It’s bad enough to be afflicted with acne. To add insult to injury, sometimes pimples leave their mark in the form of flat, dark spots that contrast vividly against your skin. For many people, especially those with darker skin, these discolored marks are even worse than the acne itself. These marks are often mistaken for scars. The good news is that they aren’t scars at all. It’s a condition known as post inflammatory hyperpigmentation, or PIH for short, and will fade in time. The bad news is that it can take weeks, months, or even years.
So what causes PIH? Your skin contains cells that produce a chemical called melanin, which is responsible for the tint of your skin. The more melanin these cells produce, the darker your skin. Wherever there’s an acne lesion or some other trauma to the skin, the cells that produce melanin may go into overdrive. This results in spots of discoloration (called macules) that contrast with your skin. Although people of all skin types suffer from this, it’s often worse for people with dark skin.
The good news is that you don’t have to wait until the marks fade on their own, which can takes months or longer. There are prescription and over-the-counter treatments you can use to lighten them up and blend them with the rest of your skin.
Before you proceed, keep in mind that it’s best to put off treating post inflammatory hyperpigmentation until after your acne is under control. As upsetting as the marks may be, there’s not much point in treating them until after you stop getting pimples.
One popular treatment for post inflammatory hyperpigmentation is hydroquinone. It’s a type of phenol that works by inhibiting melanin production without damaging the cells. You can buy over-the-counter remedies that contain small amounts of hydroquinone, such as Porcalana or Ambi Skin Care Fade Cream. However, a dermatologist can prescribe more effective topical treatments with higher concentrations of hydroquinone.
If you find that hydroquinone products aren’t working for you, other options are available. You might consider a retinoid cream such as Retin-A, which can fade PIH marks, blend your skin tone, and even help control acne. Some people use microabrasion to good effect, a mechanical process that removes layers of skin to achieve a smoother appearance. There is a slight risk for complications, however, and you may need several microabrasion treatments to get the results you’re after. Chemical peels are another alternative, although these can damage your skin and should be done by a professional.
No matter how you decide to treat PIH, always make a point of wearing a noncomedogenic sunscreen with a high SPF of at least 15+. Like any other part of your skin, those dark packets of melanin can be tanned by the sunlight. When that happens, it will take even longer for these spots to fade.
As frustrating as post inflammatory hyperpigmentation can be, this condition is very treatable. At the very least, they are not permanent scars: They’ll eventually fade on their own, and in the meantime you have plenty of options to help speed up the process.