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Poikiloderma of Civatte is a chronic skin condition characterized by erythema associated with atrophy and pigmentation changes usually seen on sun exposed areas like cheeks and sides of the neck. It occurs most commonly in fair skinned females. Usually middle aged or old women are affected, but can also be seen on other age groups.

It is a non cancerous skin condition which is usually due to reaction pattern of skin caused by sun exposure or aging and not due to any disease. Common skin changes are skin atrophy (thinning), pigmentary changes ( either hyperpigmentation or hypopigmentation ) and telangiectasia ( dilation of fine blood vessels).

The lesion are usually asymptomatic, some patients may have mild burning, itching and increase sensitivity to the affected area. You may notice reddish-brown discoloration patches often in symmetrical pattern more commonly on lateral cheeks and and sides of neck, less commonly on center chest.

The exact cause of Poikiloderma of Civatte is unknown, some contributing factors that have been identified are:

  • Chronic sun exposure to ultravoilet lights is thought to be main contributing factor as it most commonly occurs on sun exposed areas.
  • Photosensitizing agents in perfumes and cosmetics.
  • Hormonal changes associated with low estrogen level or menopause have been suspected as it usually occurs in mid-age or old age groups women.
  • Some research have also suggested genetic inheritance .

Although your physician will diagnose based on clinical findings but Antinuclear and anti-Ro antibody test may be carried out to exclude other connective tissue disease. Sometime for rare confusing cases, biopsy of the lesion might be done to exclude other pathological disease.

Poikiloderma of Civatte Treatment

There are no specific treatment with 100% results and results may be disappointing. The first and most important steps in the management of  Poikiloderma is to avoid sun exposure. You may apply broad spectrum sunscreen with SPF atleast 30+ . Beside that avoid all other cosmetics and perfumes on affected areas. Long term use of exfoliants  including alfa hydroxy acids and topical retinoids may help.

Recently, Pulsed Dye Lasers and Intense Pulse Light therapy have been used widely with successive results.  Several treatment sessions may be required for complete clearing of lesion. Some study have also described fractional photothermosis as a good options with some promising results, but again repeated session may be required for desired results. Even cryotherapy, electrosurgery and other few have been tried without  successful results.

If you have any questions regarding  Poikiloderma of Civatte , you can ask us at our Skin Care Advice Forum.


  1. Brian Hughes
    May 18, 2010 at 5:50 am

    When you reach menopause, you may need some hormone replacement therapy just to stay on top shape.;~”

  2. Greg
    May 26, 2010 at 2:42 pm

    Over the last few years, I’ve had an increase in facial sun exposure. I began to notice a red patch on my neck. It burns and seems to get more irritated after I shave, even if I only do it twice a week. I recently found out that it is Poiklioderma of Civatte. Does anyone have this and if so, are there any good results from topical solutions? I’ve heard that “Intense Pulse Light” is the main but quite expensive. My dermatologist wasn’t very encouraging about a cure and this has been very depressing, because I live with the pain of the rash and the poor appearance of it daily.


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  4. angie
    August 2, 2011 at 10:11 am

    i have recently been diagnosed with poikiloderma,after 2years at going to see dermatoligist, which at first insisted it was an allergy to my medication

  5. cheryl coston
    August 26, 2011 at 6:27 pm

    Same skin discoloration and symptoms on neck, except itching was extreme. Dermatologist diagnosed Poikiloderma of Civatte, said it was caused by sun damage and there was no treatment or cure. Was already using Retin A on face and knew it was supposed to help sun damage … so I started putting it on my neck too. Itching disappeared in a week or 2. Skin discoloration started going away in a month or 2. Gone for years until I started sun exposure again…. am using my current Renova, but not working as well as Retin A did a decade ago.

  6. jd
    December 31, 2011 at 6:57 pm


    Are you saying that using Retin A helped clear the discoloration on the neck? Would love to try if you think it works?

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