CLAIM:
The viral reel claims that white patches commonly seen on children's faces are usually caused by pityriasis alba, a harmless skin condition linked to dry skin, and not by calcium deficiency or intestinal worms. It suggests that regular use of moisturiser and sunscreen can help the patches improve over time.
FACT:
Current evidence and expert opinion indicate that white patches commonly seen on children's faces are often caused by pityriasis alba, a harmless and self-limiting skin condition associated with dry skin or mild eczema. There is no scientific evidence that these patches are caused by calcium deficiency or intestinal worms, and regular use of moisturiser and sunscreen can help improve their appearance over time. Experts also advise medical evaluation if the patches persist, worsen, or if the diagnosis is uncertain.
In a viral Instagram reel posted by Dr Imran Patel, a paediatrician with over 12.3 million followers on the platform, the doctor explains that white patches commonly seen on children's faces are usually caused by a harmless skin condition called pityriasis alba and are not a sign of calcium deficiency or intestinal worms.
In the reel, Dr Patel points to a young child with a pale patch on his face and says, "Can you see this white patch? This is called pityriasis alba." He goes on to address common misconceptions, explaining that many people believe such patches occur due to a lack of calcium or because of worms in the stomach, but says, "This is not true."
According to Dr Patel, pityriasis alba is most commonly associated with dry skin. He advises parents to apply moisturiser regularly and use sunscreen when children go outdoors, explaining that sun exposure can darken the surrounding skin and make the lighter patches appear more prominent. "This is a very common condition, and there is nothing to worry about," he says, adding that repeated application of moisturiser usually helps the patches improve over time.
The reel has gained massive traction on Instagram, amassing over 3.4 million views and 27,700 likes.
Is the white patch on a child's face normal?
Evidence suggests that the white patches commonly seen on children's faces are often due to pityriasis alba, a benign and self-limiting skin condition that is frequently associated with dry skin. While the patches can become more noticeable after sun exposure because the surrounding skin tans, current evidence does not support the common belief that they are caused by calcium deficiency or intestinal worms.
A 2006 randomised controlled trial evaluated 60 children and young adults aged 6-21 years with pityriasis alba to compare treatment with 0.1% tacrolimus ointment plus moisturiser and SPF 20 sunscreen against moisturiser and sunscreen alone. Researchers found that both groups showed significant improvement over the nine-week study period, indicating that regular skin care itself was beneficial. However, improvement was greater in the tacrolimus group. The authors concluded that "Tacrolimus ointment 0.1% appears to be an effective and safe treatment for PA." The study also reported that only a few participants experienced a mild, temporary burning sensation after applying tacrolimus.
Further evidence comes from a 2012 randomised controlled study involving 28 children aged 3-17 years with facial pityriasis alba. The researchers compared 0.0003% calcitriol ointment, 0.1% tacrolimus ointment and placebo (petrolatum) over eight weeks. Both active treatments produced greater improvement than placebo, with tacrolimus and calcitriol leading to an average 68% improvement, compared with 44% in the placebo group.
Importantly, the study also explored why pityriasis alba develops. Researchers found that affected skin had significantly increased transepidermal water loss (TEWL), a marker of impaired skin barrier function. As treatment progressed, improvements in pigmentation were accompanied by restoration of the skin barrier. The authors noted, "This suggests that PA may have a local skin barrier defect," indicating that dry skin and barrier dysfunction play an important role in the condition.
Interestingly, participants were not instructed to use sunscreen or change their sun-exposure habits, yet lesions still improved. Based on these findings, the researchers suggested that factors other than ultraviolet radiation are likely involved in the development of pityriasis alba. They also emphasised that because the condition is generally self-limiting and not medically serious, larger and longer-term studies are needed to better understand its causes and determine the most appropriate treatments.
What experts say?
According to Dr Shireen Furtado, Senior Consultant – Medical & Cosmetic Dermatology at Aster CMI Hospital, Bengaluru, white patches on a child's face are most commonly caused by pityriasis alba, particularly when they appear on the cheeks, forehead or chin. She described the condition as a harmless, non-contagious skin disorder that typically presents as round or oval, light-coloured patches with mild dryness or fine scaling.
"It is considered a mild form of eczema and is most often seen in children between the ages of 3 and 16 years," she said. Dr Furtado explained that the patches often become more noticeable after sun exposure because the surrounding skin tans while the affected areas do not. "The condition does not cause pain, itching is usually mild or absent, and it is not a sign of a serious disease," she added, noting that most cases gradually improve over several months to a year, although complete return of normal skin colour may take longer.
Addressing common misconceptions, Dr Furtado said there is no scientific evidence to support the belief that pityriasis alba is caused by calcium deficiency or intestinal worms. "These are long-standing myths that continue in many communities but are not supported by medical research," she said. She explained that calcium deficiency primarily affects bone health and growth, while intestinal worm infections may cause digestive symptoms or nutritional deficiencies but do not directly cause pityriasis alba. She cautioned that relying on such myths may delay appropriate skin care or medical evaluation. "White patches can have several causes, including pityriasis alba, fungal infections, vitiligo and other skin conditions. If there is any uncertainty about the diagnosis, parents should consult a dermatologist rather than relying on unproven beliefs or unnecessary treatments."
Speaking about the causes of the condition, Dr Furtado said that although the exact cause of pityriasis alba is not fully understood, dry skin is considered one of the most important contributing factors. She noted that the condition is commonly seen in children with sensitive skin or a personal or family history of eczema, asthma or allergies. "Mild skin inflammation may temporarily reduce the skin's pigment, leading to lighter patches after the inflammation settles," she explained. She added that cold weather, frequent bathing with harsh soaps, inadequate moisturising and sun exposure can all make the patches more noticeable or worsen skin dryness.
On treatment, Dr Furtado said that regular use of a gentle moisturiser remains the mainstay of management, as it improves dry skin and helps the patches fade gradually. She also recommended sunscreen to reduce tanning of the surrounding skin, thereby making the contrast with the lighter patches less noticeable. In some cases, she said, doctors may prescribe a mild anti-inflammatory cream if there is redness, itching or active inflammation.
Dr Furtado advised parents to seek medical evaluation if the patches spread rapidly, become completely white with sharply defined borders, are accompanied by significant itching, pain or redness, or fail to improve after several months. "A medical review is also important if there is uncertainty about the diagnosis, as conditions such as vitiligo, fungal infections or other skin disorders may require different treatment," she said.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS
