Treat Civatte's Poikiloderma with IPL
Treat Civatte's Poikiloderma with IPL
Treating Poikiloderma of Civatte with IPL in The Hague
See you reddish-brown discolorations, fine blood vessels, and mottled skin on the sides of your neck or on your décolleté? That might suit poikiloderma of Civatte: A common, benign, but often stubborn skin change in which blood vessels and pigment are visible together.
At Medicademis in The Hague, I assess the vascular and pigment components separately and in conjunction. The Lumenis M22 IPL Can treat both components if the indication is suitable. The goal is a more even skin appearance, not the complete removal of the underlying predisposition or previous sun damage.
Important: Not every reddish-brown neck discoloration is poikiloderma of Civatte. The diagnosis, skin type, recent sun exposure, and possible other skin conditions are assessed before any potential light treatment. In case of doubt or suspicious skin changes, a referral for medical diagnosis is made first.
What is Civatte's poikiloderma?
Poikiloderma of Civatte is a chronic skin change that usually occurs on both sides of the neck and can extend to the upper part of the chest. The skin appearance consists of a combination of telangiectasias (fine visible blood vessels), hyperpigmentation (brownish discoloration) and sometimes a somewhat thinner or altered skin texture. The area directly under the chin often remains relatively unaffected.
The condition is primarily associated with prolonged UV exposure and skin aging. Sensitivity to fragrances or cosmetics may also play a role in some people. Poikiloderma is not contagious and is generally not dangerous, but it can be cosmetically bothersome.
Why do you see both redness and pigment?
In poikiloderma, multiple processes occur simultaneously. Small blood vessels become more visible, and the distribution of pigment becomes irregular. This results in a characteristic reddish-brown, sometimes reticular pattern. Treatment targeting only pigment may leave the vascular component intact; conversely, brown discolorations do not automatically disappear by treating only the vessels.
How does IPL work for poikiloderma of Civatte?
IPL stands for Intense Pulsed Light. The light pulses can be captured by, depending on the settings and filters used. hemoglobin in small blood vessels and through melanin in pigment. In this way, IPL can contribute to the reduction of both redness and brown discoloration in selected skin types.
Medicadermis works with the Lumenis M22. During the intake, I assess whether IPL is suitable for your skin, which component is primary, and whether a combined or phased approach is advisable. The exact treatment settings are not determined in advance based on a general webpage.
IPL is not the only option. Results have also been described in the literature using, among others, pulsed-dye lasers and certain other vascular lasers. Which technique is appropriate varies depending on the skin type and treatment goal.
What can you expect from the result?
Scientific studies show that IPL can reduce visible blood vessels and pigment changes in poikiloderma. For instance, a study in 175 patients reported improvement in both components after a series of treatments. Another study with 66 patients described an average improvement of 50–75% after approximately 2.8 treatments. These research outcomes are no prediction or guarantee for an individual treatment with the M22.
Usually, a series of treatments is required. The number of sessions and the intervals depend on skin type, severity, recovery response, and the chosen protocol. Because UV exposure can cause new changes, sun protection remains important even after a successful treatment.
Why does treatment of the neck and décolleté require extra attention?
The skin of the neck and décolleté is different from that of the face and may react more sensitively to light and laser treatments. Possible reactions include temporary redness, warmth, swelling, darkening of pigment, and crusting. Less frequently, long-term pigment changes, blisters, or scarring may occur. Also hypopigmentation (lighter spots) is a known risk with light and laser treatment of poikiloderma.
Recent tanning, self-tanner, certain medications, active skin inflammation, or a skin type with an increased risk of pigment changes may be reasons to postpone treatment or choose a different approach. I assess these factors during the intake.
Preparation and aftercare
Beforehand, we discuss sun exposure, medication, skincare, and previous reactions to treatments. Avoid sun exposure and self-tanner around the treatment, in accordance with the personal preparation advice. After IPL, the skin may be temporarily warm and red, and pigment spots may initially darken before fading.
Carefully protect the treated area from the sun, use suitable broad-spectrum sun protection, and avoid additional irritation or friction. After assessment, you will receive specific aftercare advice tailored to the settings used and your skin reaction.
Poikiloderma of Civatte or something else?
A reddish-brown neck can also have other causes, such as contact eczema, pigment disorders, or other forms of sun damage. If the skin appearance is atypical, appropriate medical assessment is advised first. This is important before pigment or blood vessels are treated with light.
Frequently asked questions about poikiloderma of Civatte
Is poikiloderma of Civatte dangerous?
Poikiloderma of Civatte is usually a benign, chronic skin lesion. Assessment by a doctor is important for indistinct, rapidly changing, or abnormal-looking spots; not every reddish-brown discoloration on the neck is poikiloderma.
How do I recognize poikiloderma of Civatte?
Characteristic is a mottled pattern of redness, fine blood vessels, and brownish discoloration, especially on the sides of the neck and sometimes on the décolleté. The skin directly under the chin is often relatively spared.
Can IPL treat both red and brown discoloration?
Yes, IPL can reduce both the vascular and pigment components in selected patients. The result depends on the distribution of blood vessels and pigment, the skin type, and the chosen treatment strategy.
How many IPL treatments are needed?
Studies often describe treatment series of approximately three sessions, but this is not a fixed protocol for every skin type or for the M22. The number and interval are determined only after assessment.
Is IPL on the neck and décolleté safe?
The neck and décolleté require extra care due to differences in skin thickness, healing capacity, and sensitivity to pigment changes. An appropriate indication, careful settings, and proper aftercare are essential. Even with correct treatment, complications are possible.
Can poikiloderma come back?
The predisposition and effects of chronic sun exposure do not disappear with IPL. Improvement may remain visible for a long time, but new redness or pigmentation may occur. Daily sun protection helps limit further damage.
What can I do myself?
Protect the neck and décolleté daily from UV radiation, limit excessive sun exposure, and use mild, non-irritating skincare. Discuss any reactions to perfume or cosmetics during the consultation.
Is the treatment covered?
Treatment for poikiloderma of Civatte is usually cosmetic and is generally not reimbursed. Check with your insurer if you want certainty about this.
Scientific literature and background
DermNet – Poikiloderma or Civatte: clinical picture, causes and treatment options.
Rusciani et al. (2008): IPL treatment in 175 patients with poikiloderma of the neck and chest.
Goldman & Weiss (2001): IPL in 66 patients with poikiloderma of the neck.
Weiss et al. (2000): Treatment of vascular and pigment components with IPL.
Meijs et al. (2006): attention to permanent pigment reduction after certain PDL treatments.
The studies investigated various devices and protocols. Their results cannot be directly applied to an individual M22 treatment.
Not available
Personal guidance disclaimer
A Fair Use Policy applies to personal guidance, including video calling, whereby medicademis reserves the right to limit the number of contact moments at its own discretion in the event of excessive demand for support (i.e., a structurally higher number of contact requests than the average for our other clients), and to communicate this unilaterally before proceeding to do so. Naturally, this reservation does not apply should complications unexpectedly arise after the treatment.