Post-Inflammatory Hyperpigmentation (PIH)

Post-Inflammatory Hyperpigmentation (PIH) refers to darkened patches or spots on the skin that appear after an inflammatory event such as acne, eczema, burns, cosmetic treatments, or trauma. It occurs due to overproduction of melanin as the skin heals, especially in individuals with medium to dark skin tones.

Post-Inflammatory Hyperpigmentation (PIH)

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Causes

  • Acne lesions (most common)
  • Eczema, psoriasis, insect bites
  • Laser treatments or chemical peels (overdone)
  • Cuts, burns, or friction injuries
  • Excessive picking or squeezing pimples
  • Allergic skin reactions or irritants

Signs and Symptoms

  • Flat, darkened patches or spots on the skin
  • Brown, black, red, or purple discoloration (based on skin tone and depth)
  • Commonly seen on the face, back, shoulders, chest, or areas of injury
  • No pain, itching, or texture change — purely a pigmentation issue

Diagnosis

Clinical Examination

Visual inspection by a cosmetologist or skin specialist, Identification of hyperpigmented areas post-inflammation

Wood’s Lamp (optional)

UV light examination to determine if pigmentation is epidermal (superficial) or dermal (deeper)

Fitzpatrick Skin Type Assessment

Darker skin tones (Type III–VI) are more prone to PIH

History of Inflammation or Cosmetic Procedure

Past acne, burns, or treatments like peels or laser help confirm cause

Treatment Options

Topical Depigmenting Agent : Hydroquinone (HQ)

A gold-standard skin lightening agent that inhibits melanin production. Often used short-term under supervision (2%–4%).

Topical Depigmenting Agent : Kojic Acid

A natural compound derived from fungi that lightens pigment by blocking tyrosinase (an enzyme involved in melanin production).

Topical Depigmenting Agent : Azelaic Acid

A gentle, anti-inflammatory agent that helps reduce both acne and pigmentation. Safe for sensitive skin and pregnant individuals.

Topical Depigmenting Agent : Niacinamide (Vitamin B3)

Reduces melanin transfer to skin cells and also strengthens the skin barrier.

Topical Depigmenting Agent : Vitamin C (Ascorbic Acid)

A potent antioxidant that brightens skin, reduces oxidative damage, and fades dark spots.

Topical Depigmenting Agent : Retinoids (e.g., Tretinoin)

Stimulates cell turnover, helps fade pigmentation, and enhances the effectiveness of other ingredients like hydroquinone.

Vitamin C (Ascorbic Acid)

A potent antioxidant that brightens skin, reduces oxidative damage, and fades dark spots.

Chemical Peels

Chemical exfoliants that remove the pigmented upper skin layers and stimulate skin regeneration.

Q-Switched Nd:YAG Laser (Laser Toning)

Targets excess melanin in the skin without damaging surrounding tissue. Ideal for Indian or darker skin tones.

Tranexamic Acid (Topical or Oral)

A newer depigmenting agent that reduces melanin production by acting on the melanocyte activation pathway.

Platelet-Rich Plasma (PRP)

Uses growth factors from your own blood to rejuvenate the skin. When combined with microneedling, it can support faster healing and better pigment reduction.

Skin Brightening Serums (Maintenance Therapy)

Over-the-counter or prescription-grade serums with safe, long-term brightening agents

Home Remedies

Aloe Vera Gel

Soothes and may reduce pigmentation

Licorice Extract

Natural skin brightener

Green Tea Extract

Antioxidant benefits

Potato Juice or Turmeric Masks

Traditional remedies

Diluted Apple Cider Vinegar

Light exfoliant (use with caution)

Preventive Care

  • Daily broad-spectrum sunscreen (SPF 30+)
  • Avoid picking, squeezing, or scratching pimples or rashes
  • Use non-comedogenic, gentle skincare
  • Limit strong exfoliants or home peels
  • Avoid sun exposure post-procedure (peels, lasers, etc.)

Surgical Options

Laser Toning (Q-switched Laser)

Lightens pigmentation gradually without harming skin

Microneedling with Brightening Serums

Enhances penetration of tranexamic acid or glutathione

Medium-depth Peels (TCA, Jessner’s Peel)

For resistant pigmentation – performed by experienced practitioners

Platelet-Rich Plasma (PRP) – Emerging option

May enhance skin rejuvenation when combined with microneedling

Need Immediate Assistance?

Our team is available to help you schedule appointments and answer any questions about post-inflammatory hyperpigmentation (pih) treatment options.

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