Post-Inflammatory Hyperpigmentation (PIH)

Have you ever noticed that after a pimple, rash or skin injury heals, a dark mark remains long after the original problem is gone?

This is known as post-inflammatory hyperpigmentation (PIH). It's one of the most common causes of uneven skin tone and can affect people of all skin types.

Unlike active acne or inflammation, PIH is a change in pigmentation that develops as your skin heals. Understanding why it occurs is the first step toward choosing the most appropriate treatment.

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At a Glance

Post-inflammatory hyperpigmentation:

• Appears after inflammation or skin injury
• Commonly follows acne breakouts
• Can affect all skin tones
• Is not a true scar
• Often fades gradually, although treatment may help accelerate improvement

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What Is Post-Inflammatory Hyperpigmentation?

Post-inflammatory hyperpigmentation is excess melanin that develops after the skin has been inflamed or injured.

As your skin heals, pigment-producing cells may become overactive, leaving behind brown, gray or sometimes darker patches where the inflammation occurred.

The original skin condition may be completely healed, but the pigmentation can remain for months.

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What Causes PIH?

Any condition that causes inflammation can trigger post-inflammatory hyperpigmentation.

Common causes include:

Acne

One of the most common causes, particularly after inflamed pimples or cystic acne.

Eczema

Inflamed skin may leave pigmentation behind after the rash resolves.

Skin Injuries

Cuts, burns, insect bites and scratches can all result in PIH.

Cosmetic Procedures

Certain treatments may temporarily trigger pigmentation if performed on susceptible skin or without proper aftercare.

Picking or Scratching

Manipulating the skin often increases inflammation and raises the likelihood of developing pigmentation.

Who Is More Likely to Develop PIH?

Although anyone can experience PIH, it tends to be more noticeable in people with medium to darker skin tones because their skin naturally produces more melanin.

However, lighter skin tones can also develop PIH, particularly after significant inflammation.

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PIH vs. Acne Scars

These concerns are often confused.

PIH	Acne Scar
A change in pigment	A change in skin structure
Skin remains smooth	Skin may appear raised or indented
Often fades over time	Usually requires structural treatment
Color change	Texture change

Many people have both at the same time.

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Can PIH Be Improved?

Yes.

Many cases gradually improve as the skin naturally renews itself. Professional treatments and appropriate skincare may help accelerate this process, depending on the depth of the pigmentation and your skin type.

Protecting the skin from additional sun exposure is also important because ultraviolet light can make PIH darker and slow improvement.

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Our Philosophy

One of the most encouraging things about post-inflammatory hyperpigmentation is that it often improves with time.

Our role is to help determine whether your skin is likely to improve naturally, whether treatment may help speed the process or whether another condition is contributing to the pigmentation.

That way, you can make informed decisions based on your skin rather than assumptions.

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When Should Pigmentation Be Evaluated?

Post-inflammatory hyperpigmentation develops after an identifiable source of inflammation.

If a dark spot appears without a clear cause, changes rapidly or doesn't resemble the surrounding pigmentation, it should be assessed by your family physician or dermatologist before pursuing cosmetic treatment.

If we ever have concerns that pigmentation doesn't appear consistent with PIH, we'll always recommend medical evaluation first.

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Frequently Asked Questions

Is PIH permanent?

No. Many cases gradually fade over time, although improvement can take several months or longer.

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Is PIH the same as an acne scar?

No. PIH is a change in skin color, while acne scars are changes in the skin's structure.

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Can I prevent PIH?

Avoiding picking or scratching the skin, treating inflammation early and wearing sunscreen can all help reduce the likelihood of developing PIH.

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Does sunscreen help PIH?

Yes. Sun exposure can darken existing pigmentation and delay improvement.

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Which treatment is best?

The most appropriate treatment depends on your skin type, the depth of the pigmentation and what caused it. A consultation allows us to recommend options based on your individual skin.

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Not Sure Where to Start?

You don't need to know whether you're dealing with PIH, melasma or another type of pigmentation before booking.

A personalized consultation allows us to assess your skin, identify the likely cause and recommend treatment options that fit your goals—without pressure.

Book a Skin Consultation

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Related Skin Concerns

• Pigmentation
• Melasma
• Sun Spots
• Uneven Skin Tone

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Treatments That May Help

• Clarity II Pigmentation Treatments
• LaseMD Ultra
• Personalized Skin Consultation

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