What Is Poikiloderma? Symptoms and Treatments: When to See a Dermatologist

If you have an area of red, darkened skin on your neck or upper chest — and it’s not from a recent sunburn — you may have poikiloderma.


Poikiloderma is a discoloration on an area of the skin caused by decades of chronic sun exposure. You don’t need to have had sunburns in the affected area, just exposure to the sun over time. Sometimes, dermatologists call this poikiloderma of Civatte, named for the French dermatologist who first identified it in the 1920s.

Signs of Poikiloderma

Areas of the skin that are often affected by poikiloderma are:

— Your cheeks.

— The sides of your neck. It usually doesn’t affect the front neck area because your chin acts like an umbrella to shade that skin from the sun, Dr. Noëlle S. Sherber, clinical associate professor of dermatology at George Washington University School of Medicine and Health Sciences and co-founder of the private practice Sherber + Rad in Washington, D.C.

— The upper chest area.

Skin areas with poikiloderma have a few things in common:

— The skin has areas that are both lighter and darker.

— There are small red blood vessels on the surface of the skin. These look like small red lines, and they’re called telangiectasias.

— The skin is thinning. This means it may look older or more sun-damaged than other skin areas.

— The skin may have little bumps that give the appearance of chicken skin, says Dr. Ali Hendi, a skin cancer specialist in Chevy Chase, Maryland, and a clinical assistant professor of dermatology at Georgetown University Medical Center in Washington, D.C.

Skin areas with poikiloderma don’t usually hurt, but some people experience discomfort. It’s also possible that cosmetics and fragrances may irritate that skin area, Sherber says.

[See: Questions to Ask a Dermatologist.]

Who Gets Poikiloderma?

Some risk factors for developing poikiloderma are:

— Having fair skin.

— Being female, although men also can have it too.

— Being in your 40s or older. Because it often affects post-menopausal women, there may be a hormonal cause that isn’t yet fully understood, Sherber says.

— Having a family member with poikiloderma. There is a genetic tendency for developing it.

Poikiloderma and Skin Cancer Risk

If you have an area of skin that matches this description, you should have a dermatologist check it out for a formal diagnosis. Although it’s not serious, it’s helpful to confirm that what you have is poikiloderma and not another skin problem. Some autoimmune diseases like lupus can present with redness or discoloration in a similar distribution, Sherber says.

If you have poikiloderma, you likely have fair skin that’s more prone to developing skin cancer. This is another reason to see a dermatologist to begin skin cancer checks if you haven’t done so already. In fact, poikiloderma can sometimes mask skin cancer lesions because of the way that it looks, Hendi says.

[See: Surprising Facts About Sunscreen.]

Treatments for Poikiloderma or Chronic Sun Exposure

There are several treatments for poikiloderma, and they all have their own pros and cons. Plus, they typically aren’t covered by insurance because they are considered cosmetic procedures, says Dr. Tien Q. Nguyen, a dermatologist MemorialCare Orange Coast Medical Center in Fountain Valley, California. None of these treatments will turn the clock back several decades.

Various types of lasers can improve the look of the skin with poikiloderma. With this procedure, you’ll visit a dermatologist’s office to receive laser treatment on the affected area for up to 30 minutes. Although prices will vary, each laser treatment will likely be at least $500. Some types of lasers used for poikiloderma include:

Fractionated non-ablative lasers, which can remove some sun damage and improve skin texture and tone, Sherber says. They do this by creating small wounds in the skin that cause the skin to make new collagen. This type of laser works well for poikiloderma but may temporarily cause some crusting or scabbing where the laser was used, Nguyen says. You can apply petroleum jelly or a moisturizing cream to help with this temporary side effect.

Nd-YAG lasers, which targets the small red blood vessels on the skin and make them appear less prominent. The treatment may cause some temporary redness.

To really see a difference from a laser treatment, you’ll likely need three to six months of treatments, with one treatment a month.

Another type of treatment is intense pulsed light, or IPL. IPL exposes the skin to different wavelengths of light. The skin absorbs those wavelengths and uses that energy to repair skin damage. You may have some mild redness or swelling after an IPL treatment. Treatments usually cost a couple hundred dollars per session.

While IPL can be helpful, lasers are regarded as more effective for poikiloderma.

There also are treatments you can apply to the skin for poikiloderma. These will likely help with the skin texture. Look for products that have at least one of the following:

— Alpha hydroxy acids, which can brighten the skin and keep it hydrated.

Vitamin C or polyphenols, which are both antioxidants that can reduce visible sun damage.

— Retinoids, as these can help bring more collagen to the skin. Collagen is a type of protein that helps to increase skin elasticity.

— Ceramides, which help lock in moisture and may fight skin aging.

Always read any instructions that come with these products. They certain cautions, such as being extra-vigilant about avoiding sun exposure when using them.

Skin on the neck and chest can be sensitive, so add new creams gradually so you don’t irritate your skin, Sherber recommends.

[SEE: Surprising Things that Can Increase Sun Sensitivity.]

Protecting Your Skin and Preventing Future Sun Damage

If you have poikiloderma — and even if you don’t — you should take some preventive moves to protect your skin from further sun damage. That’s because sun damage can cause wrinkles and raise your risk for skin cancer.

Here are a few ways to protect your skin from sun damage:

Use a broad-spectrum sunscreen that has an SPF of 30 or higher. This number is recommended by the American Academy of Dermatology. Broad-spectrum sunscreen protects against both UVA and UVB rays. Wear your sunscreen no matter what the weather, as even cloudy days can expose you to the sun’s rays. You can also use moisturizers with sunscreen.

Don’t forget to use sunscreen on your forehead, ears and neck.

Apply sunscreen under clothing. Materials like cotton, linen and silk provide little protection against the sun, Hendi cautions.

If you’ll be out in the sun a lot, look for clothing with built-in sun protection. Look for clothing that has a UPF label, which is short for Ultraviolet Protection Factor. Clothing with a UPF of 30 to 49 offers very good protection, while a UPF of 50 or higher offers excellent skin protection, according to the Skin Cancer Foundation. You’ll often find these clothing items geared toward beachwear or for playing sports.

Wear long-sleeved shirts, a hat and pants to protect your skin.

Spend time in the shade as much as you can while outdoors, Nguyen advises.

Try to stay out of the sun during its peak hours, from 10 am to 2 pm.

You should also regularly check your skin for new or changing spots and let your primary care doctor or a dermatologist know if you see something that concerns you.

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What Is Poikiloderma? Symptoms and Treatments: When to See a Dermatologist originally appeared on usnews.com

Update 04/26/22: This story was previously published at an earlier date and has been updated with new information.

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