Your acne is clearing up and your skin is looking better every day. But then you notice dark pink or brown spots on your skin where the acne lesions have healed. Is it scarring? And what can you do about it?
A post inflammatory hyperpigmentation macule often is the remnant of an inflamed acne lesion. PIH macules can follow relatively minor pimples and papules, in addition to more serious lesions. However, the more inflamed a breakout, the larger and darker the PIH macule tends to be. Picking or popping a pimple increases the chance of developing post inflammatory hyperpigmentation.
Treating PIH
Most acne sufferers are relieved to learn that post inflammatory hyperpigmentation is not scarring. PIH will fade away over time, even without treatment. It can take three to 24 months for PIH to fully fade, although in some cases it may take longer. The length of time it takes for PIH to fade depends on how dark the PIH macule is compared to your skin tone. The bigger the contrast between the macule and your natural skin tone, the longer it will take to fade.
There are treatment options available to help fade post inflammatory hyperpigmentation more quickly. However, your acne should be under control before beginning any treatment for PIH. Otherwise, each new pimple could cause another PIH macule, reducing the effectiveness of treatment.
Whatever treatment option you choose, understand that improvement will take time. Think in terms of months rather than weeks. Also, many dermatologist recommend using a broad-spectrum sunscreen daily. The sun may darken the discolorations and increase fading time.
Over-the-Counter Treatments
Mild cases of post inflammatory hyperpigmentation may respond well to over-the-counter products. There is a plethora of "brightening" treatment products on the market today. Many use a combination of alpha and beta hydroxy acids (including glycolic acid), vitamin A, vitamin C, and other ingredients to exfoliate the skin. Others, such as M.D. Forte Skin Bleaching Gel, use lightening agents to fade discolorations.
Hydroquinone
Hydroquinone is a widely used treatment for post inflammatory hyperpigmentation. It is available over-the-counter at 1% to 2% strength, and in 3% to 4% prescription creams. Hydroquinone works by blocking the enzyme responsible for melanin production, thereby lightening the skin.
Hydroquinone creams often contain additional lightening ingredients, such as kojic acid, glycolic acid, tretinoin and other retinoids, or vitamin C. These combination creams can give you better results than using hydroquinone alone.
Topical Retinoids
Retinoids, such as tretinoin and tazarotene, are often prescribed to acne patients. Retinoids help clear acne by speeding up cell turnover rates. It is this rapid exfoliation that can also help clear PIH. Retinoid creams include Retin-A, Tazorac, and Differin. The fact that they lessen post inflammatory hyperpigmentation as they treat acne breakouts is an added benefit for many people.
Obvious results may not be apparent for several weeks to several months after beginning treatment. Topical retinoids may cause excessive dryness, redness, and/or irritation, which may in turn increase hyperpigmentation. Let your doctor know right if you experience any of these side effects.
Glycolic Acid
Glycolic acid is an alpha hydroxy acid found in many skin care products. It effectively exfoliates the skin, helping to lighten post inflammatory hyperpigmentation. Available in cleansers, creams, and gels, glycolic acid not only helps improve postinflammatory hyperpigmentation, but also leaves your skin smooth and soft.
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