7 Common Triggers of PIH: From Acne to Eczema

Key Takeaways:

• PIH is caused by excess melanin production after skin inflammation or injury.
• PIH is more persistent in medium to dark skin tones.
• Prevention focuses on gentle skincare, sun protection, and avoiding skin trauma.
• Treatments include topical brighteners, chemical peels, and laser therapies.
• Consult a dermatologist for personalised PIH management and treatment.

Introduction

Post-inflammatory hyperpigmentation (PIH) is a prevalent skin disorder that develops following an inflammatory event or damage. Melanin—the pigment that gives skin its colour is produced in excess and distributed unevenly. Thereby, resulting in darkened areas or spots on one’s skin.

PIH is especially chronic and persistent in individuals with darker skin tones (Fitzpatrick skin types IV to VI). Such individuals have a higher baseline of melanin production and encompass a sizable section of the Malaysian population.

Part of this regional prevalence can be attributed to Malaysia’s year-round intense ultraviolet (UV) exposure, high humidity, and tropical environment.

This article seeks to explore the common triggers of PIH and their underlying mechanisms. The ultimate goal is to help readers better manage the chronic disorder and avoid its recurrence.

What is PIH (post-inflammatory hyperpigmentation)?

PIH (post-inflammatory hyperpigmentation) is a dermatological condition that develops after one’s skin has been irritated or damaged by acne, eczema, burns, or even cosmetic procedures.

Characterised by dark spots or patches, it’s triggered when one’s skin produces excess melanin. Although PIH isn’t fatal, affected individuals often find its hyperpigmentation emotionally upsetting.

In fact, the condition is often more pronounced in people with medium to dark skin tones. This is primarily because their skin naturally contains more melanin than the average baseline. Thereby, making the discolouration more noticeable.

7 Common Triggers for PIH

The excess melanin production that orchestrates PIH occurrences is principally caused by seven main triggers, namely:

1. Acne Breakouts

Most often, acne is the main trigger of post-inflammatory hyperpigmentation (PIH). Inflamed pimples cause damage to the skin’s surface. This consequently causes the body to manufacture excess melanin as a healing mechanism.

In turn, this overproduction results in dark spots or patches that persist after the acne is eliminated.

So, avoid picking or squeezing pimples since this may exacerbate inflammation. Furthermore, treat acne as soon as possible to lower the risk of PIH escalation.

2. Dermatitis Atopica (eczema)

Eczema-related chronic inflammation can sometimes cause persistent skin irritation, which may lead to PIH. Scratching and rubbing the affected areas often aggravates the skin. Thereby, increasing melanin production and worsening pigmentation.

So, consider employing gentle skincare routines to minimise flare-ups. This, in turn, lowers the chances of PIH occurrence.

3. Allergic Reactions & Skin Irritation

Inflammation caused by allergic dermatitis, or allergies to specific skincare products, might result in PIH. As the skin attempts to recover, melanin synthesis can be triggered by specific products that irritate the skin.

So, always prioritise mild, non-irritating skincare formulas and conduct patch testing prior to experimenting with new products

4. Insect Bites & Scratches

In tropical climates like Malaysia, insect bites are common and often cause localised inflammation. In fact, scratching these itchy bites usually exacerbates the skin damage, increasing the likelihood of PIH.

To prevent this, always keep your nails short and apply anti-itch creams promptly. This appreciably lessens the chances of subsequent pigmentation.

5. Burns & Heat Injuries

Even minor burns or heat injuries, such as scalds, can damage skin layers, which may lead to PIH.

As the skin heals, heat can damage the basal layer of the skin. Thus, resulting in uneven melanin deposits. If left untreated, this often results in darkened patches that may persist for months.

6. Cosmetic Procedures Gone Wrong

Some specific cosmetic treatments, like chemical peels and laser therapy, may cause PIH if performed aggressively or without proper aftercare. The skin trauma from these interventions may stimulate melanin overproduction, increasing the likelihood of PIH.

As such, it’s imperative to always seek out experienced dermatologists and religiously follow their post-procedure care instructions. This appreciably reduces the risk of pigmentation.

7. Chronic Rashes or Friction

Continuous irritation from chronic rashes or repetitive rubbing caused by tight clothing and face masks may trigger skin inflammation, which could escalate to PIH.

So, consider wearing breathable fabrics. This could help appreciably reduce friction and prevent persistent irritation.

How to Prevent & Manage PIH?

To prevent and manage PIH effectively, here are some actionable and practical steps you can follow:

• Practice daily sun protection with a broad-spectrum sunscreen (SPF 30 or higher).
• Employ gentle skincare products that avert irritation and help reduce inflammation.
• Avoid picking, scratching, or irritating the skin to prevent further skin trauma that could worsen pigmentation.
• Control stress levels, as stress may worsen inflammation.
• Hydrate and eat a balanced diet full of antioxidants to promote skin healing.

For stubborn or persistent PIH, more advanced interventions may be necessary, for instance:

• Chemical peels that encourage skin cell turnover and decrease melanin synthesis
• Topical brightening treatments including hydroquinone, retinoids, and azelaic acid.
• Laser treatments, like pico laser treatment.

Also read: Best Laser for PIH (Post-Inflammatory Hyperpigmentation): PicoSure & Beyond

However, it’s crucial to remember that these therapies often call for patience because PIH can take months to improve.

 

Lastly, for individualised guidance and treatment programs catered to your skin type and condition, speak with a licensed dermatologist.

Conclusion

PIH is a prevalent acquired disorder that results from skin inflammation or injury. As a chronic condition, it’s more pronounced in individuals with darker skin tones. This is primarily due to increased melanin production or irregular melanin deposition in reaction to skin inflammation or injury.

When approached appropriately, PIH can be prevented and effectively treated. Nonetheless, maintaining a healthy, glowing complexion dictates an understanding of the basic PIH triggers.

Whether it’s eczema, acne, insect bites, or friction from clothing, recognising and treating these triggers can help avert new pigmentation from developing. With individualised treatment programs, Clique Clinic specialists can help guide you towards clearer, more confident skin.