A Dermal Therapist Answers Your Post-Inflammatory Hyperpigmentation (Acne Scar) Questions
Yads Cauchi is a Dermal Clinician, Nutritionist (BHSc, MSc) and Beauty Journalist. She's also a mum of four. Evidence based skin health and nutrition are her thing and she works from her own skin clinic based in Canberra - you can find her there, or on Instagram and TikTok @yadscauchiskin.
Post inflammatory hyperpigmentation (known as PIH, PIHP or acne scarring) is one of my favourite skincare subjects.
It's something I've personally dealt with for years... and I have no doubt I'll be managing post-inflammatory hyperpigmentation for the rest of my life. Those are the skin cards I've been dealt!
When I'm not working in-clinic on post inflammatory hyperpigmentation treatment plans for my clients, I could talk about it for hours (I swear, I’m fun at parties).
But seriously, I did just that speaking about all things post inflammatory hyperpigmentation products, PIH cream, PIH skin and PIH treatment on the Beauty IQ Uncensored podcast recently.
Want to learn more about post inflammatory hyperpigmentation? You can listen to the full episode below, or keep scrolling for the quick(er) version.
What is Post Inflammatory Hyperpigmentation?
Post-inflammatory hyperpigmentation is pigmentation that occurs after trauma to the skin.
You know when you pick at a pimple and once it's gone, it leaves a dark mark behind? That’s post-inflammatory hyperpigmentation.
These spots generally looks like flat tan, brown, pink-ish or black spots in the skin. You can also get post-inflammatory hyperpigmentation following surgery, a cut/graze, from an existing skin condition like eczema, or even from a crappy in-clinic treatment.
You can get post-inflammatory hyperpigmentation all over your body - not just on the face.
What Causes Post Inflammatory Hyperpigmentation?
- Some people are more prone to post-inflammatory hyperpigmentation than others.
- Common in people with a skin type Fitzpatrick IV and above.
- Generally, deeper skin tones are more susceptible to post-inflammatory hyperpigmentation because the skin produces more pigment (melanin).
Personally, I’m a Fitzpatrick IV skin type and of South American descent, hence why I tend to get post-inflammatory hyperpigmentation.
Post-inflammatory hyperpigmentation is also common in acne patients, which is why taking care of your acne super early is important. You need to minimise the irritation in the skin while you have active acne to minimise the chance of scarring. And yes, this means no picking!
Picking at your acne can lead to post-inflammatory hyperpigmentation, so if you are a picker (like I am), you need to grab yourself some pimple patches like COSRX Clear Fit Master Patch as they act as a barrier between you and your picking.
COSRX Clear Fit Master Patch$7.90
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Post Inflammatory Hyperpigmentation Treatment.
Post inflammatory hyperpigmentation treatment (or any kind of pigmentation treatment) should always start with a consultation with a qualified dermatologist or dermal therapist.
There are many different types of pigmentation, so it is very important to get yours properly assessed before you start any type of treatment. Additionally, it's just as important to treat your acne first before working on any pigmentation.
PIH treatment in-clinic may include chemical peels and laser treatments. Again, book in with someone who specialises in skin so A) you don’t waste your money and B) they don’t make your PIHP worse.
Post Inflammatory Hyperpigmentation Products.
Are you pregnant or breastfeeding? This has been me for the last five years, and unfortunately, some post inflammatory hyperpigmentation products and treatments aren't safe for you to use so you'll have to wait.
An example is retinoids (vitamin A) including prescription and/or over the counter vitamin A skin care.
However, there are still SO many ingredients found in at-home skincare that can be useful in post inflammatory hyperpigmentation treatment.
Some of my favourites for how to fade hyperpigmentation include:
- *Sunscreen: Always wear a broad spectrum SPF with UVA and UVB protection.
- Vitamin C and vitamin B serums.
- A chemical exfoliant with alpha hydroxy acids (AHAs) like glycolic acid and lactic acid used a few times a week.
- A specific tyrosinase inhibiting serum is very beneficial when treating PIHP topically at home.
Now, let me break down exactly which products I recommend for managing the appearance of PIHP.
Side note, you can learn more about post-inflammatory hyperpigmentation in our YouTube video below.
1. Vitamin A, Vitamin B & Vitamin C Serums.
Vitamins A, B, C are great additions to pretty much every skin routine. They cover a lot of concerns and keep your skin health in check.
Plus, they can all help brighten your skin, help soften pigment and keep your skin healthy.
My product recommendations:
SkinCeuticals C E Ferulic Vitamin C Serum 30ml$258.00
Aspect Extreme B 17$139.00
Medik8 Crystal Retinal 3 30ml$79.20 $99.00
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Starting with vitamin A, Medik8 Crystal Retinal 6 is a strong retinal (a vitamin A derivative) overnight serum that works 11 times faster than classic forms of retinol.
For vitamin B, Aspect Extreme B 17 is one of our best-selling niacinamide serums that can be used day and night.
And of course, SkinCeuticals C E Ferulic Serum is the cult vitamin C serum beloved for its brightening abilities.
2. A Pigment-Inhibiting Serum.
If you have pigment concerns, then you need to be using a pigment-inhibiting serum.
These are serums that generally contain tyrosinase inhibitors. Tyrosinase is an enzyme that is found in our skin. It is responsible for the first step in melanin production.
This is why using a tyrosinase inhibiting serum is important as it can help reduce the enzyme tyrosinase from over-stimulating, and therefore slow the overproduction of pigment in the skin.
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This creamy serum uses pigment-inhibiting ingredients to lift stubborn pigment, with extra help from 0.3 per cent salicylic acid for gentle exfoliation.
I’d use this in the morning with your vitamin C serum, and a retinol serum at night. You can read more about tyrosinase inhibiting serums here.
3. A Chemical Exfoliant.
Chemical exfoliants are acids that get rid of dead skin cells. It is my favourite way to exfoliate.
Glycolic acid is great for pigment as the molecule is small and can penetrate deeper than other AHAs, although not all skin types will be able to tolerate it. Lactic acid is the better option for sensitive and dry skin types.
asap liquid platinum 130ml$51.16 $63.96
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This chemical exfoliant is an AHA blend, so you needn’t worry about it being too strong. Use after cleansing and before your moisturiser a few times a week.
4. Sunscreen.
Finally, sunscreen is the number one thing you need for pigment concerns… or any concerns really.
This needs no further explanation, other than there's no point buying any of the products above if you're not wearing sunscreen every day.
La Roche-Posay Anthelios Invisible Fluid Facial Sunscreen SPF 50+ 50ml$39.99
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And if you're still not sure about post-inflammatory hyperpigmentation and the best treatment options for you, go and see a skin professional.
Because excellent, expert articles like this one still won't ever be able to replace professional, personalised skin advice.
Want more content on hyperpigmentation? Check out these articles:
*SPF is only one part of sun protection! Always seek shade, and wear sunnies, a hat and protective clothing. Use sufficient sunscreen for all unprotected areas and reapply sunscreen as directed. Always read the label.
