Conditions

PIH

Post-inflammatory hyperpigmentation (PIH) is a common skin condition characterised by flat, dark patches or dark marks or spots after skin inflammation or injury. While PIH can affect all skin types, it is more prevalent and severe in individuals with darker skin tones (Fitzpatrick skin types III-VI). These dark patches, ranging from brown or black, result from excess melanin production due to trauma such as acne, burns, or insect bites. Various treatments and preventive measures can help manage and reduce the appearance of PIH, ensuring clearer and more even-toned skin.

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Three Types of Pigmentation

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Understanding and addressing PIH can help individuals, especially those with darker skin tones, achieve clearer, more even-toned skin. With the right treatments and preventive measures, managing PIH becomes more effective and less daunting. At Skin Renewal, our doctor-led approach ensures that we provide you with a customised treatment solution for optimal results.

What Are The Causes of PIH?

Several factors can contribute to the development of PIH, including:

Acne Vulgaris
Atopic Dermatitis
Impetigo
Contact Dermatitis
Psoriasis
Lichen Planus
Insect Bites
Burns
Laser Treatments
Chemical Peels
Cryotherapy
Injury to the skin

How PIH Affects Dark Skin

PIH is particularly prevalent in darker skin types, including individuals of mixed backgrounds with darker pigmentation. Darker skin tones are more susceptible to hyperpigmentation or dark spots due to insults to deeply pigmented skin. Common triggers include acne, cuts, psoriasis, or eczema. Additionally, shaving rash or ingrown hairs treated harshly in male patients can lead to discolouration in the beard area.

Treatment Options for PIH at Skin Renewal

While PIH often resolves on its own, this process can take months or even years. Several treatment options can help accelerate the fading of these discoloured patches:

Topical Treatments:

Azelaic Acid: Reduces pigmentation and inflammation.
Retinoids: Promote skin turnover and reduce pigmentation.
Vitamin C: Brightens the skin and reduces pigmentation.
Niacinamide: Prevents melanin transfer and reduces discolouration.

Advanced Procedures:

Chemical Peels: These exfoliate the skin and reduce pigmentation.
Laser Treatments: Targets and breaks down hyperpigmented areas.
Microdermabrasion with TA (Tranexamic Acid): Exfoliates and reduces pigmentation.
Transdermal Mesotherapy with TA (Tranexamic Acid): This delivers active ingredients directly into the skin.
Photodynamic Therapy (PDT) with TA (Tranexamic Acid): Uses light-activated compounds to treat pigmentation.
Dermapen with TA (Tranexamic Acid): Microneedling to enhance skin absorption of active ingredients.

Deep Treatments for Severe PIH:

Endymed FSR (Fractional Skin Resurfacing): Resurfaces the skin and reduces deep pigmentation.
MesoBrite: Brightening treatment for pigmentation.
Brightening IV Infusions: Glutathione and Vitamin C infusions to brighten the skin from within.

Importance of Sun Protection

Sun protection is crucial in managing and preventing further PIH. Broad-spectrum sunscreens should be used daily to prevent the darkening of existing hyperpigmented areas and protect the skin from UV-induced pigmentation.

Types Of Pigmentation

Skin Pigmentation Disorder	Description	Common Triggers	Affected Areas
Freckles (Ephelides)	Small, flat brown spots that appear after repeated sun exposure, especially in people with fair skin. They tend to become darker in summer and fade in winter. In fair skins and particularly blonde/red haired individuals, some are born with a predisposition for developing freckles.	Sun exposure/Genetics	Common on face, shoulders, and arms
Age Spots (Solar Lentigines)	Flat, tan, brown, or black spots with a distinct edge that occur due to sun exposure over many years.	Prolonged sun exposure	Common on sun-exposed areas like the face, hands, and arms
Melasma	Larger patches of brown or greyish pigmentation, often on the face. It is more common in women and can be triggered by hormonal changes. Although rare, melasma can occur in men.	Hormonal changes (e.g., pregnancy, birth control pills)	Common on the face
Post-Inflammatory Hyperpigmentation	Darker spots or patches that occur after skin injury or inflammation from conditions like acne, eczema, or lupus.	Skin injury or inflammation	Can appear anywhere on the body
Albinism	A genetic condition resulting in little or no pigment in the skin, hair, and eyes due to lack of melanin production.	Genetic mutation	Entire body
Vitiligo	Patchy loss of skin pigmentation, resulting in irregular white patches on different areas of the body. It is an autoimmune disorder where melanocytes are destroyed.	Autoimmune disorder	Can appear on different areas of the body

frequently asked
questions

Are treatments for post-inflammatory hyperpigmentation available at all Skin Renewal clinics?

Treatments for post-inflammatory hyperpigmentation (PIH) are available in Gauteng at the Morningside, Parkhurst, Rosebank, Bedfordview, Fourways, West Rand, Irene, Waterfall, Irene, Lynnwood and Brooklyn clinics, as well as in the Western Cape at Cape Quarter, Claremont, Constantia, Century City, Stellenbosch, Paarl and Willowbridge clinics, and Kwa-Zulu Natal at the Ballito, Durban and Umhlanga clinics.

What causes post-inflammatory hyperpigmentation (PIH)?

Post-inflammatory hyperpigmentation (PIH) is caused by an excess production of melanin, the pigment that gives skin its colour, in response to inflammation or injury. Common triggers include acne, burns, insect bites, eczema, psoriasis, and skin treatments like laser therapy or chemical peels. This condition can affect all skin types but is more prevalent and severe in individuals with darker skin tones.

How can I prevent post-inflammatory hyperpigmentation (PIH)?

Preventing PIH involves managing the underlying causes of skin inflammation and protecting your skin from further injury. Key preventive measures include:

Avoid picking, scratching, or squeezing acne or other skin lesions.
Use gentle skin care products to avoid irritation.
Apply broad-spectrum sunscreen daily to protect your skin from UV damage.
Seek prompt treatment for inflammatory skin conditions like eczema or psoriasis.

Frequently asked questions