March 15, 2019 What Is Post-inflammatory Hyperpigmentation (PIH)?
Perhaps you had a pimple that you couldn’t resist popping. Maybe you scraped your skin or burned yourself on the stove. Whatever the cause, you can’t help but notice that you still have a little dark spot weeks later. That’s post-inflammatory hyperpigmentation (PIH), the term doctors use to describe the flat dark spots and discolorations on the skin following inflammation or injury.
What Is Post-Inflammatory Hyperpigmentation?
PIH is a temporary condition that can start with a pimple, rash, scrape, burn, or any other type of skin trauma that causes inflammation. As a result of this inflammation, the skin over-produces a skin pigment called melanin. This extra melanin pigment gets deposited in the skin and is what causes the dark patches to remain long after the initial injury or inflammation has healed.
PIH can often fade on its own, although it may take weeks, months, or even years to do so. Sun exposure without sunscreen or sun protection can make PIH worse by stimulating cells in the skin to produce additional pigment, which is why it’s important to wear sunscreen or avoid sun exposure when you have a skin injury.
Who Gets PIH?
Since PIH occurs after skin injury or inflammation, anyone can get this condition regardless of gender or age. Post-inflammatory hyperpigmentation can develop in all skin types, but it can be more common and more intense in people who have darker skin tones (Davis).
How Is PIH Treated?
Post-inflammatory pigmentation spots can fade on their own over time. However, this process can take weeks to months, and sometimes years.
Fortunately, there are many treatment options for PIH, including:
- Topical creams: Topical creams inhibit the formation of additional melanin and promote new skin growth, accelerating how quickly PIH spots fade.
- Sun protection: UV rays cause certain cells in your skin to create additional pigment, making PIH worse. Sun protective measures can improve the effectiveness of treatment as well as speed up how quickly PIH spots fade on their own.
- Lasers: Laser treatments use precise, focused beams of light energy to damage pigment-producing cells and fade PIH spots.
- Chemical peels: Chemical peels work by ‘peeling off’ the topmost layer of skin, which includes PIH spots.
Everyone’s skin is different, and what works for one person may make PIH worse in another. It’s important to consult with your dermatologist to determine the best treatment for you.
- Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20–31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921758/
- Ngan V. Postinflammatory hyperpigmentation. Postinflammatory hyperpigmentation | DermNet NZ. https://www.dermnetnz.org/topics/postinflammatory-hyperpigmentation/. Published 2005. Accessed April 10, 2020.
About the author
Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the ...