle-like scaly lesions on the skin’s surface. The condition is associated with atopic dermatitis and generally begins with reddened, scaly skin patches. As the patches heal, the skin loses pigmentation, producing white spots that vary in shape and size. The freckles often develop on the cheek and mouth regions of the face, the shoulders, and the trunk. The condition usually resolves without intervention, but may require moisturizers and topical steroid preparations.

The skin endures sun damage over years of exposure, and the damage tends to accelerate a process known as photo-aging. Areas of accumulated damage may appear as white freckles, but often the skin has a mixture of hypo- and hyperpigmented areas. The spots appear on parts of the body receiving the most exposure, usually the arms and legs. Dermatological treatment may be prescription topical retinoids which even out the skin pigment. Ablative and non-ablative lasers and intense pulse light therapy may can also do this.

Photo-aging can cause a condition known as actinic keratosis. Individuals having the condition have rough, scaly areas that appear as white freckles, but the lesions might also be pink, flesh-colored, or brown. Fair-skinned people are most often affected. Lesions can appear anywhere on the body but most frequently erupt on the face, ears, lower arms, and the back of the hands. Dermatologists consider the lesions precancerous since the condition can lead to cancer.

Malassezia furfur, often called tinea versicolor, is a fungal-type yeast that normally inhabits skin surfaces. The organism can exceed normal growth rates in the presence of high humidity, and abnormal colonization can occur in people with immune system abnormalities or a hormone imbalance. When overpopulation occurs, the skin exhibits white freckles or darkened areas which can converge into larger blotches. Treatment generally involves using over-the-counter topical fungal preparations.

Individuals may develop whitish freckles during the onset of a skin condition known as vitiligo. Depigmentation occurs because the cells stop producing melanin or the cells that produce the melanin die. People often inherit the condition, but some develop the disorder because of underlying conditions, including hyperthyroidism and pernicious anemia. Treatment for the genetic form of the condition includes camouflaging cosmetic agents, topical steroid preparations, and psoralen photo chemotherapy. When caused by a medical condition, treatment of that condition may halt the progression of the disorder.