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What is Poikiloderma?

Mary McMahon
Updated: Mar 03, 2024

Poikiloderma is a change in the color of the skin. People who develop poikiloderma have spots of discolored skin which can vary widely in hue. There are a number of reasons why people can develop this distinctive skin discoloration and usually a dermatologist will need to evaluate a patient to provide a diagnosis. It is important to see a medical professional for changes in skin color or texture because they can be a sign of malignancies.

In someone with poikiloderma, both hypopigmentation and hyperpigmentation can be observed. Hypopigmentation is characterized by spots which appear lighter than the surrounding skin and may be white, pinkish, or pale brown, depending on the skin color of the patient. In hyperpigmentation, the skin darkens. Many patients also have enlarged capillaries in the affected area, a condition known as telangiectasia. The skin can also be reddish, a symptom known as erythema, and the patient's skin may itch, burn, or hurt.

One common reason for poikiloderma is prolonged sun exposure, especially in areas where the ozone layer is thin. Known as sun aging or poikiloderma of Civatte, this type of poikiloderma is often seen around the face and on the arms. Over time, the skin gradually darkens as a result of sun exposure. Often the area under the chin remains pale because it is shaded from the sun. This discoloration is not dangerous but some patients may feel that it is unsightly and seek treatment to resolve the discoloration.

Changes in skin color can also accompany cancers, certain congenital conditions, and several diseases which lead to variances in skin color. If a patient presents with a skin disorder which is believed to be poikiloderma, a dermatologist may take a scraping for examination under a microscope in a pathology lab. The doctor will also typically interview the patient to collect information about other symptoms the patient may be experiencing and additional tests may be recommended if the doctor suspects that the poikiloderma is caused by an underlying medical issue.

Treatments for poikiloderma can include laser therapy which reduces the discoloration, along with topical medications to soothe skin which may be itchy or irritated. If the discoloration is caused by another medical problem, sometimes treating that will resolve the discoloration as well. In cases where poikiloderma is accompanied with malignancies, surgery may be required to remove the cancerous growths before they have an opportunity to metastasize to other areas of the body.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By kylee07drg — On Feb 08, 2012

My poikiloderma was caused by some acne medication. The medicine was intended for my face, but since I had little white bumps on my arms, I decided to try it on them, too.

The problem was that the medicine made me way more sensitive to the sun than usual. The spots on my arms that I had been using the cream on burned so badly that scabs formed.

My dermatologist gave me some steroid cream to help the area heal, but I have permanent poikiloderma there. A patch of brown is interspersed with light spots as a reminder of my mistake. It is even more noticeable in the summer, when being on the beach turns my skin tan and the brown spot even browner.

By Perdido — On Feb 07, 2012

@shell4life – My aunt is from Alabama, and she had this type of poikiloderma. It looked hideous, and she wanted to get rid of it.

She knew that years of tanning without sunscreen had brought on the condition, and she vowed to start wearing a high SPF. First, she needed to have the spots removed.

She went to a dermatologist for this cosmetic procedure. He set her up with a series of laser treatments. He asked if he could use her as a “before and after” model, and she agreed.

Though the procedures didn't totally eradicate all her spots, they helped a lot. When you look at the before and after photos side by side, you can really tell the difference.

By shell4life — On Feb 06, 2012

I live in the deep South, and people here are obsessed with tanning. Just about every woman that I know lays on the tanning bed often, and some of them think that baking to a deep brown color looks good.

However, I see an equal number of older women who have poikiloderma on their chests. They walk around with low-cut blouses on, showing off their spotted, leathery skin, and I think it looks horrible.

Mostly, it looks like a ton of freckles got stuck together in one spot. Sometimes, the area is brown, and often, there is a lot of redness present, too.

They inspire me to wear sunscreen and stay off the tanning bed. I love being out in the sun, but I take precautions, because I never want to look that way.

By seag47 — On Feb 06, 2012

Using a self-tanning product can cause you to develop poikiloderma. I found this out one summer when I used a tanning cream for several weeks in a row.

I have very pale skin, so the only way for me to safely tan was by using one of these products. I got the one formulated for fair skin, so the effect wasn't very dramatic, and I had to use it several times before seeing a noticeable change in my skin color.

I got my tan, but I also got light colored dots all over my arms. It was as if those spots just weren't responding to the product.

It looked very strange. All I could do was keep exfoliating every night in the shower and wait for the tan to fade as my dead skin came off.

By ddljohn — On Feb 06, 2012

@alisha-- I have poikiloderma of civatte too. It doesn't cover my entire neck though, it's more like orangish-reddish patches on the side of it. Mine get worse if I don't wear sunblock and if I use anything with perfumes, chemicals or other irritants in it.

I actually haven't tried the poikiloderma of civatte laser treatment but my doctor said that it's an option if I don't respond to the creams and gels I'm using now. I'm using Retinol, a cream to balance pigmentation, peeling cream and of course sun block for now. I will wait and see what happens in the next few months.

By discographer — On Feb 05, 2012

I have poikiloderma of civatte. It started several years ago where my neck turned slightly red. It has gotten worse and worse since then and now looks very red all the time. My dermatologist has put me on various topical treatments with no success and the only other treatment I have not tried appears to be laser skin treatment.

I think it's called "pulse-dyed laser treatment" and is used to treat several different types of skin discolorations like pokiloderma. My doctor says that it's a pretty successful treatment.

I honestly don't know why I developed this condition but I badly want to get rid of it. It has made me very self-conscious.

Just wondering, has anyone received a laser treatment for poikiloderma? Was it successful? Please share your experiences!

By bear78 — On Feb 04, 2012

My aunt lives on the coast and she loves tanning. As soon as the weather warms up, she's on the beach and lays under the sun for hours. She's been doing this at least for the past ten years. I always tell her not to stay out in the sun so much, especially at noon time, but she never listens.

Last year, she suddenly developed these dark patches all over her face. She went to the doctor and was diagnosed with poikiloderma. They took a sample to check for malignancy.

Thankfully, there was nothing wrong but the doctor prescribed her some topical creams as poikiloderma treatment. She had to wear very strong sunblock all the time and was not allowed to go out in the sun at all. She definitely won't be able to tan like she has been, but I wish she hadn't overdone it to begin with!

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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