Post-inflammatory – kimmm.likeofficials.com

Post-Inflammatory Hyperpigmentation (PIH)

Understanding, preventing and treating dark marks after inflammation

Post-inflammatory hyperpigmentation (PIH) is the medical term for darkening of the skin that occurs after inflammation or injury.

Any time the skin becomes irritated — whether from acne, eczema, dermatitis, cosmetic treatments, procedures, or even minor trauma — pigment-producing cells (melanocytes) can become overactive. This leads to flat brown, tan, or grey marks that linger long after the original issue has healed.

PIH is not scarring and does not cause permanent skin damage, but it can be slow to fade and emotionally distressing without the right approach.

Not sure where to start? We’ll guide you safely.

The Skin Doctor

Who Is More at Risk?

PIH can affect anyone, but some individuals have a significantly higher risk of developing visible or persistent pigmentation.

Medium to darker skin tones

People with Fitzpatrick skin types III–VI have more active melanocytes, increasing the likelihood of pigment over-production after inflammation or procedures.

Certain medications and supplements

Some topical, oral, herbal and over-the-counter medicines can increase photosensitivity or pigment risk. For a comprehensive list, see hotosensitising Medications.

Active inflammatory skin conditions

Conditions that increase inflammation raise the risk of PIH, including:
Acne, Eczema, Peri-oral / Peri-orificial Dermatitis, Seborrhoeic Dermatitis, and Psoriasis.

People prone to pigmentation

Including those with melasma, freckles, post-acne marks, or a history of PIH after treatments.

Heat- or trauma-based procedures

Laser treatments, chemical peels, microneedling, waxing, friction and even repeated rubbing can trigger PIH if not carefully managed.

The Skin Doctor

Can PIH Be Prevented?

Yes. While no strategy can eliminate risk entirely, careful planning and skin preparation significantly reduce the likelihood of PIH, particularly around cosmetic or laser procedures.

Evidence-based prevention strategies include:

Sun protection

UV exposure amplifies pigmentation. Daily broad-spectrum SPF is essential before and after any treatment.

Avoiding photosensitising medications

Some medicines increase pigmentation risk with light-based procedures. As part of our safety process, patients confirm they are not taking common photosensitisers prior to treatment. For a comprehensive list, see Photosensitising Medications.

Pre-conditioning the skin

For higher-risk patients, Dr Chris may recommend:

Conservative treatment settings

Laser and energy-based treatments are adjusted to minimise thermal injury where appropriate.

Treating inflammation first

Stabilising acne, eczema or dermatitis reduces the inflammatory triggers that lead to PIH.

The Skin Doctor

Treatment Options for PIH

If PIH does occur, it is treatable. The most effective approach depends on skin type, cause, depth and severity of pigmentation.

At The Skin Doctor, treatment is tailored carefully — particularly for patients with procedure-related or higher-risk pigmentation.

Topical pigment-modulating treatments

Often first-line therapy, including:

azelaic acid
niacinamide (vitamin B3)
vitamin C
cysteamine
hydroquinone (short-term, specialist-guided use only)

These help regulate melanocyte activity and fade pigmentation gradually.

Prescription-strength combinations

Compounded medical formulations may be used for more persistent PIH, particularly where laser is not appropriate.

Chemical peels

Gentle, medical-grade peels can assist exfoliation and pigment reduction, but must be selected cautiously to avoid further PIH.

Laser and light-based treatments

Used selectively and conservatively, low-fluence pigment-targeting lasers and LED therapy may help established PIH in suitable patients.
Improper or aggressive laser treatment can worsen PIH — which is why expertise and parameter selection are critical.

For laser-responsive pigmentation, see Pigmentation & Tattoo Removal.

Ongoing sun protection

Strict UV avoidance and sunscreen use are essential throughout recovery to maintain results.

How Long Does PIH Last?

Mild PIH may fade within weeks
More established pigmentation can persist for several months

Early, appropriate intervention often leads to faster and more complete clearing.

When Should I See a Doctor?

You should book an appointment if:

pigmentation appears after a cosmetic treatment or laser session
dark marks persist after acne or dermatitis
you belong to a higher-risk skin group and are planning a procedure
you want personalised guidance to reduce future PIH risk

We assess your skin thoroughly and develop a plan to both treat existing pigmentation and prevent recurrence.

Let's start

Book an Appointment

If you are concerned about PIH — or want to reduce your risk before upcoming treatments — our doctors can guide you safely.