Table of ContentsView AllTable of ContentsSymptomsCausesHyperpigmentation Acne TreatmentHow to Get the Best Results
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Hyperpigmentation Acne Treatment
How to Get the Best Results
Post-inflammatory hyperpigmentation (PIH) is an area of darker skin where acne or a wound has healed. The discoloration is due to excess melanin (pigment) produced as part of the skin’s natural response to inflammation, or due to pigment dropout (melanin entering the dermal layer of the skin).
This article explains post-inflammatory hyperpigmentation, why those dark spots develop, and what you can do to help them fade faster.
Verywell / Emily Roberts
Post-Inflammatory Hyperpigmentation Symptoms
PIH usually looks like a flat area of discoloration on the skin. It can appear white, pink, red, purple, brown, or black, depending on your skin tone and the depth of the discoloration.
PIH can develop in allskin types. However, it tends to be more severe and longer-lasting for people with medium to dark complexions. People with skin of color have more pigment (melanin), so there is more of a chance of PIH with certain skin problems.PIH affects both men and women.
DermNet /CC BY-NC-ND
Causes of Post-Inflammatory Hyperpigmentation
PIH develops when a wound or irritation, like a scrape, rash, or pimple, causes the skin to become inflamed. As the skin heals, it produces too muchmelanin(the protein that gives the skin its color). This darkens the skin.
Most people with acne have some degree of PIH. And it’s not just the significant blemishes that cause these spots—hyperpigmentation can follow even relatively minor pimples andblemishes.
That said, the more inflamed a breakout, the larger and darker the PIH spot tends to be. In addition, picking orpopping a pimpleincreases the chance of developing PIH because it increases inflammation.
Other causes of PIH include:
Acne Scars vs. Post-Inflammatory Hyperpigmentation
You may be relieved to learn that PIH is not true scarring. In fact, people often call it “pseudo scarring” because although it leaves a mark on the skin for a while, it does not damage the follicle.
Trueacne scarsoccur when there is either a loss of tissue, causing a pitted or depressed area, or an overgrowth of tissue leaving a raised scar.PIH, on the other hand, is flat. It’s not pitted or raised, but rather simply darker than the surrounding skin.
Acne scars are not related to hyperpigmentation, although they may look similar. Acne scars can be raised or pitted, while the spots created from post-inflammatory hyperpigmentation (PIH) are flat marks on the skin. The first step toward treating both acne scars and PIH is focused on acne control.
Acne Cosmetica: Causes, Treatment, and Prevention
Whatever treatment option you choose, understand that improvement will take time. PIH usually goes away on its own, but it can take several months to years to fade completely.Topical medications and in-office treatments can help speed this up.
This is not a comprehensive list. Your healthcare provider can guide you through all the possible options to properly treat your skin.
Alpha Hydroxy Acids (AHAs)
Alpha hydroxy acids, especiallyglycolic acid, are a good starting point for treatment.Alpha hydroxy acids(AHAs) help speed up the skin’s natural exfoliation process, which can help improve the look of PIH.
You can find these ingredients in many OTC “brightening” treatments. In addition, leave-on treatments like lotions, creams, and gels will give you better results than wash-off products like cleansers.
Other OTC ingredients that can help fade hyperpigmentation include:
More potent AHA treatments are available with a prescription. AHAs are often used as anti-aging treatments and will leave your skin soft and smooth.
Hydroquinone
These creams often contain additional lightening ingredients, which can give better results than hydroquinone alone. Ingredients combined with hydroquinone include:
To avoid lightening your natural skin color, apply hydroquinone creams only to darkened areas.Hydroquinone may cause skin irritation for some people, so it’s worth talking to your healthcare provider before beginning this treatment.
To avoid lightening your natural skin color, apply hydroquinone creams only to darkened areas.
Hydroquinone may cause skin irritation for some people, so it’s worth talking to your healthcare provider before beginning this treatment.
Topical Retinoids
Retinoid creams include:
An added benefit of retinoids is that they lessen PIH as they treat acne breakouts.
When using these treatments, look for excessive dryness, redness, and irritation, as this can trigger PIH on its own.
Azelaic Acid
Some studies have shown azelaic acid to be as effective as hydroquinone at treating hyperpigmentation.Therefore, it is a good alternative for those who can’t use hydroquinone.
Fading Over Time
The good news is that PIH can fade away over time, even without treatment. Buttimeis the operative word. PIH can take three to 24 months to disappear entirely, or even longer in some cases.
How long does it take for acne hyperpigmentation to fade?The length of time it takes for PIH to fade depends on how dark the spot is compared to the surrounding skin. The bigger the contrast between the dark area and your natural skin tone, the longer it will take to fade.
How long does it take for acne hyperpigmentation to fade?
The length of time it takes for PIH to fade depends on how dark the spot is compared to the surrounding skin. The bigger the contrast between the dark area and your natural skin tone, the longer it will take to fade.
PIH doesn’t always fade away on its own. In some cases, it’s more or less permanent.
Some treatments will help. Some may not wholly erase dark marks, but they might at least lighten them considerably. Therapy can also help speed up fade time if you’re not keen to wait for spots to lighten naturally.
Over-the-counter (OTC) products can help fade more subtle marks. However, a prescription cream might be a better choice for deeper marks or those that have been around for a long time. Yourdermatologisthas a lot of products that can do the trick.
In-Office Treatments
More persistent cases of PIH can be treated professionally at your dermatologist’s office. Treatments include:
Just one treatment isn’t enough to fade hyperpigmentation. You’ll likely need a series of treatments spaced two to four weeks apart (depending on the procedure you’re having done). Your healthcare provider can help determine which of these treatments, if any, would be most effective for you.
To get the best results possible, keep a few things in mind to help prepare your skin for whichever treatment you choose.
Control Your Acne
Before treatment, your acne should be under control. Otherwise, each new pimple could cause another dark spot, and you would never get ahead of the curve (and never see the clear, even skin tone you’re looking for).
Over-the-counter acne productsare effective for treating mild acne. However, you may need to treat more stubborn or severe breakouts withprescription acne medicationsif you want to see real improvement.
Use Sunscreen
Use sunscreen every day and a sunhat as well. The sun may darken the discolorations and make them fade more slowly.Plus, many PIH treatments (and many acne treatments) can make your skin more sensitive to the sun.
If you’re worried that sunscreen could make your breakouts worse, don’t be. There are manysunscreens for breakout-prone skin.
Monitor Your Skin
Monitor your skin for irritation. Although treatments are helping you clear your skin, acne and PIH treatments also have the potential for irritation.
Unfortunately, irritated skin could lead to even more dark spots and uneven skin tone. If PIH is a problem for you, let your healthcare provider know if your skin becomes irritated from your acne treatments.
Summary
PIH is dark spots left on the skin after a pimple heals. It doesn’t damage the skin, so it doesn’t cause pits or raised scars on the skin.
PIH usually heals over time without treatment, but it can take up to a couple of years or sometimes longer. Some spots may never fade. Treatments include OTC creams, prescription medications, and in-office procedures.
To get the best results from treatment, be sure your acne is under control and use sunscreen. During treatment, carefully watch your skin for irritation.
15 Sources
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