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Post Inflammatory Hyperpigmentation (PIH)

Author: Dr Naomi / 28 Oct 2015

What is PIH?

PIH can occur after inflammation to the skin. It can be caused by a skin disorder or because of a beauty or medical intervention. The inflammatory products cause a stimulation of the melanocytes to increase the amount of melanin, in patients who are susceptible to it. This will cause a brown appearance of the skin in the area of the inflammation

This can occur after any kind of inflammation of the skin in someone who is predisposed to it. Often those with olive or darker skin tones, including Asian, Mediterannean, Middle Eastern and Hispanic individuals, will be more susceptible. Also some patients who may have lighter skin tones themselves, but with a darker skin toned ancestry are also at risk.

Causes of inflammation of the skin are vast, and include waxing, laser, peels, IPL scratches, burns.

Prevention is better than cure, so patients with this predisposition to PIH should really be cautious with any beauty or cosmetic medical intervention, as PIH is always a risk,

Prevention of PIH

Those patients who have a history of, or are predisposed to PIH should have lightening agents prior to and after laser treatments. Also using a topical corticosteroid during the inflammatory phase of a procedure can be very helpful for prevention of this problem

Treatment of PIH

At Dr Naomi we have a specific regime for the treatment of  PIH

  1. Skin lightening agents: Including tretinoin/hydroquinone, kojic acid, vitamin C etc
  2. Regular exfoliation treatments: microdermabrasion and peels
  3. Skin needling with use of lightening agents
  4. Sonophoresis/iotophoresis with use of lightening agents

PIH after fractional laser

PIH after fractional laser


Before and after treatment for melasma and PIH

Before and after treatment for melasma and PIH



Before and after melasma and PIH  treatment forehead

Before and after melasma and PIH treatment forehead



Before and after treatment for melasma and PIH

Before and after treatment for melasma and PIH



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