Has your acne left dark brown spots or dark red spots on your skin where your acne once was? Is the skin starting to look more healthy and glowing but it has plateaued due to these dark spots left over from your acne scars? This skin condition is known as post inflammatory hyperpigmentation.
What is PIH?
The discoloration of the skin resulting after acne or some other type of inflammation is known as post inflammatory hyperpigmentation or PIH. Basically it comes from the skin’s natural response to inflammation. The skin becomes discolored after it heals and can be red, pink, purple, brown or black depending on the original color of your skin or the severity of the inflammation. The condition comes when some sort of skin inflammation like a wound, pimple, acne, or rash causes the skin to over produce melanin. Melanin is the same chemical in our skin that causes us to tan. So the skin as a response to inflammation produces too much melanin and it causes a darkening of the area where the original inflammation occurred. This dark color can last for quite some time after the injury heals and sometimes even permanently. It is most common in people who struggle with acne and usually in people with darker skin colors can see it more so than lighter skin tones.
Most post inflammatory hyperpigmentation or PIH scars usually occur after some acne lesions. This is not always the case; sometimes they can follow really tiny or small pimples. But it is pretty much a guarantee that the larger and more inflamed the breakout the darker, larger and possibly redder the PIH mark. One sure fire way to guarantee a post inflammatory hyperpigmentation mark is to pick at or pop you pimples. This is because it increases the damage at the cellular level which increases the need for a greater inflammatory response by the body. These types of marks are easily identified if the skin is carefully examined. They may be a range of colors but the skin will not feel any different over one of these macules. It just looks almost like a freckle on the skin, it isn’t raised or depressed just slightly darker and it may have a slightly shiny quality to it.
It will be quite a relief I am sure to hear that post inflammatory hyperpigmentation is not an actual scar. Most fade away over time however it can take a long time, anywhere from 3 months to 2 years for them to disappear completely on their own. There are several factors that play into the timing of PIH macule fading. It depends on the size of the mark, the color of the mark compared to your skin color. The larger the contrast the longer it will take to disappear. So if you don’t want to wait for the scars to heal on their own, there are some treatments available to you to help these marks fade much faster. The first and most important thing to work on is getting you acne cleared up. If you don’t complete this the scars will just keep happening each time you have an outbreak. So, first things first, get your acne treated! Then break out the patience and sun screen. Treating PIH marks can take a long time so it requires patience to see it through and as well, the sun can darken the marks just as it does your skin color so use a decent SPF lotion to protect your skin.
Over the Counter Treatments
Post inflammatory hyperpigmentation marks generally respond quite favorably to most over the counter products. Basically these agents are known as skin brightening or bleaching products and they are a combination of the hydroxyl acids like alpha and beta, vitamins A, C and such. There are usually also chemicals in these products to lighten the skin. Also studies have been done showing products with acetly glucosamine and niacinamide are also quite successful in treating this type of skin discoloration.
- Topical Retinoids – Retinoids are commonly given to acne patients because they can help cells generate more rapidly. This results in a great exfoliation of the dead skin cells on our face which are part of the problem in acne. The use of this product actually kills two birds with one stone. It not only helps lighten the skin and treat post inflammatory hyperpigmentation, it can help treat the actual acne that is causing the problem! It might take months to see a response with this product, and it can cause irritation so if you use this product make sure you are in communication with your doctor
- Hydroquinone – this is one of the more common products used for treating post inflammatory hyperpigmentation. It comes in varying strengths from 1-4% however the only ones available over the counter are strengths 1-2%. A prescription is required for strengths 3-4%. It works by addressing the melanin in our skin. It actually blocks the enzyme responsible for melanin production which is Tyrosinase. So it prevents melanin production and then actually lightens the skin. There are usually other ingredients to lighten the skin and such. It should be applied to affected areas only and should be tested because it can cause irritations in some people.
- Glycolic Acid – This product is found is so many skin products nowadays. It is commonly known as an alpha-hydroxy acid which not only exfoliates the skin, but also lightens it. This is why it helps PIH marks, because it has the ability to lighten skin.
- Azelaic Acid – Available in a cream or gel form this product not only treats PIH marks it addresses acne also. It helps the cells re-generate at a quicker rate and is often used for people who have a sensitivity to hydroquinone. This as with all the other products does have the capacity to irritate the skin, so make sure you are in touch with your doctor.
The marks left over after acne can often cause as much distress as the acne itself, so make sure you talk to a dermatologist about your concerns and how you can quicken the process of clearing the post inflammatory hyperpigmentation resulting from your acne. Some of these over the counter and procedural treatments such as chemical peels and derma peels may be in order to help you treat your skin problems.