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Ask our Doctors

Skin Renewal Doctors all have a broad knowledge, background and passion for aesthetic medicine. Please feel free to ask them your questions and concerns.

Conditions
Conditions

Post Inflammatory Hyperpigmentation - Dark Skin

Pigmentation and Post Inflammatory Hyperpigmentation (PIH) is a common problem, particularly in dark skin types. This also includes patients of mixed backgrounds who have more darkly pigmented skin. People with darker skin tones are prone to certain skin problems. One of the most common is hyperpigmentation, or dark spots. These spots are caused by an insult to deeply pigmented skin, such as acne, a cut, or a disorder such as psoriasis or eczema.
Videos on Hyperpigmentation in Dark Skin Types

Most often, PIH occurs due to acne lesions being picked, scratched, squeezed, and the injured skin being exposed to light. Another common occurrence in male patients is shaving rash or ingrown beard that has been scratched, scrubbed or treated with harsh products, resulting in discolouration in the beard area.

The skin produces pigment in these areas, a protective mechanism, but unfortunately, this leaves the patient looking awful and seeking help to cure this issue.

Treating PIH

Thankfully, the treatment options and technology exist to treat PIH and pigmentation, and there are fantastic options available, even for dark skin patients:

frequently asked
questions

Is treatment for PIH in Dark Skin Types available at all Skin Renewal branches?
How can one prevent Post-inflammatory hyperpigmentation PIH from forming in darker skin types?

Skin Renewal is pleased to be able to offer the “something” missing in conventional fading creams. The following new topicals are available at Skin Renewal and can be used on ALL Skin types.

  • At Skin Renewal we offer the gold Standard for pigmentation, Hydroquinone which is available on prescription. The use of HQ is strictly controlled at Skin Renewal.
  • To prevent sensitivity from Hydroquinone, we include products which prevent the irritation that occurs with HQ in our prescription pigmentation corrective creams.
  • We offer the highly effective depigmentation topical creams: Dermamelan Maintenance Cream and Cosmelan 2
  • We offer pigmentation serums with recent advances in pigmentation technology-pigmentation peptides in our home care products. This includes the Brighter Concentrate and Luminesce ranges by Lamelle. Brighter concentrate uses peptide technology to reduce melanin at eight points in its production, as opposed to just one point as with other traditional lightening treatments.
  • Lymixyl, decapeptide pigmentation topical , developed at Stanford University is also available
  • Pigmentation ranges by top cosmeceuticals houses Neostrata are available at all Skin Renewal branches.
  • In House topical brightening agents have been specially developed for Skin Renewal. The Skin Renewal brand includes traditional brightening products such as Kojic, Arbutin, Nicotinamide amongst others.
  • Topical anti oxidants that protect against infra red A, a newly discovered deep wavelength which causes accelerated ageing and pigmentation, is also available at all Skin Renewal branches.
  • At Skin Renewal it is mandatory that one of the home brightening products mentioned above be used routinely for 2 weeks on the entire problem area before any exfoliation treatment is done such as peels. A visit to one of our doctors who are experienced in treating skin of colour is mandatory before any procedure. The cost of the consultation will be redeemed after your first peel/treatment at Skin Renewal.

In Office Treatments available at Skin Renewal;

  • Superficial peels. At Skin Renewal we have twenty different kinds of superficial peels on offer which improve pigmentation. With a series of peels you can quickly achieve substantial improvement in the uneven pigmentation, while making your skin look and feel softer, smoother, and more radiant. Please see our peel chart which indicates which peels can be done on your skin type.
  • The Yellow peel is a full epidermal peel for PIH that is resistant to treatment with normal superficial AHA and BHA peels.
  • Transdermal Mesotherapy with prescription Brightening products done straight after our peels improves the final result by removing deep dermal pigment.
  • Cosmelan and Dermamelan mask treatments together with the home maintenance products offer superior results for resistant pigmentation.
  • Laser Genesis: The epidermis renews itself every six weeks, by six months, any pigment from PIH is probably in the dermis. Traditional skin rejuvenation treatments such as peels, microdermabrasion and bleaching agents are not successful for pigment such as PIH that has leached into the dermis. That is when the use of certain lasers such as the long pulsed Nd Yag become effective to safely treat darker skin including skin type 6. The Laser Genesis procedure by Cutera gently heat the dermis, causing cavitation bubbles, which disrupt the unwanted dermal pigment, breaking it into smaller particles which are able to move upward to the epidermis where it can be easily removed with exfoliation.
  • PDT Red Light post peel reduces inflammation and evens out skin tone.
  • Our Brightening Intravenous infusions with brightening anti oxidants such as glutathione which work intracellularly to remove resistant pigment. An overall lighter and even skin tone can be expected.


"I have dark marks on my thighs caused by ringworms, I would like to know what I can use to clear them away? The marks basically look like I had a sore that left a mark."

What we need to know for sure to be able to help you is the following:

1) Is the ringworm completely cleared?

2) Are the marks completely flat and smooth? OR

3) Are the marks uneven (raised or sunken) and do they have a different texture to the surrounding skin? If the marks are smooth and feel the same as the surrounding skin, then we need to deal with your case as PIH (Post Inflammatory Hyperpigmentation). If the marks are raised or sunken or differing in texture the chances are that there may be a bit of scarring and so we would need to follow a slightly different approach, based on the severity of the scarring. In order to have any success with helping you, we need to know exactly what we are dealing with. 

I am a 28 year old Lady and I have a problem with dark spots left from acne so my face has some really bad marks. I also battle with bad stretch marks on my belly after having my first child. I have tried everything you can think of to help get rid of them. And now its affecting my self confidence, what would you recommend.

Marks left on the skin after an acne breakout is commonly known as PIH, Post Inflammatory Hyperpigmentation. These pigmentation spots form due to the inflammatory response that occurred in the area. The good news is that these marks are quite easy to treat as this pigment normally lies superficially in the skin. There are 3 steps to treating these spots ; 1. Daily use of an SPF 50, unprotected sun exposure will induce more pigment to form and the spot may become darker. We recommend Heliocare 360, this SPF will not only protect your skin from UVA and UVB, but also from visible and infra-red light. 2. We need to speed up your cellular turnover rate, to get the pigment out. This can be done by the use of exfoliating ingredients such as Retinol or AHA’s (Alpha Hydroxy Acids). 3. We need to ensure that the pigment cells don’t produce any more pigment. This is done by the use of pigment suppressing ingredients. So, in a nut shell we need to Protect, Exfoliate and Suppress.

The Neostrata Enlighten range will suit your skin, not only is the main ingredients in this range pigment suppressors, but is also contains AHA’s and Retinol to speed up the cellular turnover. I would also recommend that you visit a Skin Renewal branch, one of our Medical professionals can do a thorough skin analysis and also make their recommendation with regards to homecare products as well as in clinic treatments, such as chemical peel, laser therapy as well as skin needling.

 

As for the stretchmarks, when our bodies go through sudden weight gain or weight loss, our dermis (the deeper layer of our skin) tear and this shows as stretchmarks on the skin. We need to increase collagen production in the area to rebuild the dermis again. Carboxy therapy is an excellent treatment option for this as it encourages collagen induction in the area. Carboxy can be combined with Laser genesis to improve the appearance of the skin in the area. Skin Needling is also a good option to stimulate new collagen production by releasing certain growth factors and encouraging our bodies own wound healing response. It is important to note that multiple sessions may be needed to get the desired result. I would recommend that you visit one of the Skin Renewal branches to have a thorough consultation, from there we can customize a treatment plan for your needs and budget.

 

Im an 18 year old male and have been bleaching for the past month to deal with my dark marks, after stopping I noticed it left dark grey spots on my face which are only getting darker. I'm really afraid of what the outcome could be. Is there any way to deal with this? Will later treatment work?

In a case like this, it would really be very helpful for us to be able to see what your skin looks like and see exactly what we’re dealing with. We have to assess the extent and the depth of the damage that has occurred in order to be able to help you correctly. Unfortunately in a case like this, you could be developing PIH and the best immediate advice I can give you is to ensure that you are doing the following 3 things until we can see you or at least look at your problem more closely:

1) You need to be applying a good facial SPF every day 

2) You need to be using a pigmentation inhibitor to prevent more pigment from being produced in those areas; and lastly, you need to make sure that your skin’s barrier is functioning properly in order to ensure that you aren’t developing inflammation which would worsen the problem, so something that is gentle and moisturising and will soothe and hydrate the skin is also very important. 

Our online store can help you with a variety of product options to consider should you wish to start with topicals before considering any further treatment. Definitely, do not continue applying bleaching agents to the skin as these can be very damaging. 

I am a 26 year old female & recently went to a dermatologist to treat pigmentation in the inner parts of my eyes down to the sides of my nostrils as a result of itching due to sinusitis & allergies, which I have suffered from all my life. I was advised to see an ENT specialist to advise on the underlying cause as the pigmentation is a result of allergies. What are my treatment options & can I stop the itching?

In most cases like this, the pigmentation is caused by constant scratching or rubbing or the constant use of tissue paper to wipe and blow the nose. What course of action to take as far as treatment goes, would depend on how severe the pigmentation is, so I would need to examine the area or at least see a picture to be able to advise you better. You need to remember that the pigmentation will simply re-occur as long as the trigger is still there. The ENT would most likely be able to advise you regarding the treatment and management of your sinus issue. If you can get that under control, and get the itching under control as a result, you are going to have more success in targeting the pigmentation. To start off with, I would simply advise that you begin by ensuring you are using a very good facial SPF every day, and that you are using a good pigmentation inhibiting product morning and night. That will at least be a good starting point. 

How can i get rid of hyper pigmentation on my nose and cheeks? Its very dark plz and I'm light in complexion.

Pigmentation is quite tricky, because in order to treat it, you need to know if it is dermal, superficial, hormonal or a combination. So it’s quite difficult to help you if we do not know what we are dealing with. The best course of action is to have a thorough consult which takes into account an examination of your skin and a collection of your medical history so that the likely cause may be established and the right course of treatment prescribed. There is nothing more disheartening than spending loads of money on pigmentation products and treatments, only to find that you are not using the correct products for the type of pigmentation that you have and therefore get no result. Rather invest your money in finding the right answers and starting on the correct treatment plan from the get go. 

I used toothpaste to get rid of the acne around my nose for 3 nights. But now it caused burning and irritation. That area is now dry and wrinkly and it's peeling. The skin has also turned darker. I've read about so many remedies but I don't know which one works best for my skin. I have sensitive skin and I'm black girl. What natural remedies can I use to solve my problem, preferably using ingredients I can find at home or that are sold cheaply and if I don't do anything about it, how long would it take to heal on its own?

Unfortunately, toothpaste is not very good for the skin at all, as it can be mildly abrasive, given the fact that it is made to clean your hard teeth. So unfortunately, what has happened is that you have stripped the skin of its barrier where the toothpaste has been applied, and then you get an inflammatory response in that area and then this develops into post inflammatory hyperpigmentation as a result of this. If the skin is still peeling, I would suggest applying a VERY thin layer of Vaseline to create a “temporary barrier” in that area (just for a day or 2), followed by a good SPF. If you are wanting to prevent dark marks from forming on your skin then it is vital to at LEAST use a good SPF every single day. If you simply want a very cost effective "multi-purpose" moisturiser, I would suggest you in vest in a good facial SPF to use every morning. Good quality facial SPF products moisturise and protect the skin and prevent dehydration. Once your skin is healed, I would suggest you reassess what it looks like and then take it from there.

Frequently asked questions

Is treatment for PIH in Dark Skin Types available at all Skin Renewal branches?
How can one prevent Post-inflammatory hyperpigmentation PIH from forming in darker skin types?

Skin Renewal is pleased to be able to offer the “something” missing in conventional fading creams. The following new topicals are available at Skin Renewal and can be used on ALL Skin types.

  • At Skin Renewal we offer the gold Standard for pigmentation, Hydroquinone which is available on prescription. The use of HQ is strictly controlled at Skin Renewal.
  • To prevent sensitivity from Hydroquinone, we include products which prevent the irritation that occurs with HQ in our prescription pigmentation corrective creams.
  • We offer the highly effective depigmentation topical creams: Dermamelan Maintenance Cream and Cosmelan 2
  • We offer pigmentation serums with recent advances in pigmentation technology-pigmentation peptides in our home care products. This includes the Brighter Concentrate and Luminesce ranges by Lamelle. Brighter concentrate uses peptide technology to reduce melanin at eight points in its production, as opposed to just one point as with other traditional lightening treatments.
  • Lymixyl, decapeptide pigmentation topical , developed at Stanford University is also available
  • Pigmentation ranges by top cosmeceuticals houses Neostrata are available at all Skin Renewal branches.
  • In House topical brightening agents have been specially developed for Skin Renewal. The Skin Renewal brand includes traditional brightening products such as Kojic, Arbutin, Nicotinamide amongst others.
  • Topical anti oxidants that protect against infra red A, a newly discovered deep wavelength which causes accelerated ageing and pigmentation, is also available at all Skin Renewal branches.
  • At Skin Renewal it is mandatory that one of the home brightening products mentioned above be used routinely for 2 weeks on the entire problem area before any exfoliation treatment is done such as peels. A visit to one of our doctors who are experienced in treating skin of colour is mandatory before any procedure. The cost of the consultation will be redeemed after your first peel/treatment at Skin Renewal.

In Office Treatments available at Skin Renewal;

  • Superficial peels. At Skin Renewal we have twenty different kinds of superficial peels on offer which improve pigmentation. With a series of peels you can quickly achieve substantial improvement in the uneven pigmentation, while making your skin look and feel softer, smoother, and more radiant. Please see our peel chart which indicates which peels can be done on your skin type.
  • The Yellow peel is a full epidermal peel for PIH that is resistant to treatment with normal superficial AHA and BHA peels.
  • Transdermal Mesotherapy with prescription Brightening products done straight after our peels improves the final result by removing deep dermal pigment.
  • Cosmelan and Dermamelan mask treatments together with the home maintenance products offer superior results for resistant pigmentation.
  • Laser Genesis: The epidermis renews itself every six weeks, by six months, any pigment from PIH is probably in the dermis. Traditional skin rejuvenation treatments such as peels, microdermabrasion and bleaching agents are not successful for pigment such as PIH that has leached into the dermis. That is when the use of certain lasers such as the long pulsed Nd Yag become effective to safely treat darker skin including skin type 6. The Laser Genesis procedure by Cutera gently heat the dermis, causing cavitation bubbles, which disrupt the unwanted dermal pigment, breaking it into smaller particles which are able to move upward to the epidermis where it can be easily removed with exfoliation.
  • PDT Red Light post peel reduces inflammation and evens out skin tone.
  • Our Brightening Intravenous infusions with brightening anti oxidants such as glutathione which work intracellularly to remove resistant pigment. An overall lighter and even skin tone can be expected.


"I have dark marks on my thighs caused by ringworms, I would like to know what I can use to clear them away? The marks basically look like I had a sore that left a mark."

What we need to know for sure to be able to help you is the following:

1) Is the ringworm completely cleared?

2) Are the marks completely flat and smooth? OR

3) Are the marks uneven (raised or sunken) and do they have a different texture to the surrounding skin? If the marks are smooth and feel the same as the surrounding skin, then we need to deal with your case as PIH (Post Inflammatory Hyperpigmentation). If the marks are raised or sunken or differing in texture the chances are that there may be a bit of scarring and so we would need to follow a slightly different approach, based on the severity of the scarring. In order to have any success with helping you, we need to know exactly what we are dealing with. 

I am a 28 year old Lady and I have a problem with dark spots left from acne so my face has some really bad marks. I also battle with bad stretch marks on my belly after having my first child. I have tried everything you can think of to help get rid of them. And now its affecting my self confidence, what would you recommend.

Marks left on the skin after an acne breakout is commonly known as PIH, Post Inflammatory Hyperpigmentation. These pigmentation spots form due to the inflammatory response that occurred in the area. The good news is that these marks are quite easy to treat as this pigment normally lies superficially in the skin. There are 3 steps to treating these spots ; 1. Daily use of an SPF 50, unprotected sun exposure will induce more pigment to form and the spot may become darker. We recommend Heliocare 360, this SPF will not only protect your skin from UVA and UVB, but also from visible and infra-red light. 2. We need to speed up your cellular turnover rate, to get the pigment out. This can be done by the use of exfoliating ingredients such as Retinol or AHA’s (Alpha Hydroxy Acids). 3. We need to ensure that the pigment cells don’t produce any more pigment. This is done by the use of pigment suppressing ingredients. So, in a nut shell we need to Protect, Exfoliate and Suppress.

The Neostrata Enlighten range will suit your skin, not only is the main ingredients in this range pigment suppressors, but is also contains AHA’s and Retinol to speed up the cellular turnover. I would also recommend that you visit a Skin Renewal branch, one of our Medical professionals can do a thorough skin analysis and also make their recommendation with regards to homecare products as well as in clinic treatments, such as chemical peel, laser therapy as well as skin needling.

 

As for the stretchmarks, when our bodies go through sudden weight gain or weight loss, our dermis (the deeper layer of our skin) tear and this shows as stretchmarks on the skin. We need to increase collagen production in the area to rebuild the dermis again. Carboxy therapy is an excellent treatment option for this as it encourages collagen induction in the area. Carboxy can be combined with Laser genesis to improve the appearance of the skin in the area. Skin Needling is also a good option to stimulate new collagen production by releasing certain growth factors and encouraging our bodies own wound healing response. It is important to note that multiple sessions may be needed to get the desired result. I would recommend that you visit one of the Skin Renewal branches to have a thorough consultation, from there we can customize a treatment plan for your needs and budget.

 

Im an 18 year old male and have been bleaching for the past month to deal with my dark marks, after stopping I noticed it left dark grey spots on my face which are only getting darker. I'm really afraid of what the outcome could be. Is there any way to deal with this? Will later treatment work?

In a case like this, it would really be very helpful for us to be able to see what your skin looks like and see exactly what we’re dealing with. We have to assess the extent and the depth of the damage that has occurred in order to be able to help you correctly. Unfortunately in a case like this, you could be developing PIH and the best immediate advice I can give you is to ensure that you are doing the following 3 things until we can see you or at least look at your problem more closely:

1) You need to be applying a good facial SPF every day 

2) You need to be using a pigmentation inhibitor to prevent more pigment from being produced in those areas; and lastly, you need to make sure that your skin’s barrier is functioning properly in order to ensure that you aren’t developing inflammation which would worsen the problem, so something that is gentle and moisturising and will soothe and hydrate the skin is also very important. 

Our online store can help you with a variety of product options to consider should you wish to start with topicals before considering any further treatment. Definitely, do not continue applying bleaching agents to the skin as these can be very damaging. 

I am a 26 year old female & recently went to a dermatologist to treat pigmentation in the inner parts of my eyes down to the sides of my nostrils as a result of itching due to sinusitis & allergies, which I have suffered from all my life. I was advised to see an ENT specialist to advise on the underlying cause as the pigmentation is a result of allergies. What are my treatment options & can I stop the itching?

In most cases like this, the pigmentation is caused by constant scratching or rubbing or the constant use of tissue paper to wipe and blow the nose. What course of action to take as far as treatment goes, would depend on how severe the pigmentation is, so I would need to examine the area or at least see a picture to be able to advise you better. You need to remember that the pigmentation will simply re-occur as long as the trigger is still there. The ENT would most likely be able to advise you regarding the treatment and management of your sinus issue. If you can get that under control, and get the itching under control as a result, you are going to have more success in targeting the pigmentation. To start off with, I would simply advise that you begin by ensuring you are using a very good facial SPF every day, and that you are using a good pigmentation inhibiting product morning and night. That will at least be a good starting point. 

How can i get rid of hyper pigmentation on my nose and cheeks? Its very dark plz and I'm light in complexion.

Pigmentation is quite tricky, because in order to treat it, you need to know if it is dermal, superficial, hormonal or a combination. So it’s quite difficult to help you if we do not know what we are dealing with. The best course of action is to have a thorough consult which takes into account an examination of your skin and a collection of your medical history so that the likely cause may be established and the right course of treatment prescribed. There is nothing more disheartening than spending loads of money on pigmentation products and treatments, only to find that you are not using the correct products for the type of pigmentation that you have and therefore get no result. Rather invest your money in finding the right answers and starting on the correct treatment plan from the get go. 

I used toothpaste to get rid of the acne around my nose for 3 nights. But now it caused burning and irritation. That area is now dry and wrinkly and it's peeling. The skin has also turned darker. I've read about so many remedies but I don't know which one works best for my skin. I have sensitive skin and I'm black girl. What natural remedies can I use to solve my problem, preferably using ingredients I can find at home or that are sold cheaply and if I don't do anything about it, how long would it take to heal on its own?

Unfortunately, toothpaste is not very good for the skin at all, as it can be mildly abrasive, given the fact that it is made to clean your hard teeth. So unfortunately, what has happened is that you have stripped the skin of its barrier where the toothpaste has been applied, and then you get an inflammatory response in that area and then this develops into post inflammatory hyperpigmentation as a result of this. If the skin is still peeling, I would suggest applying a VERY thin layer of Vaseline to create a “temporary barrier” in that area (just for a day or 2), followed by a good SPF. If you are wanting to prevent dark marks from forming on your skin then it is vital to at LEAST use a good SPF every single day. If you simply want a very cost effective "multi-purpose" moisturiser, I would suggest you in vest in a good facial SPF to use every morning. Good quality facial SPF products moisturise and protect the skin and prevent dehydration. Once your skin is healed, I would suggest you reassess what it looks like and then take it from there.

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