The condition occurs when the pigment-producing cells melanocytes produce an excess of the skin pigment melanin in locations where the acne lesions were previously present.
Production of excess melanin in melanocytes is called hyperpigmentation and since the condition occurs after an inflammation (i.e. acne); it is known as post inflammatory hyperpigmentation.
Why and How Is Post Inflammatory Hyperpigmentation Caused?
With most people, post inflammatory hyperpigmentation is triggered due to treatment methods used for curing acne or any other inflammatory skin condition. It doesn’t normally occur when acne is unattended to and fades naturally. The condition is mainly a side effect of treatment methods used for healing inflammations.
There is no one specific treatment method that is known to lead to post inflammatory hyperpigmentation. Almost all kinds of treatment methods for healing inflammations lead to these spots.
Here are some of the most common methods that are likely to trigger hyperpigmentation in the acne lesions…
1. Benzoyl Peroxide
Benzoyl peroxide is the most common solution recommended for treating acne and other common inflammations. Benzoyl peroxide is extremely effective when it comes to treating acne.
However, it is known to cause skin irritation amongst many people. 1 in 20 people are known to be sensitive to Benzoyl peroxide.
Once the acne fades with Benzoyl peroxide, pigmentation tends to happen naturally as a side effect (even amongst those who are not sensitive to Benzoyl peroxide).
Most doctors recommend retinoids when it comes to treating certain kinds of acne. However, retinoids are known to cause nasty skin reactions at the beginning of treatment.
This leads to development of post-inflammatory hyperpigmentation once the acne spots fade. This is mainly common among people with darker skin complexions.
3. Injury caused
Plucking of pimples is also known to leave behind scars which in turn lead to development of post inflammatory hyperpigmentation.
Our body naturally tries to heal these scars quickly and an excess of melanin is produced in the affected areas to help heal the scars at the earliest.
4. Ultraviolet light exposure
Exposure to sunlight is known to naturally trigger increased melanin production. But in most cases, exposure to sunlight only causes your skin to tan. It does not cause your skin to develop these spots.
However, exposure to ultra-violet radiation on the recently faded spots is known to cause post-inflammatory hyperpigmentation.
Intake of drugs for treatment of acne or other illnesses are also known to cause hyperpigmentation. Some drugs that have been found to trigger hyperpigmentation include chloroquine, arsenic, chlorpromazine, tetracycline, bleomycin, busulfan and antimalarial drugs.
Hormonal drugs and contraceptive pills are also known to cause hyperpigmentation amongst many individuals.
Severe amount of stress (mental or physical) can impair your body’s ability to function properly. Your body’s natural reaction to increased stress is to produce high amounts of melanin in the skin cells.
The best way to prevent this is by ensuring that you get 7 – 8 hours of sleep each and every night and by maintaining a proper, well-balanced diet.
Post inflammatory hyperpigmentation is not only common amongst individuals with acne but also other inflammatory skin conditions that involve the dermo-epidermal junction such as psoriasis, chronic dermatitis, lymphoma, eczema, lichen planus, etc.
Prevention Of Post Inflammatory Hyperpigmentation
With any illness, it’s often better to prevent the development of the condition rather than try to cure it. The same can be said for post inflammatory hyperpigmentation as healing takes a really long time to work.
Epidermal pigmentation (i.e. involving the upper most layers of the skin) will take at least 3 – 6 months to heal whereas dermal pigmentation may take a year to heal. In some cases if the intensity is quite less, you can expect the condition to vanish naturally within 10 – 15 days as well.
With that said, here are some of the best methods for preventing post inflammatory hyperpigmentation…
1. Using a sunscreen
Using an effective sunscreen to block out excess sunlight and harmful UV radiation works extremely well when it comes to preventing hyperpigmentation.
Just make sure that the sunscreen you purchase has a sun protection factor of 60 and above. Sunscreens with sun protection factors lower than 60 are not effective especially when UV radiation is involved.
2. Preventing injury
It’s better to leave behind acne spots as they are instead of plucking them. Plucking the acne spots leads to development of scars which in turn leads to post inflammatory hyperpigmentation. Stop plucking your pimples and leave them on their own. They will heal naturally in a few weeks.
3. Skin lightening creams
Use of skin lightening creams in the affected areas before and after the onset of the condition can help keep the spots to a minimum. Skin lightening creams contain tyronsinase inhibitors which help prevent the production of melanin.