Post Inflammatory

What Is Postinflammatory hyperpigmentation (PIH)?

Postinflammatory hyperpigmentation (PIH) is an acquired hypermelanosis occurring after cutaneous inflammation or injury that can arise in all skin types. PIH results from the overproduction of melanin or an irregular dispersion of pigment after cutaneous inflammation.

Are There Different Types of PIH?

PIH within the dermis results from inflammation-induced damage to basal keratinocytes, which release large amounts of melanin. The free pigment produces a blue-gray appearance to the skin at the site of injury. Epidermal hypermelanosis will appear tan, brown, or dark brown and may take months to years to resolve without treatment. Hyperpigmentation within the dermis has a blue-gray appearance and may either be permanent or resolve over a protracted period of time if left untreated.


If Untreated, How Long Does PIH Last For?

Epidermal PIH can last for 6 to 12 months or more. Dermal PIH can take years to fade, and spots may be permanent. There is also a chance new spots can show up, or that your PIH will come back again after fading.

What Can I Do About My PIH?

When it does occur, the underlying inflammatory conditions should be sought and treated as the first step to reduce the progression of inflammation and PIH (which is an inflammatory consequence). If the inflammatory conditions subsides or there is no evidence of inflammation at the time of diagnosis, the treatments of PIH should be considered as the next step. Different methods are needed to treat different types of PIH. For example, topical agents are typically used to treat epidermal PIH as deeper pigmentation does not respond well to these agents. Consult our VIDASKIN doctors for expert advice on a therapeutic regime to speedily lighten your PIH.

Which Treatments Are Research-Proven To Reduce PIH Effectively?

UV Protection

Use a physical sunblock with SPF 50 or higher and boost your SPF coverage further with oral sunscreen pills like Heliocare or Crystal Tomato to prevent more UV damage.

Shop our recommended sun protection products here.

Vitamin C

Vitamin C is a naturally occurring antioxidant obtained from certain fruits and vegetables that can help with skin lightening. It has antioxidant and anti-inflammatory properties to protect us from environmental damage that leads to pigmentation as part of skin aging.

Hydroquinone (HQ)

HQ remains the mainstay of treatment for PIH. It is a phenolic compound that blocks the conversion of dihydroxyphenylalanine (DOPA) to melanin by inhibiting tyrosinase. This reduces the production of melanin which in turn decreases the amount of pigmentation in the skin.

Azelaic Acid (AA)

Azelaic Acid has been shown to be effective in the treatment of PIH by depigmenting the skin and reducing inflammation.

Other Topicals

Combination products containing hydroquinone and retinoids appear to be the most beneficial treatment options, although there are few evidence-based studies for this. Topical tyrosinase inhibitors, such as hydroquinone, azelaic acid, kojic acid, arbutin, and certain licorice extracts, can effectively lighten areas of hypermelanosis. Other depigmenting agents include retinoids, mequinol, ascorbic acid, niacinamide, N-acetyl glucosamine, and soy with a number of emerging therapies on the horizon.

Topical therapy is typically effective for epidermal postinflammatory hyperpigmentation; however, certain procedures, such as chemical peeling and laser therapy, may help treat recalcitrant hyperpigmentation. It is also important to use caution with all of the above treatments to prevent irritation and worsening of postinflammatory hyperpigmentation.

Book your consultation with our doctors today to discuss more about curated treatment options for your post-inflammatory hyperpigmentation!

In-Clinic Treatments

Glycolic Acid (GA)

Glycolic acid (GA), found in sugarcane, is a naturally occurring alpha-hydroxy acid (AHA) that induces epidermolysis, disperses basal layer melanin, and increases dermal collagen synthesis. Studies show significant clinical improvement from baseline was noted in the peel groups by subjective measures (p<0.02), and colorimetric analysis also showed a trend of more rapid and greater improvement in the peel group.


Although topical skin-lightening agents remain the treatment of choice for PIH, lasers and light sources may be an effective adjunct to therapy or alternative for treatment failures. However, there is a paucity of literature specifically evaluating the use of devices in the treatment of PIH in all skin types. Green (510nm, 532nm), red (694nm), or near-infrared (755nm, 1064nm) lasers are pigment-specific and generate light used to selectively target intracellular melanosomes. However, due to the wide absorption spectrum of melanin (250nm–1200nm), laser energy intended for deeper targets can be absorbed within the pigmented epidermis, which can lead to complications such as dyschromias, blistering, and scars.

Book Your Complimentary Consultation Today

It is best to seek professional, expert advice from a trained doctor who can prescribe and perform suitable treatments for your unique condition. Our VIDASKIN Aesthetic Clinic is equipped with a diagnostic VISIA skin analysis machine which visualises the different depths of existing pigmentation, future pigmentation and other imperfections. Book your consultation with our doctors today for a thorough and effective treatment plan for your individual concerns!