Post-Inflammatory Hyperpigmentation Treatment
Post-inflammatory hyperpigmentation (PIH) is a condition in which the skin in an area of inflammation becomes darker than normal and stays that way even after the inflammation heals. The skin's response to inflammation results in stimulating melanocytes, which produce the melanin responsible for darkening the skin. PIH can be caused by acne, any type of injury, allergic reactions and skin disorders. Its appearance will vary depending on the cause of the inflammation. Most cases of PIH fade over time, but it can take a long time and may need medical intervention.
Avoid sunlight. The first rule is to avoid sunlight, which will increase the darkening process. Use a good sunscreen and wear protective clothing, such as shirts with long sleeves or a hat.
Keep away from chemicals and medications that might irritate the skin or affect melanin. This includes acne medications, abrasive skin cleansers and some medications, such as tetracycline and hormones.
Treat with over-the-counter products. Your local pharmacy has products, such as alpha- and beta-hydroxy acid facial peels and products containing topical Vitamin A, that may help PIH. Look for facial products that contain a combination of N-acetylglucosamine and niacinamide as they reduce hyperpigmentation caused by age and sun damage and may help with PIH. Keep in mind that these products can be expensive and may not be effective.
Apply bleaching creams with caution. Over-the-counter bleaching creams are available, but if you don't see improvement after three to four months then stop using them. Even though it is rare, prolonged use can cause permanent damage. Do not use creams that are stronger than 0.5 to 2 percent hydroquinone as they can cause permanent pigment loss. Hydroquinone can cause skin irritation so it should first be tested on a hidden area, such as the upper arm.
Consult your physician. If your PIH is due to recurrent acne, then visiting your doctor is especially important to avoid ongoing inflammation and scarring. Physicians have prescription strength topical creams that are more effective treatments for PIH than over-the-counter products.
Consider a chemical peel. A chemical peel removes several layers of damaged skin to reveal deeper layers that have more even, normal color. Glycolic acid peels are superficial, reduce pigment, and generally cause little irritation. A deeper peel can be obtained using trichloracetic acid. This can result in improved skin color but it is painful and your skin will be swollen and red for about a week.
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