The treatment of white spots on the body should be targeted based on the underlying cause. If it is caused by vitiligo, topical tacrolimus or laser treatment can be prescribed; if it is pityriasis versicolor, antifungal treatment is required; if it is idiopathic guttate leukoderma or post-inflammatory hypopigmentation, generally no treatment is needed.
1. Vitiligo usually has no known cause, with clear boundaries of white patches, sufficiently white color, no self-symptoms, and smooth surface. The white patches and surrounding normal skin often have color halos, i.e., darker colors, so they are often diagnosed as vitiligo. A skin biopsy, skin CT, or Wood's lamp can be used for further diagnosis in hospitals. Since the cause of vitiligo is unknown, there are not many specific drugs available for treatment. However, some treatment methods include physical therapies such as 308nm excimer laser or UVB phototherapy, topical medications like tacrolimus or some weak steroid ointments, and oral medications that have been used in the past such as 8-methoxypsoralen. Some people have good results with oral medication, and some prefer traditional Chinese medicine to soothe the liver and regulate qi, activate blood circulation, nourish the blood, and nourish the kidneys.
2. Pityriasis versicolor requires fungal testing. Although it also manifests as white patches, it is often multiple and may have mild scaling on the surface. Fungal testing will reveal the presence of fungi, indicating fungal infection. Therefore, antifungal treatment is required.
3. Idiopathic guttate leukoderma is often associated with slow degenerative changes in the skin, considered an aging-related disease. It presents with white spots with clear boundaries. In this case, the white patches are usually small and mainly consist of white dots, and generally, no treatment is needed as there are no symptoms.
4. Post-inflammatory hypopigmentation also does not require treatment as it may resolve spontaneously with the restoration of pigment metabolism. Some physical treatments, such as 308nm phototherapy, can help restore pigmentation. Congenital nevi do not require treatment as the treatment effect is poor.
