Any doctors in Atlanta have a good regimen for treating Poikiloderma of Civatte? (Photos)

Question

I am a 40 year old female with Poikiloderma of Civatte. I had previous melasma that was treated successfully 13 years ago with Fraxel and have had no recurrence. I wear 50 spf on my face daily and wear a hat any time I am in the sun. I have tried topical lightening creams from my dermatologist (0.5% tretinoin and 5% hydroquinone) with no success. What options do I have? It is primarily on my sides of my neck and my chest. It is impossible to cover with makeup.

Jeff Angobaldo, MD · Answer

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Thank you for your question.   I would recommend to start using triluma morning and night six weeks prior to laser treatment. Fractional treatment is very effective for suppressing discoloration and evening out skintone.  Skinpen which is a microneedling device that would also be beneficial for getting rid of melasma.  The microneedling treatment helps to wake up your natural growth factors, shrink your pores, fade discoloration and acne scars, and help increase collagen and elastin production. You would do a treatment every 4 weeks and stay out of the sun as much as possible and always wear spf 50 broad sprectrum.  Always consult with your physician first before starting a treatment.

Jason Emer, MD · Answer

It can be difficult to treat Poikiloderma of Civatte and the topical lightening creams may only be remedies. Applying a medical grade sunscreen daily that covers both UVA and UAB light frequently is also very helpful. Melasma itself needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + Brilliant, peels, Microneedling/PRP, Aerolase, and sometimes Erbium Laser (Coollaser) to get the best results. See an expert for a formal evaluation. Best, Dr. Emer

Raminder Saluja, MD · Answer

Poikloderma of Civatte, most notably on the neck can be treated by a regimen that targets melanin as well as hemoglobin.  My favorite treatment for this is with a Max G IPL.  While we have treated with PDL in the past, we have now switched to MAX G as it targets both the red discoloration and brown areas on the skin.  Make sure to sun protect with a physical block (zinc/titanium).  Poikloderma can be stubborn, so typically a patient will need several treatments every 6 weeks.  We have also used Fractional Thulium laser (LASEMD Glo) and Picosure Focus Lens, but still feel that Max G edges the other two out as it is able to hit not only the melanin, but hemoglobin as well. Best of luck.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Think of POC as 3 colours- red, brown and your normal skin colour. Sounds simple, but in reality hard to treat as 1. blending needs to be done 2. treatments have to be gentle- can't get rid off in one session.  The experience of you dermatologist will be THE rate limiting factor. Start off with SPF and high necks, add Triluma. That should get rid of epidermal brown. Then Fraxel 1927- that will reduce most of the brown and some red (2-3 sessions), what ever is left (usually red), vascular lasers, or IPL- BBL. Best done in Autumn Winter. Dr Davin Lim. Brisbane. Australia.

Any doctors in Atlanta have a good regimen for treating Poikiloderma of Civatte? (Photos)

Answers (4)

Answer: POC and treatments.

Answer: POC and treatments.

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Any doctors in Atlanta have a good regimen for treating Poikiloderma of Civatte? (Photos)

Answers (4)

Answer: POC and treatments.

Answer: POC and treatments.

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Recommended reading

Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.