Poikiloderma

Poikiloderma of Civatte is a common, benign skin condition that mainly affects the skin on the sides of the neck. It mainly affects women.

It characteristically spares the shaded area under the chin. The skin in the affected skin is red-brown with prominent hair follicles. The term “poikiloderma” refers to a change in the skin where there is thinning, increased pigmentation and dilation of the fine blood vessels (telangiectasia).

Civatte was a French dermatologist who first described a common weathering change that affects the skin of the sides and front of the neck.

The exact cause is unknown. Contributing factors are:

  • Fair skin
  • Accumulated sun exposure
  • Photosensitising components of cosmetics and toiletries, especially perfumes
  • Hormonal factors

There is no specific medical treatment for this condition. The patient should be educated about avoiding sun exposure and the correct use of sunscreens. The results of treatment may be disappointing in many cases.

  • Sun protection including daily broad spectrum SPF 50+ sunscreen
  • Avoid all perfumes on or near the affected area, including those in soap
  • Hydroquinone-containing preparations may help fade the pigmentation
  • Exfoliants including long term use of alpha hydroxy-acids and/or tretinoin
  • Pulsed dye laser (PDL) and intense pulsed light (IPL) treatments seem the best way to reduce the telangiectasia and pigmentation

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