Poikiloderma

Poikiloderma of Civatte is a common, chronic pattern of sun-related change. It usually appears as mottled red-brown colour on the sides of the neck and upper chest, often sparing the shaded area beneath the chin. The pattern combines visible small vessels, increased or reduced pigment and subtle thinning of the skin, so it does not behave like a single sunspot.

Why the neck and chest are different

These areas collect years of incidental ultraviolet exposure but are often protected less consistently than the face. Genetics, ageing and photosensitivity can influence the pattern, while fragrances or cosmetics may contribute for some people. The skin can also be more delicate than facial skin, which matters when selecting settings and spacing treatment.

Daily broad-spectrum sunscreen should extend below the jaw to the neck and chest. Clothing and shade add useful protection, and applying fragrance away from sun-exposed skin may be sensible if it appears to aggravate the area. Protection is not only preventive; it helps reduce darkening and supports any improvement achieved in clinic. Apply protection regularly enough to cover incidental exposure through driving, walking and outdoor work, not only deliberate time in the sun.

Addressing vessels and pigment

Because poikiloderma contains both red and brown components, the clinician may discuss more than one technology. LimeLight or eLOS Rejuvenation may be considered for selected mixed colour changes, while Laser Genesis may suit part of a broader redness or texture plan. The recommendation depends on which component dominates, skin tone, previous reactions and tolerance for downtime.

Our guide to sun damage and pigmentation explains related brown changes, including why melasma requires particular caution. If fine linear vessels are the main concern, the facial veins page gives more detail on vascular assessment. These links help show why one label can lead to several different treatment pathways.

What to expect from a course

Poikiloderma usually improves gradually rather than disappearing after one session. Temporary redness, warmth, swelling or darkening of pigmented areas may occur. Treatment may be staged, with reviews between appointments to judge the balance of colour and adjust conservatively. Ongoing sun exposure can bring the mottled appearance back, so maintenance and protection remain part of the long-term plan.

Review current treatment pricing and the clinic FAQ before your visit. To have the neck or chest assessed in person and understand which component should be prioritised, book a poikiloderma consultation.