What Causes Post-Inflammatory Hyperpigmentation?

Inflammation (such as after acne, allergic reactions or eczema) or trauma to the skin (such as surgery, incorrect use of lasers and light devices) or chemical peels results in the release of inflammatory cells that cause melanocytes (pigment cells) to produce more pigment in the skin.  Disruption of the bottom layer of the epidermis (the first layer of skin) from inflammation or trauma results in pigment leaking into and being trapped in the dermis (the second layer of skin).  This causes a deeper and more treatment-resistant pigmentation.

Certain medications (such as Tetracycline antibiotics, antimalarial drugs) and ultraviolet light exposure can aggravate the condition.

Post Inflammatory Hyperpigmentation

What Does Post-Inflammatory Hyperpigmentation Look Like?

Post-inflammatory hyperpigmentation is characterised by flat, black or brown spots on the skin which can occur anywhere on the body, including the genital areas, mouth and nails.

What Other Problems Can Occur with Post-Inflammatory Hyperpigmentation?

This condition equally affects men and women and is more common in patients with darker skin types.

How is Post-Inflammatory Hyperpigmentation Diagnosed?

This is usually diagnosed by physical examination performed by your dermatologist.  Occasionally, a skin biopsy may be required to distinguish this condition from other skin conditions that may have a similar appearance, such as melasma or lichen planus.  A Woods lamp (a special light used to examine the skin) can be useful in determining the depth of pigment change.

How is Post-Inflammatory Hyperpigmentation Treated?

Most cases resolve spontaneously without any treatment.  Cosmetic camouflage may be helpful in disguising the difference in skin colour until recovery is complete. 

Recovery time can be hastened with:

  • Strict sun protection, including the application of a broad-spectrum sunscreen containing zinc and titanium dioxide.
  • Topical bleaching agents (such as Hydroquinone, tretinoin and corticosteroid creams).
  • Laser therapy.  Specific lasers with specific settings need to be used by a specialist dermatologic laser surgeon to avoid further complications or worsening of the condition.