Post inflammatory hyperpigmentation or PIH for short is a pesky parting gift of many skin conditions. It’s definitely a long winded tongue twister, I mean try saying that fast and over & over, (I dare ya, *winks*) But what does post inflammatory hyperpigmentation actually mean? Is the after-math of a spot, post inflammatory hyperpigmentation? Is an age spot post inflammatory hyperpigmentation? And just what the heck is going on with our skin when it fancies itself some post inflammatory hyperpigmentation?
This is the 101 of post inflammatory hyperpigmentation my friends…
What Is Post Inflammatory Hyperpigmentation?
PIH looks like you enjoyed a super sunny day, or 15 (when do we ever tan THAT much normally?) and forgot to rub the sunblock in all over. It’s not courtesy of a cheeky friend, rubbing in the sun cream selectively *winks*. It is thanks to the compound your skin makes when you tan (melanin) getting dumper trucked and left stranded after your skin has gotten inflamed about something.
The skin story of PIH goes like this… skin sees something it doesn’t like, skin gets all fussy about that ‘thing’ and calls the cops, the skin police, your body’s ambulance brigade, pretty much any emergency response it knows the number for. When they arrive their no.1 response is inflammation.
Your body gets all inflamed because it has a rush of healing cells and blood all at once. Your highways aren’t set up for that kinda traffic, so there is some serious bottle necking happenin’ here.
Inflammation helps your body to ‘flush out’ the bad stuff. Inflammation helps us to heal, but if it hangs around for too long and becomes chronic (like rosacea) it causes more harm than good.
If your skin has been bonding with ‘The hormonal spots’ recently or you grazed your elbow, or maybe you’ve just gotten rid of a bout of eczema. Basically any skin condition or injury where your body is trying to heal itself, you are in PIH party town.
When your body sends its inflammatory crew to the scene, it also triggers certain cells in your body (melanocytes) to start making more melanin (the pigment that makes your skin darker) but just in that one area – doh!
We know that melanin helps to protect our skin from UV damage, it’s an anti-oxidant and mops up those super-active and damaging free radicals.
We aren’t sure yet, the role melanin plays in the skins emergency response to damage. It could be protecting skin from further damage to ensure healing, or it could just be a knock on consequence/ ‘domino effect’ of the biology of inflammation.
Our bodies like to maintain an ‘air of mystery’ about some things ‘eh!
What Causes Post Inflammatory Hyperpigmentation?
It’s the localised tan you didn’t ask for, so what the heck causes it? There are obvious skin conditions that cause inflammation, the most obvious has to be acne or even just the common spot. Acne causes an emergency ‘flush’ response to that area that also gets filled with puss which in turn heightens skin inflammation.
The other super obvious skin inflammation response is when you’ve walked into the bed post, tripped over a step and ‘knee-planted’ on the pavement or had a super competitive game of squash that had you body defending. Impact injury usually causes a speedy inflammatory response that leaves you looking like your skin gobbled up that squash ball!
The not very well known cause of PIH is shaving! When you’ve shaved in the past, have the little hair follicles your hair sprouts from become slightly darkened? You might of thought those dark marks are hair under the skin you can still see, well that my friend is also PIH. The small trauma of a razor (or 5 razor!) blades and the effect of a blunt hair pushing into the hair follicle.
Then there are other skin conditions that trigger your skin’s emergency response without a super obvious sign of inflammation, dermatitis, contact dermatitis, rosacea, eczema, psoriasis and even allergic skin reactions.
What Can You do About Post Inflammatory Hyperpigmentation?
How can we prevent and reverse the ‘borrowers sized’ tan we never asked for? PIH will fade naturally, whoop to that, there are also skincare ingredients you can use to help prevent PIH from pulling up a seat and if it does get that far, to speed-up your fond (?) farewell!
1) Ingredients That Help Prevent PIH
I bet you’ve gotten here already, you beat me to it, didn’t ya! The stuff that causes the visual PIH effect is melanin, and that gets told to come join the party because of inflammation. So if you wanna prevent PIH, what you wanna do is use skincare that has anti-inflammatory ingredients #Bingo.
There are more than I’ve listed here, but I wanted to start you off with a trusty condensed list of a few which are great for skin conditions that cause PIH.
- Bisabolol, it’s an ingredient to love, natural a-bisabolol is a very effect anti-inflammatory skincare ingredient that has a lot of skin skills. Get your eyes on the no.1 ingredient in this post to get savvy about all it has to give to skin.
- Omega 3 oils (linolenic acid) and high GLA (gamma linolenic acid) oils, are well known to be anti-inflammatory. That’s the reason spot sufferers find products high in these oils help prevent breakouts. A couple of oils which are omega-3 and GLA high – flaxseed oil, hemp seed oil, borage seed oil, I’ve also got a full list that you can download here.
- Green tea extract, is there anything green tea extract can’t do? Full of polyphenols, this natural extract also boasts (I mean it’s not been modest recently ‘eh) anti-inflammatory powers for your skin.
- Liquorice extract, this one is great at prevention and treatment being an anti-inflammatory as well as a skin brightening active. You’ll find this called Glycyrrhiza glabra on a skincare ingredient list.
2) Ingredients That Help Treat PIH
If you’ve already gotten a pesky patch of PIH that you want to give directions off your skin, then these are your key PIH treatment ingredients…
- Exfoliation (physical) or chemical (Glycolic acid). This speeds up your skin-cell turnover, which just means your skin sheds faster because of that, it also makes new skin cells faster. Those will be healthy new ones.
- Vitamin C, is a well studied ‘brightening’ active.
- Niacinamide, which is also a great all round skin ingredient too. If you’re specifically looking to treat hyperpigmentation, niacinamide shows synergy (this is when 1+1 actually does =5!) with N-acetyl glucosamine (it’ll usually just be called acetyl glucosamine skin the ingredients list. Paulas Choice have a few picks that pair up these 2 including the Resist Skin Brightening Treatment.
- Vitamin A, you’ll find this one as retinol or retinyl palmitate, or anything with ‘retin’ in the name.
- Kojic acid, a natural extract from mushroom and rice fermentation that actually stops ‘The brown stuff’ that is melanin from being made. Cunning that ‘eh *winks*.
- Plus controversial ingredients like Hydroquinone and B-resorcinol. I recommend them here for a full list of what you will see recommended as PIH treatment, however I would always recommend anyone of the above over these.
Is your skin prone to post inflammatory hyperpigmentation? Have you scouted out any of these anti-inflammatory and brightening ingredients?
Cheryl Woodman is a scientist & award winning skincare formulator who’s more friend next door than bow tie wearing professor. As creator of Honesty For Your Skin her aim is to help you care for your skin in the best ways possible. She’s founder of the natural & fragrance free skincare brand Honesty while also hosting 1 to 1 skincare coaching to help you get your best skin yet. Find out more here.