White spots near the nose in teenage boy is most often some mild dandruff like reaction. Dandruff like reaction not only happens on the scalp, but it can involve the eyebrows, eyelashes around the nose and the mouth. It can involve the upper chest, upper back, underarms and groins. These areas also present similar to the dandruff in the scalp like they can have mild itching they can have mild scaling or there can be red patches. Whenever the dandruff like reaction happens around the nose, there can be white fine, powdery deposits which is often mistaken for a white spot or rarely it can be because of fungal reaction, which is pityriasis versicolor, where it is a superficial fungal infection where it does not give you any symptom. It does not itch, it does not pain, it does not cause any discomfort. However it is only seen on the skin as a small white spot. This is also more common when there is hot and humid climate in an individual has a lot of oil secretion. Second during teenage there is a lot of hormone changes that happen and hence the oil gland become more active and these fungal infections are more common in these areas. Very rarely vitiligo can be present in this area. However it not only involves around the nose, it can also be present in other areas. Vitligo is often milky white, in comparison to the white spots which happen because of fungal infection or because of dandruff like reactions. Whenever it is fungal infection, then it has to be treated with antifungal treatment. When it is because of dandruff like reactions, the eczema component has to be controlled, which is often done with mild steroids or done with some non-steroidal creams, which usually suggested by a dermatologist. It can be used for some limited time and when it comes to vitiligo, it has to be investigated. Many at times, we do a dermatoscopic investigation examination to conform the diagnosis and in very rare cases, it is of doubt, then biopsy is done. Rarely infections like leprosy, can present with white patches, but not so common. However we are not free of leprosy till date and any white patch on the face should be investigated for leprosy.
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