Post-Inflammatory Hyperpigmentation – What You Need to Know

Are you struggling with dark spots and splotches on your skin? If so, you may be suffering from post-inflammatory hyperpigmentation. PIH appears on the skin surface as flat areas of purple, brown, or tan (sometimes with a blue or gray tint). It often occurs in areas of the skin that have been irritated or damaged, like acne pimples or a bug bite.

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Post-inflammatory hyperpigmentation is the dark spots that form on the skin after an inflammation or injury. It can occur with any skin condition but is more common and severe in people with darker complexions. It usually looks like light to dark brown macules or patches that vary in size and shape. It can also appear white, pink, red, purple, blue-gray, or brown, depending on the location and depth of the discoloration. Post-inflammatory hyperpigmentation can be caused by acne, eczema (atopic dermatitis), psoriasis, allergic reactions, infections, insect bites, and burns. It can even develop from a hormone change, like during pregnancy or when using birth control pills.

The resulting spots are darker than the surrounding skin because they’re loaded with melanin. Melanosome-laden macrophages, the cells that carry pigment, move from the epidermis to the dermis and deposit the pigment in response to an inflammatory process. Eventually, the color fades once the inflammation is gone, but the spots can take months or years to disappear fully.

The most common causes of PIH are psoriasis, atopic dermatitis, and acne. They can all cause PIH by irritating or damaging the skin and triggering an immune response that leads to the formation of new dark spots. Certain medications, such as oral steroids, retinoids, and birth control pills, can also trigger it. 


Inflammation can cause the pigment-producing cells in your skin to go into overdrive, leading to dark spots that remain long after a wound has healed. These discolorations are known as PIH (post-inflammatory hyperpigmentation). Skin trauma is often the culprit, including acne, cuts, scrapes, bug bites, or even friction from vigorous rubbing. Typically, PIH is brown in complexion but can also be red-toned depending on your skin tone and the type of injury.

Typically, a dermatologist can diagnose PIH by looking at the affected area. They will ask you about any other inflammatory skin conditions that might be present, like eczema or psoriasis. They may use a Wood’s lamp to assess the level of the pigmentation (epidermal or dermal) and how it is distributed. PIH is more common in people with darker skin but can affect all skin types. Usually, the dark marks fade with time, but this can take weeks or months. You can speed up the process by using skincare ingredients that encourage skin cell turnover and reduce the formation of additional melanin. For example, products that contain Liquorice Root extract are a good choice because they have anti-inflammatory properties to soothe irritated skin. You can also use skincare formulated with Vitamin C, which brightens the skin and fades discoloration. Also, be sure to use sunscreen to prevent sun damage and further darkening of your blemishes!


Post-inflammatory hyperpigmentation (PIH) is characterized by flat, tan, brown, or even black spots on the skin. It usually appears after an inflammatory condition, such as acne, eczema, insect bites, cold sores, and other skin diseases or injuries like cuts or burns. PIH can also occur due to certain medications, such as tetracycline antibiotics or antimalarial drugs. It is more common in those with darker complexions since the melanocytes in those skin tones produce more pigment.

PIH can be very difficult to treat because the discoloration is usually caused at the epidermal level of the skin, and it can be hard to get to those spots with regular topicals. Dermatologists are familiar with this problem and can diagnose it by visually assessing the skin. They may use a Wood’s lamp to help them see into the layers of the skin and locate the spot where the hyperpigmentation is residing.

Once a doctor determines the cause of the PIH, they can recommend treatments that will fade it. This can include topical medications, such as tretinoin and hydroquinone, chemical peels, laser therapy, micro needling, or a combination. 


The dark spots associated with inflammation tend to fade, though they can take months or even years. However, They may reappear and are more common in darker skin tones.

PIH can appear as macules or patches with a blue-grey tint, usually light to dark brown, purple, or tan. It can form after an inflammatory condition such as acne, burns, or insect bites. It can also form after a trauma to the skin, such as an accident, surgery, or a cut. PIH can also be caused by a chronic skin condition such as pseudofolliculitis barbae (PFB), an inflammatory condition of the hair follicles often found in people with darker complexions. PIH can be prevented by avoiding the triggers that cause it.

This includes avoiding sun exposure, wearing clothing that covers the skin, and using a broad-spectrum sunscreen with an SPF of 30 or higher when exposed to the sun. Keeping skin clean and using a mild exfoliant can help keep pores clear of dirt, oil, and dead cells that can lead to inflammation. Refraining from picking or scrubbing at blemishes, scars, or other discolorations can help prevent PIH from worsening. Avoiding inflammatory foods and eating a healthy diet can also reduce the risk of developing PIH. Taking anti-aging supplements such as niacinamide and retinol can also help.

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