Post Inflammatory Hyperpigmentation: Meaning, Diagnosis and Overview

What is Post Inflammatory Hyperpigmentation?

Post inflammatory hyperpigmentation, or PIH, is the discolouration or darkening of the skin that develops after an inflammatory wound. It is the skin natural response to inflammation. PIH presents itself as a flat area of discolouration on the skin ranging from pink to red, purple, brown or black, depending on your skin tone and depth of the discolouration.
Post inflammatory hyperpigmentation

Recovery Time

  • The healing process depends on patient condition, so the amount of time needed for treatment can vary widely depending on your skin, the severity of the PIH, the treatments you choose, and your consistency in applying the treatment. 
  • In some cases, it may exist long-term or permanently. For many people, especially those with darker skin, a minimum of 3-6 months of treatment is necessary before significant improvements are visible, and it could take a year to several years before the condition is completely resolved.


  • Woods lamp examination
  • Biopsy may be required, especially if there is no identifiable preceding inflammation to account for the pigmentation.
Eczema Diagnosis

FAQs prepared by doctor

Q1.  What are the drugs which induce hyperpigmentation?
Excess and over dose of Nonsteroidal anti-inflammatory drugs (NSAIDs), sulfonamides, barbiturates, tetracyclines and those that can complex with melanin (antimalarials) or iron (minocycline) can induce hyperpigmentation. 

Q2.  What can I do to hasten the fading of PIH?
With all topical and laser treatments for PIH there is some risk of causing new outbreaks, new pigmentation problems and possibly even new scarring. Risk of these occurrences will probably grow with increasing strength or invasiveness of topical or laser procedures. Some treatments are NOT suitable for people with active acne, sensitive skin or darker skin tones. You should investigate and weigh possible side effects against possible benefits. And discuss with your dermatologist or doctor. There is no single treatment that works for everyone. The effectiveness of each treatment varies and treatments may have to be used in conjunction with each other.

Firstly and most importantly – avoid sun exposure. Ultra Violet light can cause hyper-pigmented areas to darken further and thus prolong them. Use non-comedogenic facial moisturisers or facial sunscreens which contain a high SPF of at least 15

Q3.  What is the difference between a dark spot and an acne scar?
Darks spots are post-inflammatory pigmentation, meaning temporary pigment left behind after your acne has healed. They are not scars and most will fade over time. In dark complexions, these spots can become brown, black, or any shade in between. 
Scars are caused by acne that took a long time to heal. Scars appear as either raised bumps on the skin or as indentations.

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