About Treating Poikiloderma

Poikiloderma is a benign skin condition that presents on the lower face/jawline, sides of the neck, and upper chests of adults who have a history of chronic sun exposure. The 4 main features of poikiloderma are:

• • • Hyperpigmentation: Areas with excess brown pigment in the skin
    • Hypopigmentation: Areas where the skin appears lighter due to loss of pigment
    • Telangiectasia: Dilated superficial blood vessels that give the affected areas a somewhat red appearance
    • Atrophy: Thinning of the skin

In addition to its visible appearance, poikiloderma can sometimes cause those affected to experience itching, burning, flushing, and/or heightened sensitivity to topical products applied in the area.

How can I treat poikiloderma?

Because the overall appearance of poikiloderma is due to combination of the various changes listed above, a multimodal approach is often necessary to yield the most favorable result. This may include:

• Intense pulsed light (IPL): This is an energy-based device, akin to a laser, that is capable of targeting both vascularity and pigment during the course of a single treatment session. Because the risk of thermal damage to the skin must be balanced with efficacy, most people will require a few sessions of IPL for a good result, with occasional maintenance treatments moving forward in order to maintain it. By virtue of the heat that is delivered to the skin during treatment, IPL also brings about improvements in skin quality, in addition to targeting pigment and vascularity. For this reason, many patients will elect to treat their face, neck, and chest during each of their treatment sessions.

• Fraxel^® DUAL fractional nonablative laser: The Fraxel^® DUAL fractional nonablative laser is capable of delivering laser energy at two different wavelengths – 1550-nm and 1927-nm. The 1550-nm wavelength primarily helps to improve skin quality, thereby helping to improve the issue of thin skin that is observed in poikiloderma. The 1927-nm wavelength is extremely effective at lifting pigment from the surface of the skin. Fraxel^® DUAL fractional nonablative laser works by generating precisely controlled columns of thermal injury to the skin while leaving the surface of the skin intact. As the name “Fraxel” implies, only a “fraction” of the skin is targeted with laser energy during treatment, allowing for intact and untreated areas of skin to serve as a source of wound healing and repair. The fraction of skin subjected to laser energy undergoes a healing response that leads to the formation and remodeling of your collagen, elastin, and extracellular matrix (the skin’s moisture and blood vessel-rich skin environment), which manifests as improvements in skin quality, fine lines, laxity, and pigmentation. To learn more about the mechanism and capabilities of the Fraxel^® DUAL fractional nonablative laser, click here.

• Halo^® fractional laser: The Halo^® fractional resurfacing laser delivers laser energy at two different wavelengths – 1470-nm and 2940-nm. This unique combination of wavelengths is capable of improving the deeper quality of your skin, while simultaneously providing light surface ablation to blend texture and lighten pigment—all in a single treatment session. The 1470-nm wavelength primarily helps to improve skin quality, thereby helping to address the issue of thin skin that is observed in poikiloderma, while the 2940-nm wavelength lightens pigment by gently ablating the epidermis. Like the Fraxel^® DUAL laser, the Halo^® also employs fractional laser technology, which results in shorter healing time. To learn more about the mechanism and capabilities of the Halo^® fractional resurfacing laser, click here.

• Biostimulatory soft tissue fillers: Because atrophy (thin, crepey skin) is one of the characteristics of poikiloderma, strategies to rebuild skin quality are an important part of treatment. Soft tissue fillers such as Radiesse^® and Sculptra^® help the skin appear healthier and less thin by stimulating your own natural collagen and elastin production. These products can be placed at the same time as any of the other treatments that have been discussed, in order to maximize the productivity of your time in clinic, as well as streamline your recovery time.

How can I prevent poikiloderma from returning?

The most important thing you can do to prevent poikiloderma from returning is to protect the affected areas from the sun. Sun protective measures can include wearing an appropriately strong sunscreen, as well as clothing such as wide-brimmed SPF hats, and SFP neck gaiters.

In addition to sun protective measures, it is also important to periodically undergo treatments that are aimed at preserving skin quality on the lower face, neck, and chest. For this purpose, our patients enjoy the “Light and Tight” treatment that was specifically developed at Gateway Aesthetic Institute and Laser Center and is only offered in our clinic. The “Light and Tight” treatment consists of IPL on the face, neck, and chest, followed by 1064-nm laser skin tightening, which gently tightens collagen in these areas. Many of our patients will undergo this treatment a few times yearly for maintenance, in addition to 1-2 sessions of biostimulatory and hyaluronic acid soft tissue fillers as described above, in order to help their lower face, neck, and chest remain as healthy, and youthful appearing as possible. This is important because if your neck and chest are not included in your skin care regimen, they will appear in stark contrast to a well-maintained face.

Why trust Gateway Aesthetic Institute and Laser Center to treat my poikiloderma?

At the Gateway Aesthetic Institute and Laser Center, our board-certified dermatologists are able to utilize the most advanced laser technology, alongside powerfully regenerative soft tissue fillers, to bring about more superior results for your poikiloderma than any modality alone. Our dermatologists can also continue seeing you on an ongoing basis for the long-term maintenance of skin quality on the lower face, neck, and chest, so that these areas do not look decades older than your well-maintained face.

Because poikiloderma tends to develop in fair-skinned adults who have a significant history of sun exposure, skin cancer surveillance is of the utmost importance. It is very important to have your most sun exposed areas—face, neck, and chest—examined by one of our board-certified dermatologists before having any kind of laser treatment to address your poikiloderma, as various forms of skin cancer – such as basal cell carcinoma, squamous cell carcinoma, and melanoma– have been observed to arise amidst the redness and pigmentary changes of this condition.

Finally, our compassionate and experienced team of board-certified dermatologists understands how much a person can be bothered by poikilodermatous changes on the neck and chest—both in terms of appearance and associated symptoms. They also understand that poikiloderma, if not intervened upon in a timely manner, can cause significant changes to one’s appearance that can be difficult to reverse. You can be assured that when you trust our board-certified dermatologists to manage your poikiloderma, you are placing your care in the hands of knowledgeable, highly skilled, and experienced physicians who will approach your unique skin issues with a customized treatment plan that is tailored to restore your natural appearance, as well as your confidence in it.