White Spots on Skin and Aging

Spots are usually benign and often show up in middle age

Woman rubbing legs
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If you are starting to see small white dots on your shins and other areas of your body, don’t panic. This is probably the result of a condition called idiopathic guttate hypomelanosis (IGH), an acquired benign leukoderma (localized loss of pigmentation of the skin) often described as small, white, confetti-like spots or white freckles. These round, painless lesions of depigmentation or hypopigmentation appear on the shins, legs, arms, and other sun-exposed areas of the body like the face, neck, and shoulders.

They are generally 1 to 3 mm in size and commonly show up on the legs before progressing to other parts of the body.

IGH is not related to vitiligo, in which melanin-producing cells called melanocytes die or are unable to function properly and no longer form melanin.

Causes of IGH

It’s not really known what causes IGH. Idiopathic means that the cause is unknown, guttate means "resembling teardrops," and hypomelanosis refers to the lighter color of the affected areas. The macules (a medical term for flat skin spots) are small, around one-to-three millimeters in diameter, though they can measure up to 10 millimeters, and are circular or angular. It is suspected that the natural aging process causes the condition. The skin loses pigment through a gradual reduction in melanocytes, much like hair loses pigment during the aging process and turns gray or white. Other theories are that the condition is caused by sun damage or non-sun related seborrheic keratosis.

It is not caused by trauma or infection, nor does it indicate an increased risk of skin cancer.

Who Is Prone to Developing IGH?

IGH was originally thought to occur mostly in middle-aged, light-skinned women, but the white spots have been known to appear in the late 20s and early 30s. It is mostly found in women but can be seen in both genders, as well as in people of color who have had long-term sun exposure.

There could be a genetic connection since these white spots have commonly been observed in members of the same family.

When to Consult a Medical Professional

If you begin to notice these white spots, visit your dermatologist to rule out other conditions such as vitiligo; pityriasis alba, a skin condition usually found in children and young adults that causes the development of round or oval white spots on the face, neck, and upper arms; or tinea versicolor, a fungal infection characterized by white skin macules, patches, and flaking. If it turns out to be idiopathic guttate hypomelanosis, become more diligent in using sunscreen. Avoid tanning, which emphasizes the contrast in pigment and can cause other macules to form.

Medical Treatments

Most doctors don’t believe treatment is required since the spots are harmless. Typical treatments are:

  • Cryotherapy (also called cryosurgery or cold therapy), in which liquid nitrogen is used to freeze tissues at the cellular level 
  • Dermabrasion or microdermabrasion
  • Laser ablation
  • Phototherapy 
  • Chemical peels, such as phenol (carbolic acid) or trichloroacetic acid (TCA) peels
  • Retinoids such as tretinoin cream
  • Topical steroids 
  • Camouflage makeup

Many of the treatments, like dermabrasion, lasers, and chemical peels, use therapeutic wounding of the lesions to stimulate melanocytes to proliferate, migrate to the areas, and re-pigment the spots.

However, some of these therapies, such as spot phenol peels, can cause scabbing and post-inflammatory hyperpigmentation.

Natural Treatments for IGH

Since IGH is a benign condition, there does not seem to be much research on medical or natural treatments. There are a few home remedies that have been recommended by individuals who have claimed they show positive results and have also noted that these treatments can take up to six months or more to take effect. There is no scientific evidence that these treatments actually work.

  • Fresh gingerGinger juice increases blood flow to the depigmented areas. Ginger juice can also be mixed with lemon juice and water to improve the condition of the skin. A poultice made from ginger leaves or a paste made from the ginger root can be applied directly to the white spots.
  • Fresh cabbage juice Fresh cabbage juice, used either as a beverage or applied topically to the skin, is believed to help with the condition. Add cabbage to your diet. It can’t hurt; cabbage has numerous nutritional benefits.
  • Figs and walnutsRegularly consume figs and walnuts. Figs are rich in antioxidants and fight free radical damage and the negative effects of sun exposure. Though walnuts are probably used more for white patches caused by tinea versicolor because of their anti-fungal properties, walnuts are packed with anti-aging nutrients such as B vitamins, which are great for the skin, and antioxidants for skin regeneration and elasticity. They also boost circulation, which brings oxygen and nutrients to the skin cells.
  • Basil and lime: Add basil extract to lime juice and apply to the area to stimulate melanin production.