Acne in Skin of Color: It’s All About PIH

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Nobody wants to deal with acne breakouts – or their aftereffects, such as scarring or dark spots. But for individuals with darker skin, post-acne hyperpigmentation can be an even bigger problem. Known as post-inflammatory inflammation, it can lead to frustrating discoloration that seems virtually impossible to get rid of.

The good news is that there are safe and effective hyperpigmentation treatment options, including those that can work remarkably well for all skin tones. So, whether you have mild or severe hyperpigmentation, treatment can significantly affect your skin’s appearance. 

But first, let’s discuss what hyperpigmentation is, why it happens after breakouts, and why those with darker skin tones are at the highest risk.

What is Post-Inflammatory Hyperpigmentation (PIH)?

Post-inflammatory hyperpigmentation (PIH), or hypermelanosis, is the overproduction of melanin or abnormal deposits of melanin in the skin after inflammation, irritation, or injury. 

PIH shows as dark spots or patches on your skin, in shades of tan, brown, or even bluish-gray.

What Causes Post-Inflammatory Hyperpigmentation?

PIH happens when your skin produces extra melanin in response to an injury even though melanin is an already-occurring pigment that gives our skin, eyes, and hair their color, excess melanin results in hyperpigmentation (areas with extra pigment). 

There are various types of hyperpigmentation, but post-inflammatory hyperpigmentation is directly related to any type of trauma that occurs to the skin. The causes of PIH include:

  • Acne
  • Eczema
  • Impetigo
  • Infections
  • Bug bites
  • Burns
  • Rashes
  • Allergic reactions
  • Razor bumps
  • Psoriasis

What Does PIH Have to Do with Skin Tone?

While individuals of any age and any skin type can experience post-inflammatory hyperpigmentation, it is far more common in people with darker skin tones. 

In fact, as many as 65% of people with darker skin and acne will experience post-inflammatory hyperpigmentation. And the darker your skin, the more noticeable and persistent the hyperpigmentation tends to be.

How to Treat Post-Inflammatory Hyperpigmentation

There are two essential steps in treating PIH:

  • Managing acne
  • Reducing hyperpigmentation

Each of these components is key for optimal, long-lasting results. 

Acne treatment and management

Acne is among the most common skin conditions, and it can be an incredibly frustrating issue to battle. There are many different types and causes of acne, and the severity of breakouts can differ dramatically from person to person.

For some people, a basic skin care regimen is enough to keep acne at bay. But for so many others, professional dermatology support is a must. 

Depending on your specific case, our acne management experts may recommend a customized combination of any of the following:

  • Antibiotics (oral or topical)
  • Hormonal treatments
  • Benzoyl peroxide
  • Tretinoin
  • Extraction
  • Chemical peels
  • Microneedling

Gaining control of your breakouts can help you reduce the occurrence of post-inflammatory hyperpigmentation. It is also important to do your best to avoid picking at active breakouts, which can often lead to infection or scarring.

Hyperpigmentation treatments

You may have seen over-the-counter skin care products that promise to make hyperpigmentation disappear. And while some can help you improve post-inflammatory hyperpigmentation, it is usually necessary to undergo professional treatments to make significant progress.

At Affiliated Dermatology, our treatments for hyperpigmentation included a diverse range of options. This makes it possible to suit widely varying needs, allowing us to customize treatment plans according to individual patient needs and goals. 

Options include:

Cosmeceuticals and Prescription Skin Care

  • We always recommend using a broad-spectrum sunscreen (minimum SPF 30) consistently to prevent further skin damage and worsening of existing hyperpigmentation.
  • Products and ingredients such as kojic acid, hydroquinone, vitamin A, and alpha-hydroxy acids can also be highly effective components of a PIH treatment plan.

Chemical Peels

Chemical peels for hyperpigmentation can be a “next step” when topical treatments don’t deliver the desired results. Ingredients such as lactic, glycolic, and salicylic acids help boost cell turnover and exfoliate the skin, with varying chemical peel strengths available depending on your needs.


Another effective option is micro-needling for hyperpigmentation. Using a specialized device, one of our skilled experts increases cell turnover, rejuvenates the skin, and targets pigmentation issues. The process also involves applying serums rich in antioxidants, skin brighteners, and other ingredients, taking advantage of increased absorption immediately after treatment.

Learn More About Hyperpigmentation Treatment in Phoenix, AZ

Post-inflammatory hyperpigmentation can become a serious struggle for individuals dealing with acne in skin of color. Research shows that PIH is more common in darker skin tones, making it more likely that you’ll face PIH if you are a person of color. 

However, with hyperpigmentation treatments from Affiliated Dermatology, you can see significant improvements in the evenness of your skin tone – and the frequency and severity of your acne breakouts. Let us help you formulate a tailored treatment plan to tackle your acne and hyperpigmentation and any other skin care challenges you may have. 
Contact one of our Phoenix dermatology offices to schedule your consultation now!

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