Post inflammatory hyperpigmentation is a condition that manifests as dark lesions on the skin that appear after a disease, infection or injury has healed. These lesions range on color from slightly darker than the surrounding skin to almost black, and they tend to be more common in non-Caucasians due to their darker skin tone. The lesions are often mistaken for scars, but they aren’t permanent, although they can take months or even years to fully heal. Like most hyperpigmentation conditions, they are rarely a serious problem.

What are the causes?

Post inflammatory hyperpigmentation develops when damage to the epidermal layer of the skin causes the release and oxidation of arachidonic acid to products such as prostaglandins and leukotrienes. This in turn affects the activity of immune cells and melanocytes. Melanocytes produce melanin, the pigment that gives the skin its natural color. An excess of melanin in a part of the body creates darker spots in the skin.

Practically any injury or infection that affects the skin can result in post inflammatory hyperpigmentation. Some of the most common causes include acne, burns and allergic reactions. Many believe that the lesions are often caused by acne medication, although this is rarely the case. More often than not it is the acne and not the medication that results in any skin discoloration.

What are the treatment options

Post inflammatory hyperpigmentation treatment is usually similar to other hyperpigmentation treatments. Since other forms of hyperpigmentation are often caused by sun damage, many doctors recommend the use of sunscreen to prevent further darkening of any lesions that may form. More specific treatment options include the use of skin lightening creams containing hydroquinone or Retin-A as well as corticosteroid creams that may be prescribed by a doctor. More extreme treatments such as chemical peels, laser surgery and intense pulsed light therapy can be effective, but they also tend to be more expensive and may aggravate other pigmentation problems.

Hydroquinone

Hydroquinone is the active ingredient in many skin whitening creams that are available either over-the-counter or with a prescription. Hydroquinone is a bleaching agent that blocks melanin, and it can be fairly potent in large doses. Naturally, whitening creams that are sold over-the-counter have significantly less hydroquinone than those that require a prescription. It is sometimes combined with products such as Retin-A for a more effective treatment. Some of the side effects of hydroquinone use include skin irritation, diminished pigmentation or hypopigmentation, and a condition called ochronosis if a particulary strong dose is used over a long period of time. Ochronosis is characterized by black speckles or discolorations on the skin. As with any medical treatment, you should always consult your doctor if you believe that you are experiencing any side effects with skin whitening creams.

Retin-A

Another common hyperpigmentation treatment involves the use of topical medications containing Retin-A. Retin-A is a retinoid derived from Vitamin A and exfoliates skin to promote the growth of new skin cells. This in turn has the effect of diminishing darker skin patches. Retin-A is available in many strengths, and many topical creams such as TriLuma contain both Retin-A and hydroquinone.

Lumixyl

Lumixyl is a relatively new hyperpigmentation treatment that is marketed as a safer alternative to Hydroquinone. It is based on a series of naturally-ocurring peptides that reduce melanin without the harshness or other side effects of creams containing hydroquinone or Retin-A. It is readily available in physicians’ offices, and it is applied topically to areas that are heavily affected by hyperpigmentation.

Elure

Elure is a new hyperpigmentation treatment that is a bit more complex than some of the other topical treatments available over-the-counter or via a prescription. The treatment itself is a three-step process that includes a foaming facial wash, lotion and a night cream that reduces melanin in the skin thanks to its active ingredient, Melanozyme. Melanozyme a compound based on the naturally occurring enzyme lignin peroxidase. Most patients see noticeable results in one month, and there is less of a chance of skin irritation that is often associated with other hyperpigmentation treatments.

Other Treatment Options

Most hyperpigmentation treatments such as the ones described above come in the form of topical creams, cleansers and exfoliants, but there are other options available for those with extreme cases of hyperpigmentation. These hyperpigmentation treatments aren’t used as often due to higher cost, inconvenience and possibility of side effects. One treatment that has gained popularity in recent years is nonablative laser treatment, which involves the use of lasers to heat up and eliminate hyperpigmented patches. This treatment is commonly used to eliminate small spots as opposed to larger patches. A similar and more reliable treatment is cryotherapy, which involves the freezing of localized lesions such as age spots.

Watch this video on chemical peels for hyperpigmentation