How long does it take for hyperpigmentation to go away

What is post-inflammatory hyperpigmentation and what causes it?

Post-inflammatory hyperpigmentation appears as flat spots of discolouration.

Post-inflammatory hyperpigmentation (or PIH for short) is a type of hyperpigmentation of the skin that is mainly triggered by the way skin regenerates after inflammation. It can affect the face and body, typically especially UV-exposed areas, and appears as flat spots of hypercoloration. These range in color from pink to red, brown or black, depending on skin tone and the depth of hypercoloration.

Men and women are equally susceptible, and all skin types can get post-inflammatory hyperpigmentation although it is more prevalent in darker tones of skin. In fact PIH is one of the common reasons why people with darker skin tones seek the advise of a dermatologist1.

The root cause of PIH is increased melanin production. Melanin is the pigment that defines the color of a person’s skin and the increase in melanin is triggered by the way skin regenerates after inflammation or injury. The more inflammation there is, the more prominent the area of discoloration will be both in terms of size and color.

1- Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. E.C. Davis and V.D. Callender. J Clin Aesthet Dermatol. 2010 Jul; 3(7): 20-31

Squeezing pimples increases the chance of post-inflammatory hyperpigmentation

Sun can trigger and aggravate post-inflammatory hyperpigmentation symptoms

PIH often affects people with acne (also referred to as a post-acne mark) and it can sometimes be triggered by skin treatments such as dermabrasion, chemical peels and laser therapy.

In the case of acne the blemish triggers melanocytes – the melanin-producing cells – to release excessive melanosomes (pigment granules). The excessive pigment granules darken and discolor the formerly stressed area. Once initial blemishes have subsided, spots of hypercoloration, so-called post-acne marks, can remain.

About 1 in 2 acne suffers experience PIH1, with severe impact on their psychological well-being. Studies show that the self-consciousness in social settings or feeling like an “outcast” is significantly amplified when post-inflammatory hyperpigmentation is formed, as compared to acne inflammation alone2.

For many former acne sufferers, the marks are a bitter reminder of their battle with blemishes. Even once the acne-related inflammation subsided, the marks can persist longlasting and stigmatize these patients over years.

1: Source: Kaufman et al., Am J Clin Dermatol. 2018; 19:489–503, Perkins et al., JEADV. 2011; 25(9):1054–1060.
2: Darji, K. et al., “Psychosocial Impact of Postinflammatory Hyperpigmentation in Patients with Acne Vulgaris.” J Clin Aesthet Dermatol. 2017; 10(5):18–23.

Whilst not the cause of PIH, sun exposure can aggravate symptoms, darkening the affected patches and prolonging the time it can take for them to fade. Most acne-related PIH will eventually fade over time, but it can take several years or even a decade until it is fully gone3.

  The sun is closely associated with other forms of hyperpigmentation such as age spots (also known as sun spots) and melasma. This is why we recommend sun protection. Limit the time you spend in the sun and keep out of the sun during its most intense hours. Wear protective clothing and sun hats whenever possible and apply a sun protection factor of at least 30.

3: Abad-Casintahan, F. et al., “Frequency and Characteristics of Acne-Related Post-Inflammatory Hyperpigmentation.” J Dermatol. 2016; 43:826–828.

Eucerin Sun Gel-Cream Oil Control SPF 50+ and 30 give oily, acne-prone skin the sun protection it needs

A sensible attitude to sun protection will also help to prevent or reduce the severity of post-inflammatory hyperpigmentation:

• Limit the time you spend in the sun - Keep out of the sun during its most intense hours
• Wear protective clothing and sunhats whenever possible
• Apply a sun protection product that offers the level of protection your skin needs and that is proven to be suitable for your skin type and/or condition.

Eucerin’s superior sun protection range includes face and body products that are suitable for blemish-prone skin, atopic skin and skin that has recently undergone dermatological treatments.

Eucerin’s DERMOPURE range also includes products specifically formulated to reduce the darkening of post-acne marks from sun exposure and prevent the appearance of blemishes, such as Eucerin DERMOPURE Protective Fluid SPF 30.

Chemical peels exfoliate skin and stimulate the growth of new skin

Laser therapy removes hyperpigmented skin cells but can have side-effects such as inflammation and irritation

• Chemical peels involve applying a chemical solution (such as an AHA) to exfoliate skin (remove dead skin cells), stimulate the growth of new skin cells and reveal new skin. 
• Laser therapy has a similar effect but tends to be more precise as the dermatologist has more control over the intensity of the treatment. Laser treatments involve ‘zapping’ the affected areas with high-energy light. The mildest treatments work on the skin’s epidermis (surface layer), while more intense treatments can penetrate the deepest layers of the skin. Find out more in Laser therapy: how should I care for my skin after treatment?

The Eucerin DermoPure post-acne mark range reduces post-acne marks and protects them from darkening due to the sun​

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