I am 44 years old, and use a sunscreen with all of the UV
protections, but for the past 5 years, my arms and legs have been
developing white spots. When I go out into the sun, the rest of my
skin tans but not these spots. What are they, and how can I get rid
The spots you are noticing on your skin are a condition called
vitiligo (vit-ill-eye-go). Vitiligo most commonly affects the hands
and feet, or around the eyes, ears, and mouth, but may be found all
over the body. Although it may simply develop on its own, sun
damage can definitely contribute to it. Some doctors even believe
that the condition may be an autoimmune disease. This means
that the body's defenses against germs are turned against the
body itself. In this case, they damage pigment producing cells. A
type of skin cells called melanocytes is primarily responsible for
producing the pigment melanin, which gives people their color and
shields them from sun damage. In vitiligo, however, the
melanocytes become damaged and no longer produce any
pigment, which is why the skin has white patches. This condition is
mainly cosmetic in nature, and therefore harmless, and may be
most easily prevented through the use of protective sunscreens.
Because the disease leaves unpigmented patches on the skin, the
darker the person is, the more noticeable the patches are.
Fairer-skinned individuals hide the spots easily simply by not
tanning, but darker people - and especially African-Americans -
may have to work a bit more to conceal the spots. In some cases,
hiding the patches may be as easy as applying makeup that
matches the skin tone. Some dermatologists sell products
designed for use on the body skin, as opposed to the cosmetics
intended for the face that are sold in stores. For darker people,
tattooing over the patches in a color that matches the skin is
another option, but the individual is still going to be faced with the
problem of pigmented skin changing its color with sun exposure.
Actual treatments for vitiligo have not proven to be extremely
effective, but some definitely show more promise than others.
Doctors may prescribe a topical corticosteroid to counteract the
condition. Another option is a time-consuming round of treatment
called PUVA, where patients take a pill called psolaren
approximately an hour before entering a special tanning box,
where they are exposed to ultraviolet light. These visits must take
place once or twice per week for at least a year, and are
impractical for most people.
Perhaps the best place to start is with taking folic acid and vitamin
B12 supplements while getting some sun exposure, as several
studies have shown that this combination may often reverse the
depigmentation associated with vitiligo with very few side effects.
No matter how you choose to handle the white spots, be sure to
keep in mind that those are patches of skin with absolutely no
melanin to protect them from sun burn. It's great that you're using
sunscreen that blocks both UVA and UVB radiation, but you might
want to consider a higher SPF and pay close attention to covering
and protecting those patches.