Sunday, October 12, 2014

What is Post-Inflammatory Hyperpigmentation?

You are no doubt wondering, what is post-inflammatory hyperpigmentation? Yet I bet many of you suffer from this common condition. Another way to say post-inflammatory hyperpigmentation is after-infection dark spots. Some people think these are scars, but actually they are spots of pigmentation that occurred due to blemishes that received sun exposure.

Without UV sunlight, the infection from blemishes would come and go and the pigmentation of your skin wouldn’t change at all. It is solely due to sun exposure that this hyperpigmentation condition occurs.

People who have darker skin, whether African-Americans, certain Europeans, and even Caucasians who have a lot of melanin in their skin, are all susceptible to this condition. I’m going to use a few questions from clients (and my answers) to illustrate what this condition is all about and what you can do to lessen its effect on your skin.
I am a 30-year-old Asian-Indian woman and have occasional breakouts that always leave very dark pigmentation after healing. It will take 3 to 4 months for the mark to lighten and disappear. I use concealer and do not enjoy being anywhere without having makeup on in order to camouflage the pigmentation. I want to be free of my makeup to enjoy a more athletic and outdoor life. Any recommendations?

You have a very common complaint, not that you should feel better by hearing that! The condition you are asking about is called post-inflammatory hyperpigmentation. The blessing is you no doubt have beautiful skin tone due to your heritage. The curse is you are susceptible to pigmentation irregularities.

Anytime you have blemishes, they are like wounds in the skin. The deeper the infection the more tissue that is damaged, and the longer these places will take to heal. Since you have so much pigmentation naturally in your skin, you will be prone to this condition more so than someone who has very white skin (especially redheads and those who burn but never tan).

I’m sure it is disheartening that these pigmentation spots take so long to clear. Three or four months is a distinct possibility, especially in the warmer months and especially if you are outside in the sun a lot. Whether or not you can be free from makeup may be out of your control if you continue to get these pigmentation places and want to cover them up. But being able to enjoy a more athletic and outdoor life is your choice. I don’t think you have to curtail being out in the fresh air of nature; you just have to take precautions against sun exposure.

Being extremely careful about sun on your face is a lifestyle habit you will absolutely need to adopt. Any sun on your face will stimulate melanin and therefore darken all pigmentation, whether on healthy skin or skin that is damaged and healing from a blemish.

The truth is sunscreen is not enough to protect your skin. It is a manmade product with the ability to screen out only some of the harmful UV rays. Don’t feel falsely armed if you wear sunscreen; you will also need to physically block the sun from reaching your face. You do this by wearing hats and sitting in complete shade if you are outside.

Be careful about products that claim to lighten skin. There are some prescription products available through your dermatologist that might help, but the reviews are mixed on how well these products actually work to lighten the skin. Some products bleach, and others inhibit melanin production; melanin is what is causing the darkness. In the winter or colder months, your skin will naturally lighten, or the spots will, due to a decrease in sun exposure.

My top recommendation would be to become hyperaware of how much sun you are receiving. I guarantee it is more exposure than you think you are getting. Always wear sunscreen. And keep hats with you or in your car so you won’t be caught out in the sun unprotected. 

For more information about pigmentation issues, see: