Post Inflammatory Hyperpigmentation (PIH): Concerns

What Is Post Inflammatory Hyperpigmentation (PIH)?

Post Inflammatory Hyperpigmentation (PIH) is a common condition where the skin produces excess melanin after an injury or inflammation during the healing process. It results in patches of darker skin tone that can take weeks, months or even longer to resolve. PIH can affect both the skin’s surface level (epidermis) and the deeper level (Dermis)

Symptoms of Post Inflammatory Hyperpigmentation (PIH)

PIH presents as patches or spots of darker skin tone that vary in colour from light or dark brown to pink or red or even grey. It’s often a consequence of injuries or trauma to the skin, or conditions like acne, eczema, burns and insect bites. Post Inflammatory Hyperpigmentation does not cause any other symptoms other than darkening of the skin, so should not itch or be painful.


PIH can affect people of all ages but is more common in individuals with darker skin tones. Common triggers can include acne, infections, burns, rashes, allergic reactions. Some medical or cosmetic treatments can also cause PIH if administered incorrectly, or as part of the skin’s natural healing process.

When the skin suffers any trauma, it can cause inflammation which helps the area to heal. Unfortunately, this process can also stimulate the melanocytes (cells that produce melanin – what gives our skin it’s colour) to release excess pigment, that can remain in the skin long after the wound has healed. Areas of PIH can darken in colour with exposure to sunlight or persistent or recurrent inflammation. The more inflammation there is, the deeper the pigmentation can be and will be more obvious. (This is why we don’t recommend popping spots, as it can increase the amount of inflammation!) 


Post Inflammatory Hyperpigmentation is usually only temporary, but can be deep in the skin, so can take multiple treatments and consistency to resolve. The key is reduce the amount of inflammation in the skin, so controlling breakouts or calming the irritation to prevent PIH from forming. Depending on the depth and severity of symptoms, there are a few options to reduce the appearance of darker spots.


Sun Protection – protect your skin from UV exposure by wearing a broad-spectrum sunscreen, seek shade during peak sun hours and wear a wide brimmed hat/protective clothing with an SPF factor. While protecting the skin from the sun will not alleviate symptoms, it will prevent them becoming darker or deeper.


Skincare Products – ingredients called tyrosinase inhibitors can help reduce the appearance of PIH as they block tyrosinase, the enzyme that your skin needs to make melanin. These ingredients help to target the cause of pigmentation, by reducing the over-reactive melanin production and gives long lasting relief from melasma.


The most effective tyrosinase inhibitors include hydroquinone and tretinoin, which are prescription-only medical grade skincare products. Other tyrosinase inhibitors include kojic acid, arbutin, vitamin C and liquorice root extract.


Other skincare products can help reduce breakouts or calm irritation to help prevent inflammation in the skin.
A consultation with our skin specialist can help determine the best products for your skin type and symptoms.


Chemical Peels – Chemical Peels involve applying an acid solution to the skin to exfoliate the upper layers of the epidermis, revealing fresher skin with a more even skin tone. It is important to note that multiple treatments may be required to attain the desired result.


Combination therapy – in some cases, a combination of treatments may be recommended for optimal results. A consultation with our skin specialist can help determine the best treatment plan for your symptoms.

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