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White spots on face. Diagnosed with pityriasis alba. Could stopping thyroid and cortisol medication cause it?

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Practicing since : 2001
Answered : 297 Questions
Hello Doctor,

I have been having white spots on my face since past few weeks. Went to a dermatologist other day, and he told me it was Pityriasis Alba, and prescribed a hydrocortisone ointment - Daktacort.

I have had this same issue around 7-8 months, but the spots disappeared after a while without any medication. Now, again, it's back, spreading each day on my face.

Please could you tell me why this occurs and the best solution to it. By the way, I suffer from pituitary adenoma namely Prolactinoma, and have very low thyroid and cortisol levels. Moreover, I have stopped thyroid and cortisol medications due to excessive weight gain. Could this be a reason for it?
Age : 28, height : 5ft, 6ins, weight : 80kgs
Please help! Desperate for an answer
Posted Thu, 26 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. V. Kumaravel 19 hours later

Thanks for the query.

I do understand your concerns related to thyroid and cortisol.

Stopping cortisol and thyroid may not be the reason for your skin problems, but we should be clear whether thyroid and cortisol is required or not.

I would like to know some more details to guide you further.
1. Whether your pituitary adenoma was functional or not?
2. What was the size of the adenoma?
3. What were the other hormone levels?

I will be able to answer your query better if you could provide me the above mentioned details.

Awaiting your reply.

Above answer was peer-reviewed by
Follow-up: White spots on face. Diagnosed with pityriasis alba. Could stopping thyroid and cortisol medication cause it? 1 hour later
Hello Dr Kumaravel,

Thanks for your answer, and the answers to your queries are as follows:

1. The pituitary adenoma is still functional.
2. It is a macro-adenoma. Not sure of the size
3. All hormone levels are very low, except for Prolactin - which is extremely high

I was prescribed Cabergoline (twice a week), Hydrocortisone (daily) and Thyroid (daily) medicines. I was also given testosterone injection once a month. But I stopped all medications because of my excessive weight gain which did not reduce much after exercise and diet control. The weight gain was around the waist, buttocks and on the face (it's become a round face)

But now, I have lost weight a bit, and seem to be getting back in shape slowly. But I seem to be feeling the sideeffects of not having medications now, which are
1) Excessive sleepiness, difficultly in waking up:
2) Drowsiness
3) Lethargy and feeling weak
4) Forgetfulness
5) Frequent headaches
6) Difficulty in concentration
7) Chest getting enlarged slowly - due to prolactin

I find it extremely depressing with my weight gain, which is why I stopped medication. I do not have facial hair growth, and have gynaecomastia, short stature - 5ft 6 (my sister is taller than me) etc

Please help!

Answered by Dr. V. Kumaravel 10 hours later

Thanks for your follow-up.

Your reports are in favor of Prolactin secreting functional pituitary macroadenoma with associated Hypopituitarism.

I feel you have to continue the cabergoline that was prescribed and dose to be adjusted based upon your prolactin levels, clinical profile and visual symptoms.

All your current symptoms may be related to stopping your thyroid and cortisol. Since all your hormones are low, you would require Excess cortisol replacement and inadequate thyroid replacement also can cause weight gain. You might also have associated endocrinologist and restart taking these medications and you will definitely improve.

Hope I answered all your questions. Please accept my answer in case you do not have further queries.

Best wishes and regards.
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