What is Post-Inflammatory Hyperpigmentation?

Post-inflammatory hyperpigmentation is a dark spot or discoloration of the skin that follows an inflammatory wound like acne, bug bites, scrape, or rash. The skin becomes inflamed and as it heals, it produces too much melanin, leading to discoloration and hyperpigmentation.
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So you have the skin breakout, whether you decided to leave it alone or did the #1 no-no- doing your own at-home extraction- you’re now left with a dark spot, for weeks even sometimes months!  Why? What is it? And what can you do about it? 

As a licensed esthetician with 10 years of experience, I’ve seen a lot of these post breakout dark spots and have helped many overcome and clear those spots with simple at-home routines and in-office treatments with little to no downtime.

Post inflammatory hyperpigmentation or PIH can be  almost more annoying than what caused it- a nice pimple breakout!  Post inflammatory hyperpigmentation is your skin’s natural inflammatory response after inflammation, like a pimple, or even a bug bite, has healed.

When Does Post-Inflammatory Hyperpigmentation Occur?

Post-inflammatory hyperpigmentation can occur in all skin types but is more common in medium to dark skin tones with more melanocytes in the skin (melanocytes are what add pigment to the skin- the more melanocytes, the darker the skin).  When there’s any damage that occurs either in the epidermis (just below our stratum corneum,  or the outermost layer of skin, containing some dead skin), or even in the dermis, our keratinocytes, or skin cells, deposit more melanin in these areas.  Inflammation from the injury then triggers these melanocytes further, spreading pigment to surrounding skin cells.  That melanin pigment causing the dark spot(s) is trapped in the small tissues in the papillary dermis (just below the epidermis) where the injury and inflammation previously was.  

I am a skin type 5 on the Fitzpatrick scale (this is a system we use in esthetics to determine one’s skin type and which treatments are safe), which would be a medium to dark-skinned tone, have dealt with this issue many times in the past! You are not alone if you are experiencing dark spots from breakouts.  

You get rid of the pimple you had for maybe 1-2 weeks and are now left with a dark spot for several weeks, or even longer, and still have to cover that imperfection! 

How Can You Treat Post-Inflammatory Hyperpigmentation?

The first step is to treat the cause: acne & breakouts, while simultaneously treating the pigment.  If you’re currently still experiencing breakouts, it’s important to come up with a treatment plan with your skincare professional to ensure the cycle of breakouts and post-inflammatory hyperpigmentation discontinues. 

Depending on the severity of the post-inflammatory hyperpigmentation on your skin, at-home treatments and topicals, such as a good Vitamin C serumexfoliator, glycolic treatments, or retinol can simply help clear the post-inflammatory hyperpigmentation within a few weeks.

Because post-inflammatory hyperpigmentation occurs in the papillary dermis, that’s where these at-home treatments come into play.  For example, an at-home exfoliator allows you to remove the stratum corneum (dead skin cells and the outermost layer of the epidermis) by overturning your epidermal skin cells more quickly. 

Shedding this skin allows for new skin cells to produce and others to heal quicker.  I also love a good Vitamin C Serum to not only help maintain your overall skin health with the amazing antioxidant & protecting benefits, but some vitamin c serums contain ingredients like Arbutin & Mushroom Extract, which help to brighten the skin and correct uneven skin tone. My favorite go-to vitamin C serum is the Super Serum by iS Clinical.  By protecting against the environment aggressors and with a high dose of l-ascorbic acid, this is also a good serum for more breakout-prone skin. 

For more severe cases, in addition to the at-home products listed, your skin care professional may recommend light to medium chemical peels, microdermabrasion, or even microneedling to help break up the hyperpigmentation. 

Luckily, post-inflammatory hyperpigmentation is not a scar that will remain in the skin and does not actually damage the tissues. It is temporary and can be easily treated with your skincare professional’s help. 

Stay tuned for more blogs on post-inflammatory hyperpigmentation, more breakdown on in-office treatments to treat post-inflammatory hyperpigmentation, their downtime, and what to expect.

If you have post-inflammatory hyperpigmentation, chat with a Pomp esthetician to learn more about it and what products may be best for your skin type, and how to treat it at home.

Andrea McCollough
POMP Aesthetician
Owner/Operator of AM Aesthetics, LLC