Post-Inflammatory Hyperpigmentation Acne Scars

You've probably noticed those dark spots that pimples leave behind. The remnants of pimples past are called post-inflammatory hyperpigmentation (PIH).

Call them acne marks, dark spots, or blemish scars, post-inflammatory hyperpigmentation is incredibly annoying.  Why do they develop?  Can anything be done to treat them?  Here are answers to your most burning questions about post-inflammatory hyperpigmentation and acne.

What Is Post-Inflammatory Hyperpigmentation, or PIH?

A woman with a paper bag over her head.
PIH Acne Scars. harpazo_hope / Getty Images

PIH is an acronym for Post-Inflammatory Hyperpigmentation. Post-inflammatory means "after inflammation." Hyperpigmentation means "increased pigmentation," or a darkening of the skin.

So, post-inflammatory hyperpigmentation is the discoloration or darkening of the skin that develops after an inflammatory wound.

Post-inflammatory hyperpigmentation spots are darker than the surrounding skin tissue.  They can vary in color from pink to red, purple, brown, or black, depending on your complexion.

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What Causes Post-Inflammatory Hyperpigmentation?

In a word: inflammation. Post-inflammatory hyperpigmentation is the skin's natural response to an inflammatory wound.

Acne is a common cause of post-inflammatory hyperpigmentation. Controlling inflammatory acne breakouts is an important step in reducing post-inflammatory hyperpigmentation development.

Although deeper, larger blemishes are more likely to leave a spot behind after it heals, even a relatively small inflamed pimple can cause post-inflammatory hyperpigmentation to develop.  And if you pop your pimples or pick at the scabs, you're upping your chance of developing post-inflammatory hyperpigmentation.

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Who Can Get Post-Inflammatory Hyperpigmentation?

If you have skin, you can develop post-inflammatory hyperpigmentation. Certain factors can make you more susceptible to developing post-inflammatory hyperpigmentation, though.

Obviously, having inflammatory acne will increase your chances of developing post-inflammatory hyperpigmentation than mild, non-inflammatory breakouts

Your skin tone also influences your chances of developing post-inflammatory hyperpigmentation. It is more common in medium to dark complexions.

Some people are just more prone to developing post-inflammatory hyperpigmentation than others.  A smallish pimple that may heal without a mark for one person can leave a long-lasting dark blemish on a person prone to post-inflammatory hyperpigmentation. 

This is where knowing your skin is key.  If you know you're prone to developing post-inflammatory hyperpigmentation, getting your acne under control ASAP is important to nip post-inflammatory hyperpigmentation in the bud.

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Is Post-Inflammatory Hyperpigmentation Permanent?

Post-inflammatory hyperpigmentation isn't a scar, at least not in the true sense of the word. There is no loss (or gain) of skin tissue. Only the color of the skin is changed.

So, luckily, post-inflammatory hyperpigmentation isn't necessarily permanent though in some cases it can be.

Post-inflammatory hyperpigmentation can fade on its own. Granted, it does take quite some time (think in terms of months rather than weeks).

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Can Post-Inflammatory Hyperpigmentation Be Treated?

There is good news for you: post-inflammatory hyperpigmentation can be treated. Mild discolorations can respond to over-the-counter products containing alpha hydroxy acids, hydroquinone, or N-acetyl glucosamine (NAG) and niacinamide.

Many day spas and salons also offer treatments that can fade post-inflammatory hyperpigmentation. The most common of these include light chemical peels and microdermabrasion.

But more stubborn cases are best treated by your dermatologist. You dermatologist can prescribe topical medications and suggest other procedures to help diminish post-inflammatory hyperpigmentation.

Getting acne under control is a must-do first step, though.  You won't be able to successfully fade post-inflammatory hyperpigmentation if new pimples keep creating new dark marks.

Again, this is where a dermatologist is a great asset.  Your dermatologist will help you get your breakouts clear first, before treating post-inflammatory hyperpigmentation.  (This may be frustrating to you if the dark marks are what bother you most, but know that acne treatment is the first step.)

After acne is clear, then your dermatologist will help you treat post-inflammatory hyperpigmentation.

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