How to Fade Hyperpigmentation (and what causes it?)

Blemishes can leave behind a variety of different types of scars. As if having pimples and/or other skin issues isn’t bad enough, you then have to deal with scars after you’ve finally cleared up the issue?

Unfortunately, the human body has its own way of tending to tissue that has been damaged, and scarring is one part of this process. One particularly annoying type of scar left behind is known as post-inflammatory hyperpigmentation (PIH). If you’re looking for answers about those dark scars that have been left behind after pimples, then you’ve come to the right place.

Here’s the rundown of what this type of scar is, and how it is caused.

What is Post-Inflammatory Hyperpigmentation?

So, what exactly causes post-inflammatory hyperpigmentation? Post-inflammatory hyperpigmentation (PIH) is the medical term for the skin discoloration that occurs after an inflammatory wound (like a pimple that leaves scars). This is your skin’s natural response to this kind of injury, and it is fairly common to see these dark spots or marks after having a blemish. Also referred to as “macules,” post-inflammatory hyperpigmentation is a flat area of darkened/discolored skin.

The discoloration can range from pink or red to even darker colors, like brown, purple, or black. This is mostly dependent upon the individual’s skin pigmentation, as well as the depth of the scar/discoloration.

Melanin

As your skin is recovering from irritation of any kind, it can produce too much melanin, leading to PIH. This isn’t always from blemishes or bumps on the skin. It can occur after any kind of wound, such as a scrape, rash, cut, burn, or even simple irritation. Melanin is a protein in tissue that gives your skin its color. When too much melanin is produced as lesions are healing, you are left with PIH. It remains even after the blemish is long gone, and it can hang around for quite some time. How long? This varies from person to person.

While these scars can come from a variety of inflammatory wounds, it is most often pimples that cause PIH on the face. If you’ve ever had a blemish, then you likely had at least a small amount of post-inflammatory pigmentation left afterward – even if it was just a pink spot that was gone in 24 hours. These scars can happen even after the smallest zit or papule.

Popping Pimples May Worsen PIH

It should be noted that the larger the blemish or breakout, the darker the PIH is likely to be. And (this is a biggie), picking at, or popping, pimples increases the likelihood of hyperpigmentation. So, whatever you do, avoid poking, picking, popping, or messing with any blemish in general. All of that extra irritation from fooling with it can worsen scarring. So, just don’t do it!

Post-inflammatory hyperpigmentation can follow certain dermatological procedures, as well. How much PIH depends on many factors, including skin tones. Research has found that Asian individuals are more prone to PIH after certain laser resurfacing. This makes sense, as this type of procedure literally damages tissues (and irritates them) in order to repair them. This is just one of many potential causes for post inflammatory hyperpigmentation.

PIH vs Acne Scars

Not all scars are classified as PIH. There are many different types of scars that pimples (and other wounds) can leave behind. You now know what PIH is, but let’s discuss some of the other types of scars that can remain after a breakout so that you know the difference.

Icepick Scars – These scars are deep, narrow, and pitted. Like PIH, the name is pretty self-explanatory (as if an ice pick has created the indentation).
Rolling Scars – This type of scar is a wider indentation with a sloping edge.
Boxcar Scars – These are wider depressions, like rolling scars, but they have more sharply defined edges.
Atrophic Scars – These scars are also depressed, but they’re just a bit flatter and thinner than the others.
Hypertrophic or Keloid Scars – These scars differ from all others, in that they are actually raised from the skin. They are often thick and lumpy.

There are even varying types of post-inflammatory color changes. These include:

Post-inflammatory Pigmentation – These brown marks are most often found on individuals whose skin tans easily.
Post-inflammatory erythema – These are pink or purple patches that are flat.
Post-inflammatory Hypopigmentation – As opposed to darkened scarring, these appear as white marks on the skin.

It can be tough to determine exactly what kind of scar you have. Only a doctor or dermatologist can professionally diagnose the type of scarring you have and recommend ways to help diminish it.

Post-Inflammatory Hyperpigmentation: Who is at Risk?

Risk factors for this type of hyperpigmentation have been rigorously studied. Individuals with medium-to-dark toned skin are at a higher risk for this kind of scar. While people with light skin can get these types of scars, they are more common in those with darker skin tones.

Other skin conditions may mimic the appearance of PIH, including tinea versicolor, melasma, and even drug-induced hyperpigmentation. Doctors, scientists, and dermatologists are constantly researching this type of scarring and monitoring patients in order to improve the currently known treatment methods and help patients to move on with their lives.

The most common causes of post-inflammatory hyperpigmentation are breakouts, contact dermatitis, lichen planus, mechanical trauma, and skin-directed physical therapy like dermabrasion, laser treatments/surgery, and chemical peels. Remember that PIH is a clinical diagnosis. You can not (and should not) diagnose or treat yourself at home.

How to Get Rid of Scars and Fade Hyperpigmentation

If you are suffering from post-inflammatory hyperpigmentation or any other kind of scars, then you should see your doctor or dermatologist. They utilize proper diagnostic methods that you simply can’t use at home.

One thing you should never do is try any home remedies or especially harsh chemicals to try and fix PIH.

There are a ton of resources online touting ways to get rid of scars “naturally,” or to fade them more quickly. Do not be fooled into thinking you can do this on your own with lemon juice or hydrogen peroxide. You might end up making matters worse. If you’re trying to find a shortcut for how to get rid of scars, just don’t! However, there are creams that you can apply to help speed up the fading safely, like Beverly Hills MD Advanced Scar Therapy.

Time Can Help

The great news is that (generally) these scars will fade over time. This will, of course, vary from person to person. For some, scars may fade quickly over days, weeks, or months. Others might see these pesky reminders on their face for years – or even decades. This is another important reason for you to see a doctor or dermatologist for post-inflammatory hyperpigmentation. They will be able to make a professional assessment regarding how fast or slow your PIH will fade.

You should also note that the darker the spot, the longer it usually takes to fade. So, if you’ve got a pink or red spot, it will likely fade much more quickly than one that has become purple or brown. Just remember, there are some hyperpigmentation spots that will never fade on their own and some may never fade.

Other Helpful Tips for PIH

One of the best things you can do is to remember that beauty comes from within. A smile is more powerful than any blemish or scar could ever be. And know that a spot on your face does not define who you are. Time will likely help fade hyperpigmentation. But if it doesn’t, then you can always turn to a doctor or dermatologist for professional help.

No matter what, though, you should love the skin you’re in. Scars show that your body has recovered from injury. They represent your strength and resilience.

There are also a lot of other people out there dealing with these and other kinds of scars. Makeup works wonders for so many. That Instagram model that you follow may have some scars that she or he cleverly hides with the use of makeup or photo editing. So, if you’re having trouble with post-inflammatory hyperpigmentation, remember that you’re not alone. And it’s not the end of the world. You can easily cover these scars and let your insides shine!

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Sources
1.https://onlinelibrary.wiley.com/doi/abs/10.1002/lsm.20512
2.https://www.dermnetnz.org/topics/acne-scarring
3.https://link.springer.com/chapter/10.1007/978-3-642-54446-0_5
4.https://link.springer.com/chapter/10.1007/978-3-319-70419-7_14
5.https://emedicine.medscape.com/article/1069191-overview#a2