What Is Poikiloderma of Civatte?
Poikiloderma of Civatte is a chronic skin condition characterised by a mix of redness, brown discolouration, visible fine blood vessels (telangiectasia), and thinning of the skin. It typically affects the sides of the neck, lower cheeks, and upper chest, while sparing the shaded under-chin area.
This condition is benign and cosmetic, meaning it does not cause systemic disease. Still, it can be an aesthetic and emotional concern due to its visibility. It is most strongly linked to cumulative sun exposure, with hormonal changes and fragrance sensitivity acting as additional triggers.
Who Gets Poikiloderma of Civatte?
- Most common in fair skin types (Fitzpatrick I–III) with a long history of sun exposure.
- Less frequent in darker skin tones (Fitzpatrick V–VI), although sun damage in the same areas can still occur.
- Often appears in women during peri- and post-menopause, suggesting a hormonal influence.
- More noticeable in individuals with sensitivity to fragrances and cosmetics, especially when perfumes are applied to the lateral neck.
Symptoms and Clinical Features
- Symmetrical reddish-brown patches with a net-like (reticulated) appearance.
- Fine broken capillaries (telangiectasia) are visible on sun-exposed areas.
- Thinning skin with mild surface atrophy, often associated with long-term photodamage.
- Symptoms are usually absent or mild but may include burning, sensitivity, or flushing.
What Causes Poikiloderma of Civatte?
Sun Damage (Primary Cause)
- Chronic ultraviolet (UV) exposure leads to vascular dilation, pigmentation changes, and skin thinning.
- Visible light also contributes to pigment irregularities.
Read more on why the sun is more dangerous in South Africa.
Hormonal Factors
- Frequently noted in peri- and post-menopausal women, suggesting oestrogen decline increases susceptibility.
Perfume and Cosmetic Sensitivity
- Perfumes and cosmetics applied to the neck may act as photosensitizers, triggering or worsening the condition.
- Studies have shown higher rates of fragrance allergy in patients with poikiloderma.
Diagnosis and Histology
Under the microscope, Poikiloderma shows:
- Epidermal thinning with surface atrophy.
- Melanin irregularities with pigment leakage into the dermis.
- Dilated superficial blood vessels with mild inflammation.
- Solar elastosis, reflecting chronic UV damage.
Treatment Options at Skin Renewal
In-Clinic Treatments
At Skin Renewal, every treatment journey begins with a thorough, doctor-led consultation to understand the unique triggers and presentation of your Poikiloderma of Civatte. Because this condition involves a delicate interplay of vascular changes, pigmentation, and skin thinning, we follow a combination-treatment philosophy, blending advanced light and laser technologies with supportive medical skincare. This tailored approach not only targets the visible redness and brown patches but also strengthens and rejuvenates the skin from within, ensuring safer, more effective, and longer-lasting results.
The most effective results come from light and laser treatments that target both redness and pigmentation:
This integrated approach not only targets the visible redness and brown patches but also restores skin health from within, ensuring safer, more effective, and longer-lasting results.
Topical Treatments
While less powerful than devices, topicals help maintain results:
Though Poikiloderma of Civatte is a chronic condition, it does not have to define your skin or your confidence. With Skin Renewal’s doctor-led care, advanced combination treatments, and ongoing skin health support, meaningful improvements are possible.
