Post‑Inflammatory Hyperpigmentation
Symptoms
Post‑inflammatory hyperpigmentation (PIH) manifests as flat brown or gray macules at sites of prior inflammation or injury. Lesions match the shape of the initial insult and can persist for months. Darker skin types exhibit more pronounced PIH. Sun exposure darkens lesions further. PIH itself is asymptomatic.
Cause
Inflammation from acne, eczema, burns, or procedures increases melanocyte activity and melanin dispersion into the epidermis or dermis. Dermal pigment appears gray‑brown and fades slowly. Trauma‑induced oxidative stress stimulates melanogenesis. UV exposure sustains hyperpigmentation. In darker skin, melanosomes are larger and more reactive, making PIH more common.
Treatment
Sun protection and avoidance prevent further darkening. Topical agents like hydroquinone, azelaic acid, and retinoids lighten epidermal pigment over time. Chemical peels, fractional lasers, or IPL accelerate clearance but carry risk of worsening pigmentation if overused. Patience is required, as improvement may take 3‑12 months. Treating underlying inflammatory conditions prevents new PIH.
Dr. Beth Schulz-Butulis
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.