Poikiloderma of Civatte

Well, bugger. I'm pretty sure I've figured out what is going on with the skin on my neck and chest, and it isn't simple aging. Well yes, it is aging, but something else added on.

I grew up in the desert southwest, and sometimes used sunscreen. I didn't diligently start using sunscreen until I was in my late teens, although I wasn't an avid sunbather. I have strawberry blond hair, blue eyes, and fair skin, so a deep golden tan just wasn't in the cards for me. But I did get my share of sunburns.

When I did start to regularly use sunscreen, I focused on my face. I really didn't pay any attention to my neck or chest. Weeeell, now I'm seeing the consequences.

My oldest son had a lacrosse tournament yesterday in Santa Cruz. It was a beautiful sunny day in a gorgeous beach town, about 80 degrees with a nice ocean breeze. I was prepared...lots of sunscreen and a very wide brimmed straw sun hat, long sleeves. When we got home around 10pm last night, I took a shower and inspected my skin afterward. And got a big WTF moment! I thought the skin on my neck was getting better! NO, IT'S WORSE!!!

So I started to mildly freak out. I started searching this morning for what might be going on, and the first search I did was "chicken skin on neck" for lack of a better description. The only results that came up were for a condition called "keratosis pilaris". It's a very common skin condition that causes bumps mostly on the back of arms, thighs, and buttocks. It can be easily managed by glycolic acid. But that's not what is going on with my neck.

So then I just did a general search with "aging neck". I started looking through images, and bingo! The pictures looked exactly like what I was experiencing. I was initially excited, because I finally found a name for it: Poikioderma of Civatte. Rather exotic sounding name, right?

From aocd.org:

"Poikiloderma of Civatte, also known as sun aging, is a condition caused by sun exposure. The skin changes as a result of chronic, long term exposure to the sun as well as normal aging. Chronically exposed children can acquire significant damage by age 15. These affects may also become apparent as early as age 20.Lesions associated with poikiloderma of Civatte are usually asymptomatic, although some patients do report mild burning, itching and increased sensitivity of the affected skin. These chronic reddish-brown discolorations are commonly found on the neck and cheeks.
Although the exact causes of poikiloderma of Civatte are unknown, many contributing factors have been identified. Chronic exposure to ultraviolet light is the primary factor, explaining why sun exposed areas are the most prone to developing these lesions. Photosensitizing chemicals in perfumes and cosmetics have been identified as a possible cause of poikiloderma of Civatte. A genetic predisposition may also exist.
No specific treatment exists for poikiloderma of Civatte but there are various remedies, such as topical retinoids, hydroquinone, and alpha hydroxyl acids that may help. It is very important to protect the skin from the sun to prevent further damage. Avoid being outside in the direct sunlight from 10am-3pm. If spending extended time outside is unavoidable, wear a wide brimmed hat, long sleeved shirt and long pants. A daily moisturizer with an SPF of 15 or higher is recommended for daily use. SPF clothing, which provides an SPF of 55+, also can help block the sun’s harmful rays."
Well, eff. No treatment. What really bugs is that I was (I thought) super protected yesterday from the sun! I wore 50 SPF sunscreen, a hat that resembled a small flying saucer, and I reapplied the sunscreen. And it ended up looking worse!
I think I'll have to break down and head into the dermatologist. I'm overdue for my annual skin cancer check anyway...


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