Best Laser to Treat Poikiloderma of Civatte?

Can Fraxel Repair be used on Poikiloderma of Civatte?

Doctor Answers 3

Kinda Pricey overkill

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Until the onset of light-based medical devices, Poikiloderma of Civatte was a difficult entity to treat. Lasers and IPL's have given us some great weapons in treating this rather common and totally benign condition.

Poikiloderma of Civatte was first described by the great French dermatologist Jean Civatte ( who left a great body of work!).

Many regard it as a response to sunlight rather than a true disease. Poikiloderma refers to the combination of atrophy, telangiectasias ( "broken" blood vessels), and pigmentary changes ( both hyperpigmentation and hypopigmentation.) It usually occurs on the sides of the neck.

Like so many dermatologic conditions the cause is unknown. It is speculated that it is caused by chronic exposure to ultraviolet light. Photosensitizing chemcials in perfumes and cosmetics have also been implicated. This thought is advanced by the fact that most patients are middle-aged or elderly women. Similarly, hormonal changes are suspected since many women that develop this condition are peri-menapausal.

As mentioned, lights have truly advanced this treatment. IPL has been very beneficial. Dr. Weiss, a dermatologist and contributor on this site authored a nice article in Plastic and Reconstructive Surgery 2001 showing this. The KPT and pulsed dye lasers are also very good. However, these lasers are not as safe to use in this area ( the neck can be tricky) so if you seek laser treatment make sure the physician is experienced in this area.

I am not sure why you would want the Fraxel Repair since there are other methods which are less expensive, risky and have far less down-time. There is a study in Dermatologic Surgery Feb 2006, demonstrating its effectiveness in one patient., but there is not nearly as much scientific data with Fraxel as with IPL or conventional lasers. So, the answer is yes, you could have this treated with Fraxel repair, but the decilsion should be up to you and your physician.

I hope I have helped.

Virginia Beach Dermatologist

Lasers for Poikiloderma

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Lasers and IPL can work really well for treating Poikiloderma of Civatte. We recommend either Intense Pulsed Light (IPL) or the V-Beam Pulsed Dye Laser. We also have both the Fraxel Repair and Restore Lasers which would not be my first choice for your condition. I would be skeptical if someone was recommending that as the first choice for Poikiloderma.

Jerome Potozkin, MD
Danville Dermatologic Surgeon
4.2 out of 5 stars 5 reviews


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Yes, Fraxel can treat this benign skin condition. However, because the Repair Fraxel is ablative (removes skin), it would not be my first choice to treat the neck and chest area. Poikiloderma is a skin pigmentary disorder which could be just as easily treated with the Fraxel Restore or a broadband light source (IPL/fotofacial) device. The neck and chest skin will not heal as rapidly as the face which is why ablative lasers are not commonly used in these areas. While the Fraxel Repair is safe to use on the neck and chest, the healing will be longer and the risk may be excessive when a less aggressive (nonablative) modality would work just as well.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 56 reviews

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