Poikiloderma of Civatte


What is poikiloderma of Civatte?

Poikiloderma of Civatte is a skin condition that appears as mottled, reddish-brown patches usually on the sides of your neck, upper chest and cheeks.

This condition is mainly cosmetic and not a health concern. It doesn’t cause symptoms. Long-term sun damage is the primary contributing factor. So, while it’s a cosmetic condition, it’s also a sign that you may need better sun protection.

A French dermatologist named Achille Civatte first described the condition in 1923.

Who does poikiloderma of Civatte affect?

This condition is most common in middle-aged and older individuals who have fair skin. People assigned female at birth (AFAB), especially those who’ve completed menopause, are affected more often than people assigned male at birth (AMAB).

How common is poikiloderma of Civatte?

Healthcare providers don’t know how often it occurs, as many people don’t seek treatment.

Symptoms and Causes

What does poikiloderma of Civatte look like?

This condition causes changes to your skin, including:

  • Discoloration: You may develop an uneven skin tone marked by reddish-brown spots.
  • Telangiectasias: These are spidery red lines on your skin. They occur when the tiny blood vessels (capillaries) near the surface of your skin break.
  • Skin thinning (atrophy): This can appear as dry, wrinkly and sensitive skin.

These changes usually occur on the sides of your neck and cheeks but not the area under your chin. The pattern is similar on both the left and right sides of your body (symmetrical). Poikiloderma of Civatte can also affect other areas of your body frequently exposed to the sun, including your:

  • Chest, usually in a V pattern from the neck to the center of your breasts.
  • Arms, especially your forearms.

What are the symptoms of poikiloderma of Civatte?

Most people don’t have any symptoms. Rarely, you may experience slight burning or itching in the affected areas.

What causes poikiloderma of Civatte?

The exact cause of this condition isn’t known, but most experts think ultraviolet (UV) light from sun exposure plays a major role.

Other factors that may increase your chance of developing poikiloderma of Civatte include:

  • Chemicals, certain perfumes and cosmetics can react with light and cause skin damage.
  • Fair skin, which is more easily damaged by UV light than darker skin.
  • Genetic factors, inherited from your parents.
  • Hormonal changes, including low estrogen levels that occur in people after menopause or removal of their ovaries.

Diagnosis and Tests

How is poikiloderma of Civatte diagnosed?

Healthcare providers diagnose this condition by examining your skin and reviewing your medical history. If the diagnosis isn’t clear, they may perform a skin biopsy. This is a sample of skin tissue your healthcare provider collects and sends to a laboratory for analysis.

A biopsy can help distinguish poikiloderma of Civatte from other conditions that may look similar. These include:

  • Genetic conditions that affect the skin such as congenital poikiloderma (also called Rothmund-Thomson syndrome) and Bloom syndrome. Both syndromes involve other body systems. They can also cause severe disability and an increased risk for different types of cancer.
  • Skin diseases such as cutaneous lupus, dermatomyositis and mycosis fungoides.

Management and Treatment

How is poikiloderma of Civatte treated?

The types of treatments range from:

  • Taking steps to protect your skin.
  • Medicated creams.
  • Light and laser therapies.

General treatments

These include measures to help you avoid additional damage to your skin:

  • Protect your skin from further sun damage. Apply sunscreen with an SPF (sun protection factor) of at least 30 when you go outdoors and wear protective hats and clothing. Poikiloderma of Civatte is preventable in many people if they use appropriate sunscreen and sun protection.
  • Stop using products containing skin irritants, such as perfumes. If you wear cosmetics, ask your healthcare provider about what types of products are safe to use on the affected area.

Lasers and light therapies

These treatments reduce brown pigmentation and red telangiectasia and improve skin texture. This technology uses various types of light energy to precisely destroy damaged skin cells. Your skin produces new, healthier cells to replace the old ones.

These types of treatments include:

  • Pulsed dye lasers.
  • Intense pulsed light (IPL) therapy.
  • Fractional nonablative lasers.

How effective are the treatments for poikiloderma of Civatte?

When you compare your skin before and after treatment, you’ll likely notice some improvement in skin coloration. But treatment won’t eliminate the signs of poikiloderma of Civatte entirely.

Are natural remedies for poikiloderma of Civatte effective?

You may see home treatments and natural remedies online for poikiloderma of Civatte. Some of these include plant and herbal extracts, supplements, natural oils, baking soda and hydrogen peroxide. There’s no scientific evidence showing that any of these remedies are effective. Talk to your healthcare provider before using any natural products to treat this skin condition.


How can I prevent poikiloderma of Civatte?

You can prevent this condition by limiting your exposure to UV rays from the sun:

  • Apply a sunscreen with an SPF of 30 or higher whenever you go outside. Reapply every two hours, or after swimming or exercising.
  • Avoid the sun when it’s brightest — between 10 a.m. and 2 p.m.
  • Wear a hat and protective clothing that shields the skin on your neck and face from the sun.

Outlook / Prognosis

What is the outlook for poikiloderma of Civatte?

Poikiloderma of Civatte is a chronic condition that doesn’t have a cure. Treatments may improve the look of your skin and prevent the condition from getting worse.

Living With

When should I see my healthcare provider?

Talk to your healthcare provider about any new changes in the color or texture of your skin. Early detection and treatment can help reduce the extent of skin damage and rule out more serious health conditions.

A note from Cleveland Clinic

Poikiloderma of Civatte is mainly a cosmetic condition that causes brown and reddish spots on your neck and cheeks. It may show some improvement with medicated creams and laser and light therapies. The best thing you can do to prevent this and other more serious skin issues is to protect your skin from the sun. Consistent use of sunscreen, wearing protective clothing and avoiding midday sunrays are essential.

Last reviewed by a Cleveland Clinic medical professional on 05/24/2022.


  • American Academy of Dermatology Association. Prevent Skin Cancer. (https://www.aad.org/public/diseases/skin-cancer/prevent/how) Accessed 5/24/2022.
  • Australian College of Dermatologists. Poikiloderma of Civatte. (https://www.dermcoll.edu.au/atoz/poikiloderma-civatte/) Accessed 5/24/2022.
  • DermNet NZ. Poikiloderma of Civatte. (https://dermnetnz.org/topics/poikiloderma-of-civatte) Accessed 5/24/2022.

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