Post Inflammatory Pigmentation

Post Inflammatory Pigmentation At A Glance

  • Best Results2-6 treatments
  • Treatment RecoveryImmediate
  • Procedure Time5 to 10 minutes
  • Skin SpecialistDermal therapist, nurse, dermatologist
  • Duration of ResultsPermanent if controlled
  • AnaestheticNot required
  • Back to WorkImmediately
  • Cost$

Post Inflammatory Pigmentation

Post Inflammatory Pigmentation is darkening of skin due to inflammation. The most common cause is acne. With adequate sun protection, control of inflammation together with pigment reduction creams & lasers, the vast majority of PIH can be treated. Even with the very latest pico lasers, it takes 3-6 months for optional results.

FactsFacts on Post Inflammatory Pigmentation

  • The most common cause of PIH is acne
  • Effectively treating the cause will prevent recurrence
  • Sunscreens form the basis of management
  • Fading creams such as ascorbic, azelaic & Kojic acids may help
  • Lasers such as Spectra & Pico lasers can speed up pigment resolution
  • Peels can also improve pigmentation

What is PIH or Post Inflammatory Hyperpigmentation?

Post Inflammatory Pigmentation

PIH is a medical term to describe darkening of skin secondary to inflammation. The most common cause by far is acne. Other causes include eczema, dermatitis, chicken pox as burns from chemicals, lasers & IPL. The cause of PIH is over production of a compound called melanin by the pigment producing cells in your skin.

How long will it take pigmentation to go away?

About 6-12 months, however 50% will last longer than 12 months. 25% of these will take 5 years to resolve. The biggest mistake dermatologists see is the delay in achieving absolute control of the cause of pigmentation. In the vast majority of patients, the primary culprit is active acne.

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You have got to use SPF twice a day if you want me or my team to help you.

Why does acne cause post inflammatory pigmentation?

Inflammation from any cause can lead to PIH. In susceptible individuals that produce an exaggerated melanin response (usually ethnic – Asian skin types), PIH can be a sequelae.

The most important concept to understand is that you must prevent new lesions of acne, otherwise you will be frustrated (& broke) chasing your pigment. With lasers & topicals, my team will definitely fade PIH, what is beyond our control is the amount of new acne spots you may get in the future. For patients with PIH, control of acne must be absolute. Even if you get 5 spots per month & only 3 will lead to PIH, over a course of a year you will get 36 new spots. Get it?

Treating acne early & placing it into remission prevents long term acne scarring.

Who is prone to PIH or post inflammatory pigmentation?

Darker skin types including ethnicities such as Asians, South Americans, & Middle Easterners are more prone to pigmentation changes. This is because the pigment producing cell, called the melanocyte is more active. Additionally patients who love the sun or do not sun protect are more prone to pigment.

PIH is common in Asians, Middle Eastern & African ethnicities.

Davin’s Viewpoint on PIH and treatments

8 out of 10 patients I see will still have active background inflammation. Control MUST be absolute. Take acne for example, if you have 3 pimples per month but 2 ‘pigments’, over a year you will have 24 spots & in two years you will have nearly 50. Hence in darker skin types, control must be almost 100%. A medical dermatologist can help treat the cause of inflammation.

For PIH I normally start patients on a routing of pigment correctors such as HQ, or ascorbic, azelaic, Kojic mixed with arbutin & AHAs, in addition to tranexamic acid. My laser of choice is either Nano Spectra or the newer generation three Pico lasers (over older generation one Picosure). Regardless, most patients will require several treatments over 3-6 months.

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