Treatments for Poikiloderma of Civatte

I was recently diagnosed with poikiloderma of civatte. Unfortunately, I suffer from this condition due to short-term, aggressive tanning when I was in my 20's. I got a bad sunburn on my face, neck and chest with the use of a sunlamp and outdoor tanning. I had acne problems at the time and was told tanning would help with that. I am 41 now and I have noticed a definate acceleration of symptoms.

I don't have the classic red/brown patches on the sides of my neck but I have the textural issues and some cherry angionomas, broken blood vessels and brown spots. I also have flushing of the face, neck and chest on occasion (almost like hot flashes). My main concern is the textural issues - I have very pronounced, raised hair follicles and bands that run along the front and sides of my neck and upper chest. I am currently undergoing vibraderm treatments for the textural issues (I am on my 3rd treatment) and using a HQ free pigment gel and exfoliants in between treatments. I have noticed a very slight improvement but not really enough to be noticeable.

It was suggested I also undergo IPL treatments and I am currently saving money to have that done next. I am just wondering what the prognosis is for at least achieving partial clearance of this condition.

I have read it is very difficult to treat. I am not looking for perfection as I know the damage has already been done but even a small improvement would be nice. It is almost disfiguring and every time I look in the mirror I am distressed by what I see. Any input and/or suggestions would be greatly appreciated.

Doctor Answers (5)

Suggestions...

+2

We have successfully treated many cases like yours, and a careful IPL is the first step, aside from prevention with regularly using sunscreen, meaning every 4 hours in the sun with an SPF 30.

You may need 4-6 treatments for an even color to emerge. I like IPL, but VBeam and KTP can also work. The neck is a high risk area to work on, so be careful as burns are common. In the right hands, it can be a safe and effective treatment.

Good luck.


Bay Area Dermatologist
4.0 out of 5 stars 10 reviews

Poikiloderma (red/brown neck sun damage) improved with IPL.

+2

I agree with the other physicians that you will achieve a lot of benefit from a series of careful IPL treatments to the area of your neck and chest from the old sunburns. Textural changes may very slightly improve with this as well, but careful fractional resurfacing may be of benefit too. I don't know that a single IPL treatment will make enough of a difference that you feel it is worth it, so carefully research your options before spending the money.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.5 out of 5 stars 40 reviews

IPL treats pigment, Fraxel treats texture

+2

IPL treatments will improve the red and brown discolorations that you describe.  However, to improve the texture your best option is fractional resurfacing.  I would recommend the Fraxel restore, as it is very safe for the chest, which is an area that is very sensitive.  You will need at least 4 treatments but you will likely see a significant improvement.  Fraxel will also improve the discolorations.

Jordana S. Gilman, MD
Atlanta Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

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Treating neck and chest texture issues

+2

While the IPL may help a bit for the redness or brown sun damage, we do not think you would get much effect out of the IPL treatments for texture changes. Instead consider some form of laser resurfacing or pulsed dye laser treatments.

For resurfacing, we use the Erbium laser but do not perform treatments on the neck and chest due to suboptimal healing in these areas. Look into fractional resurfacing instead of Erbium, but find a practitioner that can show you pictures of their own patients that have undergone similar treatments.

While the pulsed dye is designed to treat vascularity, we have found that it helps our Rosacea and Poikiloderma treatments with skin texture.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Save your money for a better treatment

+2

It is hard to tell without examining you, but in general patients with similar symptoms would get much better response from several monthly IPL treatments. Active FX would be a good option as well, and particularly suitable for improving textural changes. It is, however, an even more expensive treatment, and you would need several of these as well. It is unlikely that you would get a substantial improvement from vibraderm.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.