Post-Inflammatory Pigmentation After Acne: Why It Happens and What Can Help
Your acne has finally settled, but you're still left with brown or darker marks where the breakouts were.
If this sounds familiar, you may be experiencing post-inflammatory pigmentation after acne, also known as post-inflammatory hyperpigmentation or PIH.
It is a common concern we see in clinic, and one of the most frustrating parts of having acne because the inflammation may have disappeared while the pigmentation remains.
At Epicell Skin Clinic in Pascoe Vale, Melbourne, we assess the skin to determine whether the marks are pigmentation, scarring, redness or a combination of concerns before recommending treatment.
What is post-inflammatory pigmentation?
Post-inflammatory pigmentation occurs when the skin produces or retains increased amounts of melanin following inflammation or injury.
With acne, inflammation can stimulate pigment production. Once the pimple has healed, the inflammation may be gone but the increased pigment can remain.
The result can be a brown, tan or darker mark where the acne lesion previously appeared.
Importantly, post-inflammatory pigmentation is not the same as an acne scar.
Is it acne scarring or pigmentation?
This is an important distinction.
A flat brown or darker mark left behind after a pimple is more consistent with post-inflammatory pigmentation.
A red or pink mark may be related to post-inflammatory erythema, where the skin remains visibly red after inflammation.
A depressed or raised area may represent an actual acne scar, where the structure of the skin has been altered.
You can also have acne scarring, redness and pigmentation at the same time.
This is why simply treating every acne mark with the same treatment may not produce the result you are looking for.
Why does acne cause pigmentation?
Inflammation can stimulate the cells responsible for producing melanin.
The more significant or prolonged the inflammation, the greater the potential for pigmentation to develop.
Picking or squeezing acne can also increase inflammation and skin injury, potentially increasing the risk of a persistent mark.
Sun exposure can make pigmentation more noticeable and can contribute to pigmentation persisting for longer.
This is why controlling acne and protecting the skin from UV exposure are important parts of managing acne-related pigmentation.
Who is more likely to develop post-inflammatory pigmentation?
Post-inflammatory pigmentation can occur in anyone, but it tends to be more noticeable and persistent in people with more melanated skin types.
The intensity of pigmentation can also vary depending on the severity of the inflammation, the individual skin response and exposure to UV and visible light.
This is one reason why pigmentation treatment needs to be individualised.
How long does pigmentation after acne last?
There is no single timeframe.
Some marks gradually fade on their own, while others can remain for many months or longer.
The depth and intensity of the pigmentation, the degree of inflammation and ongoing sun exposure can all influence how quickly it improves.
If you continue to experience active acne, new pigmentation can also continue to develop.
For this reason, treating the cause as well as the pigmentation is often important.
How is post-inflammatory pigmentation treated?
Treatment depends on your skin type, the severity of the pigmentation and whether you still have active acne or other inflammation.
Depending on your individual assessment, treatment may include:
Targeted skincare
Chemical peels
LED treatments as part of an acne management plan
Laser or light-based treatments where appropriate
Treatments aimed at improving overall skin health and texture
Medical support when required
At Epicell, we may use treatments such as skin peels, Laser Genesis or Cutera Excel V+ depending on the type of pigmentation, redness and overall condition of your skin.
Not every person will require laser, and not every type of pigmentation should be treated with the same device.
Can laser help acne pigmentation?
In some patients, laser or light-based treatments may form part of a treatment plan for acne-related redness or pigmentation.
However, the appropriate treatment depends on what is actually present.
For example, the treatment approach for brown post-inflammatory pigmentation may differ from the approach for red or pink post-inflammatory marks.
Your skin type and risk of post-inflammatory pigmentation also need to be considered when selecting treatment settings.
This is why we recommend an assessment before deciding whether laser is appropriate.
What about chemical peels?
Chemical peels can be useful as part of a broader acne and pigmentation treatment plan.
Depending on the peel selected, they may help improve the appearance of uneven skin tone, congestion and superficial pigmentation.
The choice of peel should be based on your skin condition rather than simply choosing the strongest option.
A stronger treatment is not necessarily a better treatment, particularly when the skin is already inflamed or pigmentation-prone.
Skincare matters too
Professional treatments are only one part of managing post-inflammatory pigmentation.
Your home skincare routine can be important for supporting the skin barrier, managing acne and reducing the factors that contribute to ongoing pigmentation.
Daily broad-spectrum SPF50+ is particularly important.
Without consistent sun protection, pigmentation can become darker and more difficult to manage.
Your skincare routine should also be appropriate for your skin type and acne status rather than focusing solely on trying to “bleach” the pigmentation away.'
What if I still have acne?
If you are still developing acne, treating the pigmentation alone may not be enough.
Every new inflammatory lesion has the potential to leave another mark.
At Epicell, we can look at the bigger picture, including:
Active acne → inflammation → redness/pigmentation → texture and scarring
Addressing the underlying acne and inflammation can help reduce the cycle of new marks developing.
Depending on your circumstances, medical support may also be recommended.
What happens at an Epicell skin consultation?
We start by assessing your skin rather than immediately choosing a treatment.
Your consultation may include an Observe skin analysis to help us evaluate your skin and identify areas of concern.
We look at:
Active acne
Pigmentation
Redness
Skin texture
Previous acne scarring
Your skin type
Your current skincare
Previous treatments
Your history of pigmentation following acne
From there, we can explain what we believe is contributing to your concerns and develop a treatment pathway.
Post-inflammatory pigmentation treatment in Melbourne
If you're looking for acne pigmentation treatment in Melbourne, it is important to establish whether the marks you're seeing are pigmentation, redness, scarring or a combination.
At Epicell Skin Clinic in Pascoe Vale, our nurse-led approach focuses on assessing the skin first and then selecting treatments based on your individual concerns.
Our aim is to improve the overall health and appearance of your skin rather than simply treating the visible mark.
Don't let the acne be gone but the marks remain
Post-inflammatory pigmentation can be one of the most frustrating reminders of previous acne.
The good news is that there are treatment options that may help improve uneven pigmentation and overall skin appearance.
The first step is understanding what you're actually treating.
If you're concerned about pigmentation after acne, an Epicell skin consultation can help determine the most appropriate treatment pathway for your skin.
Epicell Skin Clinic110 Cumberland Road, Pascoe Vale, Melbourne
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