Poikiloderma (short for Poikiloderma of Civatte) is a common benign change to the skin that commonly affects the neck, especially in women. It is thought that fair skin, years of cumulative sun exposure, and hormones all influence the appearance of this condition. Additionally, perfumes or cosmetics may play a role in its appearance. The skin changes of poikiloderma include thinning of the skin, increased pigmentation, and dilation of fine blood vessels in the skin, called telangiectasias.
There is no specific medical treatment for Poikiloderma of Civatte. Prevention is the most effective strategy, and most importantly is sun avoidance and the use of sunscreen. The skin of the neck and the upper chest that is affected by this condition is very sensitive, and the results of certain treatments may be disappointing, especially light or laser-based treatments. In addition to the use of broad spectrum SPF 50+ sunscreen and avoidance of perfumes or scented soaps, treatments may include topical hydroquinone to help fade pigmentation associated with the condition or an exfoliant such as lotion containing alpha hydroxy acids or tretinoin cream.
In Colorado, we are particularly susceptible to gradual chronic changes to our skin like Poikiloderma due to regular exposure to intense ultraviolet radiation as a result of our sunny dry climate and high elevation. We recommend using a face moisturizer with SPF every single day, and this can be also be applied onto the neck and upper chest for daily protection from the sun. If you are to be out in direct sun, we recommend a broad-spectrum sunscreen with SPF 50+, which should be reapplied every 2 hours. Mineral-based sunscreens that contain zinc oxide or titanium dioxide are preferred over chemical-based sunscreens whenever possible, and lotions that can be rubbed in by hand are preferred over sunscreen sprays.