If you have acne, you've probably experienced those dark spots that stay behind long after your blemishes have healed. For many people, these marks can be just as distressing as the pimples themselves.

These dark spots are called post-inflammatory hyperpigmentation, and they're probably more common than you realize. Read on for an in-depth look at this common condition, including who gets it, why it happens, and what you can do about it.

What Is Post-Inflammatory Hyperpigmentation?

Your skin color comes from melanin, which is a pigment made by cells called melanocytes. Anytime you have increased skin melanin, it's called hyperpigmentation. This causes the area to appear darker than the surrounding skin, and it can happen for a variety of reasons.

As it turns out, post-inflammatory hyperpigmentation (PIH) is one of the most common causes of these darker spots. PIH occurs when your skin makes extra melanin in response to irritation or injury. The extra pigment then deposits in your skin, making it look darker.

PIH is usually a tan or brown color, but it can also appear gray or black depending on the person. The discoloration only affects areas where the skin was irritated or injured, whereas the surrounding skin stays its normal color.

What Causes Post-Inflammatory Hyperpigmentation?

Your skin can develop PIH anytime it's inflamed, irritated, or injured. Anyone can experience PIH, but it's more common in darker skin tones. Here are some of the most common reasons people develop PIH:

  1. Inflammatory conditions like acne, eczema, and psoriasis.
  2. Skin infections like ringworm or impetigo.
  3. Cosmetic procedures like chemical peels and lasers.
  4. Skin injuries like burns or chronic chafing.

How to Get Rid of Post-Inflammatory Hyperpigmentation

Treating Post-Inflammatory Hyperpigmentation is definitely possible, but it can take time and patience to get the results you want. For most people, a combination approach will give the best and quickest results. Untreated PIH will usually resolve on its own after several months, as long as you've addressed the underlying cause of skin inflammation.

Identify the Underlying Problem

Whether it's acne, eczema, or something else, the first step is treating the underlying cause of PIH. This prevents new spots from forming while you're treating the old spots.

For example, some people with an itchy rash may be having an allergic reaction to a certain skin care product. A board-certified Dermatologist can help sort this out by doing a patch test in their office. This test involves leaving small patches with common allergens on the skin for 48 hours. Afterward, the Derm checks to see if your skin had any reactions. This way you know which specific ingredients to avoid in your products.

Use Sunscreen Every Day

Ultraviolet (UV) radiation from the sun is a major contributor to PIH, and this is especially true in people with darker skin tones. Using daily sunscreen with an SPF of 30 or more is an important part of preventing and treating PIH. A good option to try is EltaMD UV Restore Tinted Broad-Spectrum SPF 40, which also includes antioxidants like Vitamin C to help even out skin pigmentation.

Leverage Skin Care Ingredients

There are many different over-the-counter and prescription products that can help treat Post-Inflammatory Hyperpigmentation. If you're starting without a prescription, look for products that have skin-lightening ingredients, like Retinol, Kojic Acid, Niacinamide, and Vitamin C.

If these don't work, or if you want to start with something stronger, prescription-strength Retinoids are one of the most effective treatments available for PIH. Your Dermatologist may also recommend using them in combination with Hydroquinone, another effective skin-lightening medication. It's important to use this treatment as directed, as it can cause blue-gray skin discoloration when not used properly.

Consider Office Procedures

Some in-office procedures, like chemical peels and resurfacing lasers, can be very effective options for treating PIH. The best treatment will vary from person to person, so it's important to consult an experienced board-certified Dermatologist to help choose the best option for you and your skin.

PIH can be frustrating to deal with. Still, rest assured that it's common, and if you do want to address it, there are many treatment options out there. No matter which path you choose, start by identifying the underlying cause and remember to use sunscreen every day. By taking these small steps, you can help your skin thrive in all of its glory.



    Maria Robinson, MD, MBA is a board-certified dermatologist and dermatopathologist with over ten years of clinical experience. Dr. Robinson has a passion for nutrition and integrative dermatology, and is the co-founder of www.integrativederm.org, where people can explore holistic dermatology treatments. Through her writing, she strives to empower people with accurate health information so they can make positive decisions that lead to healthy and vibrant skin.

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