Post-Inflammatory Hyperpigmentation – Dark spots following skin injury or inflammation
Post-inflammatory hyperpigmentation (PIH) is a common condition in which dark spots or patches of discoloration develop on the skin after it experiences injury or inflammation. It results from an overproduction of melanin (the skin pigment) in response to the inflammatory process. PIH can occur in all skin types but is more common and pronounced in individuals with darker skin tones.
Causes of PIH:
PIH occurs when the skin produces excess melanin during the healing process of inflammation or injury. Common triggers include:
- Acne: A frequent cause, leaving dark spots after pimples heal.
- Eczema and Dermatitis: Chronic inflammation can result in discoloration.
- Injuries: Cuts, burns, or abrasions.
- Infections: Fungal or bacterial infections of the skin.
- Cosmetic Procedures: Laser treatments, chemical peels, or dermabrasion.
- Irritation: Caused by harsh skincare products or over-exfoliation.
Symptoms:
- Appearance: Flat areas of discoloration ranging from light brown to black, depending on skin tone and severity.
- Location: Found at the site of previous inflammation or injury.
- No Physical Symptoms: Typically does not cause itching, pain, or discomfort.
Risk Factors:
- Darker Skin Tones: Higher melanin content increases the likelihood and visibility of PIH.
- Sun Exposure: Exacerbates hyperpigmentation by stimulating melanin production.
- Chronic Inflammation: Prolonged or repeated inflammatory episodes increase risk.
Diagnosis:
PIH is usually diagnosed through:
- Clinical Examination: Based on medical history and the appearance of the skin.
- Wood’s Lamp Examination: A special light may be used to determine the depth of pigmentation (epidermal or dermal).
Treatment:
- Topical Therapies:
- Skin-Lightening Agents: Hydroquinone, azelaic acid, kojic acid, or niacinamide.
- Retinoids: Such as tretinoin or adapalene, to promote skin cell turnover.
- Vitamin C: Reduces melanin production and brightens skin.
- Sun Protection:
- Daily use of broad-spectrum sunscreen (SPF 30 or higher).
- Avoid excessive sun exposure, as UV light worsens pigmentation.
- Professional Procedures:
- Chemical Peels: Use of glycolic acid, salicylic acid, or other agents to exfoliate pigmented skin.
- Laser Therapy: Specific lasers target pigmented areas but require caution in darker skin tones.
- Microneedling: Stimulates skin renewal and can help improve discoloration.
- Over-the-Counter Products:
- Formulations containing alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs).
Prevention:
- Avoid picking or scratching at acne or skin injuries.
- Use gentle skincare products to minimize irritation.
- Treat inflammatory skin conditions promptly to reduce the risk of PIH.
Prognosis:
PIH often fades over time but may take months or years, depending on the depth of pigmentation and individual factors. Early treatment and diligent sun protection can significantly speed up improvement and prevent worsening.