We’ve all had acne at one point in our lives, so we all know the pains of battling this pest. However, in some people, after acne is finally gone, there stays a dark mark where it used to be. What is that? This mark is called acne-induced post-inflammatory hyperpigmentation and can often stay on the skin long after the acne itself has healed. So how do you avoid post-inflammatory hyperpigmentation (PIH) and how to cure this issue once and for all?
What is post-inflammatory hyperpigmentation?
In some cases and some people, once the acne has healed, it leaves behind a pigmented mark. This mark is called post-inflammatory hyperpigmentation (PIH) and is usually a result of increased production of melanin or “an irregular dispersion of pigment after skin inflammation”. Hyperpigmentation occurs after acne passed its healing stage and after all the redness, swelling and other signs of the inflammation have passed.
To recognize PIH, just look for very flat and smooth areas of skin that have discoloration or dark markings. It depends on your skin tone how will PIH be presented since it can go from white pink and red to purple, brown and black. In some cases, hyperpigmentation after acne occurs deep in the skin, which causes the mark to be bluish or grayish. Unfortunately in the last case, hyperpigmentation can stay with you forever.
Specialists still don’t know why some people experience PIH and some don’t—this issue definitely requires more research. As doctors explain, all we know is that some people with lighter complexions develop redness and pink marks after acne, while hyperpigmentation is most likely to occur in medium and dark complexions.
Hyperpigmentation vs Acne Scaring
It’s quite easy to tell PIH from acne scarring. Acne scars have a distinct change in skin texture while hyperpigmentation only contains the darkening of the skin. Sometimes, they can happen at the same time, but they are not the same. Many people experience hyperpigmentation without scaring and vice versa.
How to Treat PIH
Most post-acne marks go away on their own after some time, but what happens if you have a few dark spots after a breakout that won’t seem to go away? Well, you have a few options that depend on your preferences and the seriousness of your issue. You can try in-office treatment, at-home treatment or the combination of the two—one will most likely fade those dark areas. Make sure you find a reputable cosmetic clinic and book your appointment so you can receive a quick and painless laser treatment that reduces pigmentation and leaves you with an even complexion. This treatment is also suitable for acne scarring, so it’s a two-in-one solution for many people.
A very effective way to boost the effectiveness of your in-office treatment is to practice at-home solutions for pigmentation. For lighter skin that tends to have red or pink marks, the best option is creams with retinoids or alpha hydroxy acids. People with darker skin who often have brownish marks can reach for hydroquinone, kojic acid, arbutin or a combination of these to apply as skincare.
How to Prevent PIH
If you want to prevent PIH, the best thing to do is retain good control of the inflammation and put it out quickly and effectively. It’s important to treat your breakouts while they are active by using anti-inflammatory actives like topical treatments like niacinamide, azelaic acid and zinc supplements—these can be helpful with reducing redness and swelling. The most important thing to do, though, is not to pick, squeeze and traumatize the area on your own. Messing with your acne can only worsen the hyperpigmentation or discoloration and even leave permanent textural scaring—no extractions at home by any means!
Additional Protection
No matter if your PIH is brown, blue or pink, it’s important to use daily sun protection (broad-spectrum sunscreen) to prevent the spots from becoming more prominent. If you’re looking for a skincare routine that features all the necessary things, apply sunscreen and vitamin C serum in the morning, and opt for glycolic acid, kojic acid and cysteamine actives before bed—these will bring gentle exfoliation and brightening of the skin. If you’re up for prescription treatment, ask your doctor about retinoids and hydroquinone.
Now that you know the proper strategy to fight PIH, you can expect to have much clearer skin and a uniform complexion without makeup.
Diana Smith is a full time mom of two beautiful girls interested in health and beauty related topics and alternative medicine. In her free time she enjoys long walks in the woods, hard exercising and preparing healthy meals for her family.
