SKINREPUBLIC

Dear Dr. Jen,

My son has white spots on his face.  He has been diagnosed to have pityriasisalba and vitiligo by different dermatologists.  I've been told a biopsy can only be the only way you can differentiate between the two.  I don't want a biopsy done since the white spots are near the eye and will cause a scar.  Does pityriasisalba and vitiligo really look the same?  I am worried he will have difficulty finding a job with his skin condition.

Miguel

Dear Miguel,

Having white spots on the face are commonly seen.  These are either confused to be pityriasisalba or vitiligo or even a fungal infection.  Though a biopsy is the surest way to tell them apart, there are other clues that you can consider.

Pityriasisalba manifests as dry, hypopigmented patches on the face and sometimes on the upper arms as well.  HYPO-pigmented being the operative word here.  Meaning the lesion lack some pigment making it appear creamy to whitish, but not totally devoid of pigment.  This is a self-limiting disease and will only necessitate moisturizers or if itchy, some mild corticosteroid cream.

Vitiligo on the other hand, is DE-pigmented which stands to mean that it is totally devoid of pigment.  Vitiligo patches look as white as a sheet of bond paper.  This condition is usually long term and may need more attention and treatment than the former condition described.  It is not contagious nor does it affect any other organ in the body.

Either skin condition enables him to lead a normal, happy life.  Be one step ahead when your son is applying for work.  Get a medical certificate from your PDS dermatologist to specifically address his white spots and clear him for work. That way, if his employer questions his health, your son can present the medical certificate without delay.

Dear Dr. Jen,

I'm 30 years old and recently had a lot of pimples on my face and back.  I've been going to the spa for some facials but it hasn't been improving.  I can't recall how many times I've switched creams, washes and other brands of anti-acne regimens.  I am desperate to get rid of my pimples.  I used to have such nice skin!

Dawn

Dear Dawn,

From flawless to pimply, it can be quite frustrating.  It might be worth your while to see a PDS dermatologist to review all the creams you have applied.  You may need something stronger than the over-the-counter anti-pimple medicines.

Your derma will also dig into your medical history (if you are taking any medications or undergoing hormonal imbalance) that may have increased the progesterone in your body.  More importantly, bring all your make-up, cleansers, lotions, creams and all things you have been applying.  The culprit may lie in something as simple as using the wrong moisturizer or hair product that may have clogged your pores. Whatever the cause is, it would be good to seek treatment before your pimples give you any scars (which is another problem altogether). Good luck and hope it gets treated soon!

If you have any questions or concerns please text 0922 845 5556or call (032) 232 5929 or email [email protected].

Dr Tan is a diplomate of Philippine Dermatological Society (PDS). She is affiliated with Perpetual Succour Hospital.  For other information on PDS, check http://www.pds.org.ph/.