What does it look like?
Typically, symmetrical redness, fine telangiectasias, and reticulated brown pigmentation are seen on the sides of the neck and upper chest; the shaded area under the chin may be less affected. In poikilodermic patterns where the diagnosis is uncertain, dermatological evaluation is important.
Scientific data
In a 7-year clinical experience of 175 patients, over 80% clearance of vascular and pigmented components was reported following a three-session IPL protocol; transient side effects were at approximately 5%. An earlier series of 135 patients also reported greater than 75% improvement in pigment and telangiectasia. These are not randomized controlled trials, but they provide extensive clinical experience in this indication.
Why does IPL/BBL make sense in this presentation?
Poikiloderma is not solely a pigment disorder or solely a vascular disorder. The filterable spectrum of broadband light allows melanin and hemoglobin to be targeted with different parameters within the same clinical program.
Safety and care
Neck skin may respond differently than facial skin; aggressive energy can increase the risk of pigmentary changes. Post-procedure sun protection and photoprotection aimed at reducing recurrence are an essential part of the treatment.
Our approach at our Bodrum clinic
We evaluate the predominance of pigment and vascular components separately and select the filter and pulse structure accordingly. We use more gradual energy and careful follow-up in the neck/décolleté area.
References
- Treatment of poikiloderma of Civatte using intense pulsed light: 7 years of experience. PMID: 18177401.
- Treatment of poikiloderma of Civatte with an intense pulsed light source. PMID: 10971554.
- Histopathologic changes induced by IPL in poikiloderma of Civatte. PMID: 22540888.
