What causes the appearance of white spots on the back?

The appearance of white spots on the skin can respond to various dermatological problems . One of the diseases that most frequently produces white spots on the back is pityriasis versicolor , a common pathology in young people and that usually appears in hot weather .

“It is a superficial cutaneous mycosis caused by the Malaysian fungus , which we usually have on the skin but which, in certain people, transforms into its pathogenic form, giving rise to white spots on the back,” explains Lidia Maroñas, a dermatologist at the International Dermatological Clinic (CDI) .

According to Nayra Merino, a dermatologist at the Spanish Academy of Dermatology and Venereology (AEDV) , it is not contagious from person to person. “You need specific pH conditions. Factors such as hormonal changes, fat secretion, sweat and the state of the immune system influence ”, he assures.

Treatment and prevention


The specialists consulted emphasize that, once the lesions have appeared, it is advisable to treat them with antifungal creams, gels or fungal sprays . Even, in certain cases, with oral antifungal treatments.

The way to prevent these spots from appearing is to “maintain adequate hygiene after exercising . The use of shampoos with selenium, cyclopyroxolamin or ketoconazole once or twice a week also helps their appearance ”, indicates the AEDV specialist. Lidia Maroñas adds that it is also recommended to use non-occlusive sportswear , that is, that it allows perspiring easily.

Other causes

The appearance of white spots can also respond to other causes. For example, idiopathic guttate hypomelanosis, vitiligo , atopic dermatitis , post-inflammatory hypopigmentation, white striae, macular hypomelanosis, tuberous sclerosis, or skin cancer .

Gout hypomelanosis

They are small white spots that usually appear in areas chronically exposed to the sun such as the legs, the forearms and, eventually, the back. “In general, the way to prevent it is the use of photoprotection measures and laser or photodynamic therapy can be used to treat them,” says the CDI dermatologist.


It consists of the appearance of well-defined white spots in any location , although frequently in the facial area and extremities. It belongs to the group of autoimmune diseases in which the body’s own defenses react against melanocytes, cells that give pigmentation to our skin. Merino points out that “the treatment of this entity is based on corticosteroids, topical immunomodulators and phototherapy , among others.”

Atopic dermatitis

Very frequent, it consists of pruritic squamous erythematous lesions , that is, with scaling and itching . “When resolved, it can leave white spots due to post-inflammatory hypopigmentation or the use of corticosteroids.”

Post-inflammatory hypopigmentation

As previously discussed, it appears as white spots as a sequel to inflammatory skin diseases, such as atopic dermatitis, psoriasis , acne , etc. The specialists consulted comment that, for its prevention, it is best to treat early the underlying inflammatory disease in its acute phase so that it leaves as few white spots as possible.

White stretch marks

They can appear in their evolved phase as white spots on the back. ” Deep hydration with nourishing creams is essential to prevent its appearance ,” says the AEDV dermatologist.

Macular hypomelanosis

It is not an infection, but a genetic characteristic to which certain people are predisposed, according to Lidia Maroñas. And he adds: “There is no specific prevention or treatment that has shown efficacy. However, controlled sun exposure can be helpful in some cases. ”

Tuberous sclerosis

It is a genetic disease that usually manifests in childhood and requires multidisciplinary care.

Skin cancer

Certain skin cancers can manifest with a white spot . It is essential to always consult the dermatologist for an isolated white spot of recent onset, especially if it begins to have relief or bleeding , according to both specialists.

Although not all are serious, Lidia Maroñas insists on the need for them to be controlled in Dermatology. “Vitiligo and tuberous sclerosis are also diseases that require monitoring and control,” he specifies. Nayra Merino clarifies: “Of all the pathologies mentioned, none is specific to the back . Although it is true that pityriasis versicolor is more frequent in this area of ​​the body, it can also appear on the neck, shoulders, chest and even the face and abdomen in extensive cases ”.

On the other hand, according to the AEDV specialist, there may be cases of the appearance of white spots on very dry areas of skin , which may precede the appearance of eczema, a process called pityriasis alba. “The best way to prevent it is to use mild oil-shower soaps, which do not make much foam and emollients on a daily basis. Topical immunomodulators can be used to treat these spots, “says Merino.

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