Have you noticed a reddish-brown, slightly blotchy discolouration on the sides of your neck, often with fine visible vessels, that seems to appear either sides on the neck? This is a very common presentation called poikiloderma of Civatte, and it’s frequently dismissed as “just sun damage” when the fuller picture is a little more layered, and a little more useful to understand.
What Is Poikiloderma of Civatte?
Poikiloderma of Civatte is a combination of three changes happening in the same patch of skin at once: increased pigmentation, visible thread veins (telangiectasia), and mild thinning of the skin. Rather than one concern, it’s really three overlapping ones, which is part of why it can look more stubborn than a single pigmentation mark or a cluster of visible vessels on their own.
Why the Neck Shows This Pattern More Than Almost Anywhere Else
The sides and front of the neck carry significant cumulative UV exposure over a lifetime — far more than most people realise, because so little of it comes from deliberate sun-seeking. Daily incidental exposure (driving, walking, sitting near a window) adds up over decades. At the same time, the neck has thinner skin and fewer oil glands than the face, which makes it less resilient to that exposure and slower to recover from it. The result is a concern that tends to show up here first, and more visibly, than on skin that’s better equipped to handle the same UV load.
The Telltale Sign: Why It Spares the Chin
One of the clearest ways to recognise poikiloderma of Civatte is the pattern itself. It typically appears on the sides and front of the neck but not directly underneath the chin, because the chin casts a natural shadow that shields that small area from direct UV exposure year after year. In effect, the discolouration is a visual record of sun exposure accumulated over decades — a map of where UV has and hasn’t reached.
The Perfume Habit Most People Have Never Been Told About
This is the part that catches most people out: spraying perfume directly onto the neck and then heading out into daylight can actively contribute to poikiloderma of Civatte. Many fragrances contain photosensitising compounds, bergamot oil and other citrus-derived ingredients are common examples, which react with UV light on the skin. This is known as a phototoxic response, and it increases inflammation and pigmentation in exactly the area the perfume was applied.
On its own, one instance of this makes little difference. But repeated over years — perfume on the neck, then out into the sun, again and again — this habit can meaningfully contribute to the mottled pigmentation and vessel changes associated with poikiloderma of Civatte.
What Actually Helps
Because poikiloderma of Civatte has three components working together — pigment, vessels, and skin thinning — addressing it properly usually calls for more than a single approach.
In clinic, treatments that target pigment and vessels together, such as IPL (Intense Pulsed Light), tend to give the most noticeable improvement. This is typically most effective alongside a homecare routine that supports the skin’s barrier function and helps manage pigment production between sessions — treating the visible change without supporting the skin underneath it rarely holds up over time.
At home, two changes make the biggest long-term difference, and both are straightforward to build into an existing routine:
Apply SPF to the neck and décolletage every day, not just the face, this area is one of the most commonly missed when it comes to daily sun protection, despite carrying just as much cumulative exposure.
If you wear perfume, spray it onto clothing or hair rather than directly onto sun-exposed neck skin, particularly before spending time outdoors.
Why Understanding the Cause Matters More Than Chasing a Quick Fix
Poikiloderma of Civatte tends to develop slowly, over years rather than weeks, and it’s far easier to manage and improve in its earlier stages than to reverse once it’s well established. Understanding what’s driving it now — rather than after years of the same habits — makes a meaningful difference to how well it responds to treatment, and how much of that improvement holds over time.
Frequently Asked Questions
Is poikiloderma of Civatte the same as sun damage? It’s related to sun exposure, but it’s more specific than general sun damage. It’s a combination of three distinct changes — pigmentation, visible vessels, and skin thinning — that develop together in areas of high cumulative UV exposure and lower resilience, such as the sides of the neck.
Can perfume really cause skin discolouration? Yes, in the right circumstances. Certain fragrance ingredients, particularly bergamot oil and other citrus-derived compounds, are photosensitising. When perfume is applied to the neck and then exposed to UV light, it can trigger a phototoxic reaction that increases pigmentation and inflammation in that exact area — a habit that, repeated over years, can contribute to poikiloderma of Civatte.
Why does the discolouration avoid the area under the chin? Because that small area is naturally shaded by the chin itself, it receives far less direct UV exposure than the sides and front of the neck over a lifetime. The pattern of poikiloderma of Civatte essentially traces where sun exposure has and hasn’t reached.
What’s the most effective treatment for poikiloderma of Civatte? Because it involves pigment, vessels, and skin thinning together, treatments that address pigment and vessels simultaneously — such as IPL — tend to be most effective, particularly when combined with a supportive homecare routine and consistent daily SPF.
Ready to Understand What’s Driving Your Skin’s Presentation?
If you’d like an honest, professional assessment of what’s contributing to the discolouration on your neck and how to address it, we are happy to talk it through. Follow here and book your 10 min phone call or go straight for a consultation to get started on your journey to clear your skin.
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