Poikiloderma
Poikiloderma (most commonly Poikiloderma of Civatte) is a chronic skin condition that causes redness, brown pigmentation, and visible small veins, usually on the sides of the neck, upper chest, and occasionally the cheeks.
Overview
Poikiloderma (most commonly Poikiloderma of Civatte) is a chronic skin condition that causes redness, brown pigmentation, and visible small veins, usually on the sides of the neck, upper chest, and occasionally the cheeks.
It results from long-term sun exposure and skin ageing, often appearing as a combination of diffuse redness, mottled pigmentation, and fine vascular changes.
Although harmless, poikiloderma can be cosmetically distressing.
The affected skin develops a net-like or mottled appearance, often contrasting with the paler, unaffected areas under the chin (which are shaded from sunlight). The texture of the skin can also feel slightly rough or thin.
At Derma Reading, our dermatologists specialise in treating poikiloderma using the advanced Excel V+ laser by Cutera. This dual-wavelength laser system targets both the red and brown components of the condition — reducing vascular redness and pigmentation simultaneously to restore a clearer, more even skin tone.
Symptoms of Poikiloderma
Poikiloderma is primarily a cosmetic condition, it’s also an indicator of chronic sun damage.
Poikiloderma typically develops gradually over years and has a distinctive appearance. Common signs and symptoms include:
The pattern is often symmetrical and chronic. It does not fade easily and tends to slowly worsen without treatment. While poikiloderma is primarily a cosmetic condition, it’s also an indicator of chronic sun damage, so protective measures are essential.
Causes of Poikiloderma
Poikiloderma develops due to a combination of sun damage, skin ageing, and sometimes hormonal or photosensitising factors. Over time, repeated ultraviolet (UV) exposure damages both the superficial pigment cells (melanocytes) and the small blood vessels (capillaries) in the skin. This leads to the mixed pattern of redness and brown pigmentation characteristic of the condition.
Key contributing factors include:
Diagnosis is straightforward for dermatologists. The condition is typically recognised by its pattern and distribution, especially the red-brown discolouration on the sides of the neck with sparing beneath the chin. In some cases, a dermatoscope or digital imaging system may be used to assess pigmentation and vascular changes in detail.
If there is any uncertainty or the presentation is atypical (for example, in younger patients or with other associated symptoms), a small skin biopsy may be performed to rule out other, rarer forms of poikiloderma linked to systemic or genetic causes.
Over time, repeated ultraviolet (UV) exposure damages both the superficial pigment cells (melanocytes) and the small blood vessels (capillaries) in the skin.
What to Expect in Treating Poikiloderma
The most effective way to improve its appearance
While poikiloderma is harmless, it can be persistent and difficult to disguise with cosmetics. The most effective way to improve its appearance is with laser or light-based treatments that address both the red (vascular) and brown (pigmented) components of the condition.
At Derma Reading, our dermatologists offer a range of advanced treatment options, tailored to your skin type and goals.
The Excel V+ is our first-line treatment for poikiloderma. This dual-wavelength laser (532 nm KTP and 1064 nm Nd:YAG) allows precise targeting of dilated blood vessels and pigmentation at different depths within the skin.
The 532 nm wavelength targets redness and superficial capillaries, while the 1064 nm wavelength penetrates deeper to treat larger vessels and reduce pigmentation. The result is a significant improvement in colour uniformity and skin clarity.
Excel V+ treatments are comfortable thanks to integrated cooling technology that protects the surface of the skin. Most patients describe the sensation as a gentle warmth or light snapping, and no anaesthetic is required. Sessions typically last around 30 minutes, and downtime is minimal — redness may persist for a few hours but resolves quickly.
A course of three to four treatments, spaced four to six weeks apart, delivers the best results. Maintenance sessions every year or two may be recommended to counteract further sun-related damage.
For patients with sensitive skin or general redness, Laser Genesis (also performed with the Excel V+ platform) can be added to the treatment plan. This non-ablative laser gently heats the dermis to stimulate collagen, improve texture, and reduce diffuse redness. It’s a comfortable treatment with no downtime and provides an overall rejuvenated glow.
While lasers offer the most effective improvement, topical products can help maintain results. Dermatologists may recommend:
Avoiding perfume or scented products directly on the neck and using high-SPF sunscreen are key preventive measures. Sun-protective clothing and hats also help reduce recurrence after treatment.
After Excel V+ laser treatment, you can expect mild redness or warmth for a few hours, occasionally accompanied by light flaking or darkening of pigment spots before they fade. Makeup can be worn the next day, and most patients resume normal activities immediately.
For optimal healing:
Frequently Asked Questions
No. Poikiloderma of Civatte is a benign condition caused by sun damage and ageing. It is not associated with cancer or systemic disease, although it indicates that the skin has experienced chronic UV exposure.
Topical products can improve texture and mild pigmentation, but they cannot address the dilated capillaries or deeper redness. Laser therapy remains the most effective option for significant, lasting improvement.
Yes, when performed by experienced dermatologists. The Excel V+ offers adjustable wavelengths and built-in cooling, allowing precise, safe treatment for a wide range of skin tones.
Most patients describe the laser as a mild warming or flicking sensation. Cooling during treatment makes it very tolerable, and sessions are quick.
Most patients benefit from three to four sessions spaced over several months. The exact number depends on the severity of redness and pigmentation.
Yes, results are long-lasting. However, continued sun exposure can cause new pigmentation and vessels to appear, so consistent sun protection and occasional maintenance sessions are recommended.
Yes. While traditionally more common in women due to perfume sensitivity, men can develop poikiloderma through sun exposure or outdoor occupations.
At Derma Reading, all Poikiloderma treatments are performed or overseen by consultant dermatologists with extensive experience in vascular and pigmentary laser therapy. Our clinic is CQC-registered and equipped with the latest Cutera Excel V+ laser, ensuring precise, safe, and effective results.
We provide a personalised, evidence-based approach to care, tailoring each treatment plan to your individual skin type, concerns, and comfort. From consultation through to aftercare, our goal is to restore a clearer, healthier, and more even complexion with minimal downtime.
If you’re bothered by redness, pigmentation, or mottled skin on your neck or chest, our dermatologists can help. The Excel V+ laser offers a proven, medical-grade solution for Poikiloderma, addressing both redness and pigmentation safely and effectively.
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