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Ask A Skin Doctor: Postinflammatory Hyperpigmentation

Dear Doctor

I need to fade or get rid my dark spots.

post inflammatory hyperpigmentation

Dear Patient

This skin condition is known as post-inflammatory hyperpigmentation.

Treatment of Post Inflammatory Hyperpigmentation

Before treatment for Post-inflammatory hyperpigmentation (PIH) can be begun, the underlying condition must be well controlled to avoid the development of new PIH lesions.

The at home treatment for PIH includes:

1. SPF 30 Sunscreen

Broad spectrum sunscreens that offer protection from UVA and UVB rays and that have a sun protection factor (SPF) of 30 or above should be used every day. Sunscreens prevent the tanning of the hyperpigmented patches since this increases their fading time.


2. Skin Brighteners

Skin brighteners or skin lighteners can be used but only if the skin is not inflamed, if direct sunlight is avoided and suncreens are used religiously. Examples of skin brighteners include:

  1. Vitamin C or ascorbic acid is a natural antioxidant which reduces melanin production by the skin and gives it a radiant effect. It is found in products like Olay Total Effects tone correcting night moisturizer and Neutrogena dark spot corrector.
  2. Vitamin B3 or niacinamide is another skin brightener used to reduce hyperpigmentation. It interrupts abnormal pigment formation by reducing the transfer or melanosomes to the skin cells. It is found in products like Olay Total Effects tone correcting night moisturizer.
  3. Licorice extract in a skin brightening agent which also has anti-inflammatory properties. It is found in the Dark Spot Corrector Kit.

3. Retinols

Retinols are found in products like the Dark Spot Corrector Kit and Neutrogena dark spot corrector.


4. Mild Chemical Peels

Mild or superficial chemical peels like lactic acid (AHA), glycolic acid (AHA) and salicylic acid (BHA) can be used to manage hyperpigmentation.

30% Glycolic acid peels can be bought over the counter. Higher concentrations are available with a prescription. The effects may not be visible until after a few months. For example the 30% Glycolic acid at home peel has to be used monthly for 8 to 10 months.


5. Skin Bleaches like Hydroquinone

Hydroquinone reduces melanin formation by interfering with the activity of the enzyme known as tyrosinase. Hydroquinone is available over the counter at concentrations of 1% and 2%. An example of a non-prescription product is Ambi Fade Cream which contains 2% hydroquinone.

Skin bleaches like hydroquinone should only be used if the skin is not inflamed, if direct sunlight is avoided and sunscreens are applied daily on top of it.


6. Camouflage Therapy

Camouflage cosmetics can also be used to cover up post-inflammatory hyperpigmentation.

Cover-up makeup usually comes as sets which include concealing creams and setting powder. The Smart Cover-up Starter Kit and the Dermablend Cover Cream are two good examples.

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