Post-Inflammatory Hyperpigmentation (PIH) & Acne Marks Treatment in Singapore
Post-inflammatory hyperpigmentation (PIH) is a common cause of dark spots and acne marks that remain on the skin after acne or inflammation has healed.
During the COVID-19 pandemic, prolonged mask wearing also brought greater attention to “maskne” (mask-related acne). For some people, the acne eventually cleared but left behind persistent brown or dark marks — a common example of post-inflammatory hyperpigmentation.
However, PIH is not limited to acne or maskne. It can develop after many forms of skin inflammation or injury, including cuts, burns, insect bites and skin irritation.
PIH can affect all skin types but may be more noticeable and persistent in medium to darker skin tones. Depending on the depth and severity of the pigmentation, treatment options may include topical skincare, chemical peels and selected laser treatments.
If dark marks remain long after your acne has cleared, understanding whether they are post-inflammatory hyperpigmentation, redness or acne scars is an important first step in choosing the appropriate treatment.
What Causes Post-Inflammatory Hyperpigmentation?
Post-inflammatory hyperpigmentation develops when inflammation or injury triggers the skin to produce excess melanin — the pigment responsible for skin colour.
When inflammation occurs within the epidermis, melanocytes can produce and transfer increased amounts of melanin to surrounding skin cells. This can leave behind flat areas of brown or dark pigmentation after the original inflammation has resolved.
If inflammation affects deeper layers of the skin, pigment may also enter the dermis, where it can be taken up by immune cells called macrophages. This deeper pigmentation may appear darker or more persistent and can take longer to improve.
Common causes of PIH include:
- Acne and inflamed pimples
- Picking or squeezing acne
- Cuts and minor skin injuries
- Burns
- Insect bites
- Skin irritation or inflammation
- Certain skin treatments or procedures
Sun exposure can also make existing pigmentation appear darker and more noticeable. This is why daily sun protection is particularly important when managing post-inflammatory hyperpigmentation and acne marks. PIH can occur in anyone, but it tends to be more noticeable and may last longer in people with medium to darker skin tones due to higher baseline melanin activity.
Are Acne Marks the Same as Acne Scars?
Acne marks and acne scars are not necessarily the same. Flat brown or dark marks left behind after acne are commonly caused by post-inflammatory hyperpigmentation (PIH). Red or pink marks may instead be associated with post-inflammatory erythema (PIE). Acne scars, on the other hand, involve changes to the skin's texture or structure. These may appear as depressed scars, such as rolling, boxcar or ice-pick scars, or as raised scars.
Because pigmentation, redness and acne scars require different approaches, identifying what is causing the visible marks is important before starting treatment.
Post-Inflammatory Hyperpigmentation (PIH) Treatment
Post-inflammatory hyperpigmentation (PIH) treatment for dark spots and acne marks depends on the depth of the pigmentation, your skin type, and what caused the inflammation. Treatment options may include topical skincare, chemical peels and selected laser treatments. As PIH can occur at different depths within the skin, the treatment approach should consider both the existing pigmentation and the underlying inflammation or skin condition that caused it.
1. Topical Treatments for PIH
Topical skincare may be used to support the gradual improvement of post-inflammatory pigmentation. Depending on the individual's skin, products may contain ingredients that help regulate excess melanin production, encourage skin renewal or support the skin barrier. Daily broad-spectrum sunscreen is also important, as UV exposure can stimulate melanin production and make existing acne marks appear darker.
2. Laser Treatment for Post-Inflammatory Hyperpigmentation
Laser treatment may be considered for selected cases of persistent post-inflammatory hyperpigmentation. Different laser wavelengths interact with pigment at different depths within the skin, so treatment should be selected according to the type and depth of pigmentation present. For individuals prone to PIH, treatment parameters should also be carefully considered, as excessive heat or inflammation may potentially trigger further pigmentation.
Post Inflammatory Hyperpigmentation (PIH) & Acne Marks Treatment in Singapore
There are a variety of topical treatments available to help lighten post-inflammatory hyperpigmentation (PIH) and dark acne marks. However, as pigmentation can occur at different depths within the skin, topical treatments alone may not always be sufficient.
Our doctors may combine laser treatments with topical skincare to target pigmentation at different depths and improve the appearance of persistent dark spots. Following a consultation, the doctor will assess your skin type, the depth and extent of the pigmentation, and customise a suitable hyperpigmentation treatment for your skin.