Is Post Inflammatory Hyperpigmentation a Permanent Acne Scar?

Will Those Dark Spots Pimples Leave Behind Ever Go Away?

Post-inflammatory hyperpigmentation, those dark discolored spots left behind after a pimple heals, can be even more aggravating and distressing than pimples themselves. And these spots are all too common. Most people with acne have some degree of post-inflammatory hyperpigmentation (PIH). 

Post-inflammatory hyperpigmentation isn't a true acne scar.

Would you be relieved to learn that post-inflammatory hyperpigmentation is not true scarring. It is often called "pseudo scarring" because although it leaves a mark on the skin for a period of time, it does not actually damage the follicle.

True acne scars occur when there is either a loss of tissue (as in atrophic scars) or an overgrowth of tissue (as in hypertrophic scars).

PIH, on the other hand, is a flat spot that is darker than the surrounding skin. This discoloration can range from pink to red, purple, brown, or black.

Post-inflammatory hyperpigmentation often fades away, and can completely disappear, over time.

The good news? PIH can fade away over time, even without treatment. But time is the operative word here. It can take three to 24 months for PIH to fully fade, although in some cases it may take longer.

Don't want to wait that long? Treatment can help speed up fade time.

The length of time it takes for PIH to fade depends on how dark the PIH macule is compared to your skin tone. The bigger the contrast between the macule and your natural skin tone, the longer it will take to fade.

If post-inflammatory hyperpigmentation doesn't fade on its own, treatment can help.

But there is some bad news here. For some people, post-inflammatory hyperpigmentation will not fade away on its own. In some cases, it's more or less permanent. 

Before you give up hope, though, there are treatments out there that will help, if not completely erase the marks, at least lighten them considerably. 

Over-the-counter products with ingredients like glycolic acid and niacinamide can help fade more subtle marks. For deeper marks, or those that have been around for a long time, a prescription cream is a better choice. Your dermatologist has a bevy of products that can do the trick.

Another good point to remember -- if you beat acne you'll also stop developing PIH. This is an important step in clearing up PIH. And another step with which your derm can help. 

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Article Sources

  • Dreno B, Gollnick HP, Kang S, Thiboutot D, Bettoli V, et. al.  "Understanding innate immunity and inflammation in acne: implications for management."  J Eur Acad Dermatol Venereol. 2015 Jun; 29 Suppl 4:3-11.
  • Goh CL, Abad-Casintahan F, Chow SK, Kubba R, Miyachi Y, et. al.  "Evaluating acne-related post-inflammatory hyperpigmentation is a challenge even amongst experts." J Dermatol. 2014 Dec; 41(12):1106-8.