Understanding Post Inflammatory Hyperpigmentation (PIH)
Post inflammatory hyperpigmentation (PIH) refers to darkened patches on the skin that occur after an inflammatory skin condition, skin injury or other form of skin trauma. PIH can occur after inflammatory acne, eczema, psoriasis, contact dermatitis, atopic dermatitis or infections.
What Causes Post Inflammatory Hyperpigmentation?
When skin is damaged or inflamed through cuts, burns, acne, infections or other skin conditions, the body produces more melanin in that area as part of the healing process. This overproduction of melanin leads to hyperpigmented spots that show up darker than surrounding skin.
Risk Factors for Developing PIH
Those with darker skin tones are at higher risk since deeper skin layers already contain more melanin. Hormonal changes, genetics, excessive sun exposure, smoking and aging can also increase susceptibility. The severity depends on extent of inflammation and skin damage.
Appearance of PIH on Skin
PIH lesions appear as patches or spots darker than surrounding skin. They may be light to dark brown, red, black or purple in color. They can appear anywhere inflammation or skin trauma occurred but frequently show up on the face, neck, shoulders, upper chest or back.
Typical PIH Symptoms
Since PIH is a skin discoloration condition, visual spots and skin darkening are the primary symptoms. However, patients may also experience some sensations like:
Changes in Skin Texture
Areas with PIH may feel rougher or more uneven compared to surrounding skin. This texture change along with color change can make spots more noticeable visually.
Minor Itching or Burning
There may be mild accompanying itch or irritation localized around hyperpigmented patches. As the spots fade, any discomfort typically diminishes as well.
Self-Consciousness
Discolored lesions can lead some people to feel embarrassed, self-conscious and affect self-confidence and body image, especially if located prominently like the face or neck.
Treatments to Lighten and Remove PIH
When PIH occurs after acute skin inflammation or damage, it may fade gradually over 6 to 24 months on its own as skin heals. However active treatment can speed up lightening hyperpigmented spots.
Over-the-Counter Brightening Creams
Hydroquinone, kojic acid, vitamin C, niacinamide and retinol can inhibit melanin production and exfoliate skin to quicken fading of discoloration when applied topically to affected areas.
Professional Chemical Peels
In-office chemical peels with glycolic acid or salicylic acid can accelerate cell turnover to remove darker skin cells so newer cells with less melanin take their place.
Laser Resurfacing Procedures
Laser treatment uses concentrated beams of light to eliminate damaged skin layers where excess melanin has accumulated to reveal healthier skin underneath.
Lifestyle Adjustments to Speed Healing
Supporting your skin internally while treating externally can optimize recovery and minimize PIH recurrence. Key self-care strategies include:
Avoid Further Skin Inflammation
Be gentle with skin prone to PIH - avoid picking/popping acne, minimize harsh scrubs or products with drying alcohol, and shave carefully. This prevents worsening existing spots or triggering new ones.
Use Broad Spectrum Sunscreen
Protect all skin from UV exposure which exacerbates hyperpigmentation. Apply SPF 30+ sunscreen twice daily year-round to inhibit further melanin production.
Eat More Vitamin C and Antioxidants
Get plenty of vitamin C from citrus, bell peppers, broccoli, strawberries and supplements to support collagen formation. Foods with antioxidants like pomegranates, blueberries, spinach and tomatoes fight inflammation.
When to Seek Medical Care
In most cases PIH will slowly improve over time, but seek qualified dermatology care if you experience:
Minimal Fading After 12 Months
Spots unchanged for over a year may need prescription strength brighteners, chemical peels or laser therapy to reverse stubborn hyperpigmentation.
Spreading Skin Discoloration
Expanding dark patches could indicate a more serious underlying condition requires diagnosis like melasma, actinic keratosis or melanoma.
Post Inflammatory Hyperpigmentation Pictures
Here are pictures demonstrating typical PIH appearance, progression and resolution with treatment over time:
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How can I tell if skin spots are PIH or something more serious?
Look at when spots appeared - PIH arises after clear inflammatory skin conditions or injury. Suspicious marks with irregular borders that aren't linked to an inciting cause warrant inspection. Have a dermatologist evaluate any concerning spots.
Can wearing makeup make PIH worse?
Heavy makeup layers may irritate and inflame skin more leading to excess pigment production. Use non-comedogenic options sparingly only where needed until spots heal. Remove gently and thoroughly each night.
Will PIH completely go away or leave permanent scarring?
In most patients, diligent skincare both internally and externally helps PIH lesions eventually fade and resolve fully. However, some deep scars or textural changes may remain permanently from significant inflammation.
What home remedies can I try to treat PIH spots?
Proven DIY approaches include lemon juice fades to inhibit melanin formation, aloe vera or apple cider vinegar soaks reduce inflammation, gentle exfoliating scrubs with sugar or oatmeal, and masking with turmeric paste or honey overnight.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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