Postinflammatory hyperpigmentation is a condition where brown or black spots of increased pigment develop on the skin due to previous inflammation, such as burns, injuries, infections, or allergic reactions. It can be treated with medication or surgery, but may take time to resolve. The condition can be caused by inflammation in the epidermis or dermis, and is often associated with acne and eczema. Treatment options include skin-lightening creams, steroids, and retinoids.
Postinflammatory hyperpigmentation, or postinflammatory hypermelanosis, is a disease in which spots of increased pigment develop on the skin, appearing brown or black. These patches develop in areas that have previously been affected by inflammation. Possible causes of skin inflammation include burns, injuries, infections, and allergic reactions. Postinflammatory hyperpigmentation usually resolves on its own within about a year, but treatments are available that include medications and some surgical procedures. Even with treatment, it may take some time for the condition to go away, and some people choose to hide the affected skin using makeup.
Two different processes can give rise to postinflammatory hyperpigmentation. In some cases, the outer layer of skin, or epidermis, can become inflamed and, as part of what’s known as an inflammatory response, cells known as melanocytes are stimulated to produce more of the pigment melanin. This pigment is transferred to surrounding cells in the epidermis, causing what is called epidermal hypermelanosis. Sometimes the inflammation affects the lowest layer of the epidermis, and the released melanin then enters the underlying skin layer, known as the dermis. This process is known as dermal melanosis and causes areas of increased pigment to form at a deeper level.
Symptoms of postinflammatory hyperpigmentation are mainly the development of darker colored patches of skin, which can range in shade from brown to black. When the extra deposits of pigment are in the uppermost layers of the skin, the spots tend to be lighter in color. The pigment that builds up in the deeper layers of the skin usually appears darker. The diagnosis of postinflammatory hyperpigmentation can be made when there is a history of previous injury or disease that occurred in the same areas of skin where darker spots subsequently developed.
Some common skin conditions, such as acne and eczema, can lead to postinflammatory hyperpigmentation. Once present, areas of pigment can become even darker when exposed to ultraviolet light. Some medications can also make the condition worse, including antimalarial drugs, the antibiotic tetracycline, and some drugs used in cancer treatment.
Treatment of postinflammatory hyperpigmentation isn’t always necessary, and some people may find it easier to wait for the patches to fade, using sunscreen to avoid darkening them, and hiding them with cosmetics. Available treatment options include skin-lightening creams, steroids, and medications known as retinoids. A combination of treatments is often needed to reduce epidermal hyperpigmentation and unfortunately there is no effective remedy for deeper skin hyperpigmentation.
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