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What Is Post-Inflammatory Hyperpigmentation (PIH)?

A close up photo of a woman's face

For many of us, dealing with an unexpected breakout can be stressful enough. You reach for your arsenal of skincare weapons to get that unwelcome acne under control, and then it’s time to celebrate, right? Not so fast—blemishes can have a way of leaving their mark (literally). Skin irritation can often result in something referred to as post-inflammatory hyperpigmentation (PIH)—also known as those dark spots that linger after a blemish has healed.

If you’re struggling with post-breakout redness and discoloration, you’ve come to the right place! Below, we’re getting into the nitty gritty details on post-inflammatory hyperpigmentation, including the most common causes, our golden rules for prevention, and pro tips to help fade those stubborn marks.

What Is PIH?

Although its name may sound a bit intimidating, post-inflammatory hyperpigmentation is actually pretty easy to understand—it’s your skin’s natural response to an inflammatory wound. PIH can affect any skin type or gender equally, but is generally more frequent and severe in people with medium to dark skin tones. The skin discoloration left behind by PIH usually appears as a flat mark on the skin. This is not to be confused with acne scars, which are usually indented or raised areas on the skin. Post-inflammatory hyperpigmentation can appear on your face or body and ranges in color, from brown to tan or dark brown.

But here’s where things get a bit more complicated. Post-inflammatory hyperpigmentation is often confused with post-inflammatory erythema (PIE), which differs mainly by its color. Whereas PIH typically appears in a brownish tone for people with darker skin types, PIE typically appears in lighter skin tones in a red, pink, or purple shade.

What Is the Cause of PIH?

Although it’s usually experienced post-pimple, PIH is not just reserved for acne-prone skin. It can show up after pretty much any event that leaves your skin inflamed, like a rash, scrape, sunburn, cosmetic procedure, or any other skin injury. This is because, as your skin begins to heal, it overproduces melanin—the complex protein that creates the beautiful range of our hair, skin, and eye colors. It’s this excess of melanin that’s ultimately to blame for post-inflammatory hyperpigmentation.

How Long Does It Take for PIH to Fade?

There’s a silver lining when it comes to post-inflammatory hyperpigmentation—it’s usually not permanent and will fade over time, even without treatment. It may take several months (typically 6-12 months) to fade, but your post-inflammatory marks should eventually disappear.  And there are a few methods to consider to speed up that time and give your skin a helping hand. Let’s dive in!

How Do You Get Rid of PIH?

Hyperpigmentation that shows up after skin inflammation is perfectly normal and considered very common—as much as 65% of darker complexions with acne have experienced PIH. In other words, post-inflammatory hyperpigmentation shouldn’t hold you back from reaching your complexion goals for even-toned, healthy-looking skin. Here’s how to handle it like a pro, with our expert tips on how to prevent and treat post-inflammatory hyperpigmentation. 

The Sooner You Start, the Better

Those marks may already be there, but taking quick action is still super important! The right skincare steps, when applied early on, can help prevent further darkening and fade PIH marks more effectively.

Speak to Your Dermatologist

The first (and most important) step is to get ahead of whatever may be causing your skin flare-ups—this can prevent new discoloration from forming and give those existing marks a chance to fade. Since hyperpigmentation can show up in a number of different forms, speaking with a dermatologist is always your best bet. A qualified derm can help you find the root cause of your PIH and help set you up for success.

Be Patient With Your Skin

We know it can be hard to hear this, but that PIH isn’t going to magically disappear overnight—it will require some patience on your part. Everyone’s skin is unique and fade time will vary for each person. Plus, we hate to break it to you, but the expected recovery speed is typically pretty slow for PIH. Try to keep positive, realistic expectations and remember that with the right skincare products and concealing makeup (and maybe some yoga for patience), it is possible to disguise PIH.

Apply a Broad-Spectrum Sunscreen Daily

Need yet another reason to apply plenty of sunscreen everyday? You can add PIH prevention and treatment to the list! Although the sun’s rays may not be a direct cause of post-inflammatory hyperpigmentation, sun damage can worsen symptoms by darkening the discolored area. Even worse, UVA and UVB rays are known to accelerate skin aging and contribute to other types of hyperpigmentation, like age spots or melasma.

Pro Tip: For maximum sun protection, The American Academy of Dermatology recommends that you apply a waterproof, broad-spectrum sunscreen with an SPF of 30 or above each morning and re-apply every two hours (or as needed) when spending time outdoors .I Try to seek shade when the sun is at its strongest, between 10 a.m. and 2 p.m., and grab that sunhat—because protective clothing can help, too!

Avoid Aggressive Treatments

There are a number of cosmetic treatments that may help ease post-inflammatory hyperpigmentation faster, including salicylic acid or glycolic acid chemical peels and laser treatments. But before jumping headfirst into every possible treatment, it’s crucial to remember that these options should be recommended by a dermatologist and performed by a qualified professional. This is because overly aggressive treatments can actually backfire, leading to more skin irritation —and therefore, possibly more discoloration.  

Try Some Gentle Exfoliation

Luckily, the vast majority of PIH is classified as epidermal, meaning that the discoloration occurs only on the top layer of your skin. This means that skin affected by post-inflammatory hyperpigmentation will shed just like all other skin cells. Adding some gentle chemical exfoliants into your skincare routine may therefore help stimulate cell turnover and promote smoother, more radiant-looking skin.

Pro Tip: Glycolic acid (a member of the AHA family) is one gentle chemical exfoliant that is commonly used in formulas aimed at targeting post-inflammatory hyperpigmentation. This skin-loving ingredient can be found in many exfoliating serums and may help bring new skin calls to the surface.

Camouflage Spots With Concealing Makeup 

One of your best friends when dealing with PIH is definitely a great anti-aging concealer! With the right concealing makeup, you can camouflage those stubborn post-breakout marks and feel more confident in your skin. Be sure to look for a full-coverage, waterproof concealer that offers buildable coverage for the most natural-looking, airbrushed finish. 

For the latest pro tips on how to achieve a more even-toned complexion, check out this useful IT Cosmetics guide on how to cover acne scars.

Sources:

  1. “Act Your Age When It Comes to Skin Care.” American Academy of Dermatology, 6 Nov. 2016.
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