Small spot on the face on upper left cheek ( below left eye )

[Sree]

Hi Dr.

I have noticed a very small spot ( somewhat circular in nature ) below my left eye ( right by the left side burn ) for the past few days/weeks. It is somewhat paler than my normal brown skin but not milky white in colour. Would this however be the beginning of Vitiligo? I dont have any lose of skin colour in any other areas of my body such as armpits, nipples, penis etc...  

The area near this patch have a few acnes and that portion of skin looks like sun burnt a bit.

I am 31 years old and in relatively good health. I dont have any diseases like thyroid condition or other ailments. I exercise daily and am in pretty good shape.

My hair started graying when I was 21 or 22, but apart from few gray hairs in my beard and scalp, I dont have any excess amoung of gray hair either.

My question is how would I recognize the beginning symptoms of vitiligo? Would it always begin with milky white patches only? Would it be paler and become more and more whiter over time?

I would appreciate your opinion on this. I had some hypo pigmentation issues in the palms of my hand a few weeks back and my physican had suspected it to be vitiligo and ever since then, I am in a paranoid mood and would very much appreciate your clarification.

Thanks Doctor.

SRK

[Alan Rockoff, MD]

Itching is not a sign of vitiligo, though it may be a sign that you are worrying about vitiligo.

If you're stilll concerned, I suggest you see your doctor for reassurance.

Dr. Rockoff

[Sree]

Dr:

Over the past few days ( a week or so ), I am experiencing itching and low key burning sensation in parts of my face.. These itches are not severe, but I could certainl feel them.. I used to apply petrolium jelly, vaseline intensive care lotion and nivea cream in rotation to relieve dryness in the skin, but gave them up due to itching.. I started applying cortoid cream from yesterday onwards with some minor improvements in the itching. The pale coloured spot on the upper left cheek near left sideburn is still there. Is this something I should be concerned about? Would you recommend me seeing my doctor?

Is itching associated with initial symptoms for vitiligo?

I would appreciate if you could clarify.

Thanks

Sree

[Alan Rockoff, MD]

It sounds like you did what I suggested before I suggested it!

Dr. Rockoff

[Sree]

Hi Dr:

Just to add to my previous posting, after the my physician suspected the hypopigmentation in the palms of my hands to vitiligo, my dermatalogist examined me twice and ruled out vitiligo completely.

The circular pale spot I was referring to in my earlier posting is not bumpy and one cannot feel the difference between that part and rest of the skin in that sense. The colour of this patch is very close to my skin colour ( wheat complexion ), but somewhat paler and if I look closely inthe mirror, I can see the difference.

I once again appreciate your clarification and I do hope and pray that this has nothing to do with vitiligo..

thanks again

SRK

[Alan Rockoff, MD]

More than likely, you just have hypopigmentation--partial loss of pigment--rather than vitiligo.  To be sure, however, you might want to have a dermatologist shine a Woods light on your skin in a darkened room.  This helps differentiate partial pigment loss from complete.  Of course, you can just wait it out and see if the discoloration goes away, but the Woods light exam can set your mind at ease faster if you're worried.

As to what might have caused this, most likely it was some mild irritation.  This can interfere with pigment a little bit for a while, but isn't permanent.

Best.

Dr. Rockoff