Now that we’re living in an age of brightening products (is there a brand that hasn’t come up with some sort of magical lightening or glow-intensifying product in the last year and half?) it seems like high time to discuss at least part of what those products are trying to correct. So settle in kids, let’s talk about hyperpigmentation. First a definition (or a few): hyperpigmentation is caused when melanin (what gives our hair and skin color) is overproduced in certain spots on the skin, causing them to look darker than your natural skin tone. There are a couple of common causes—age spots on skin that is often exposed to the sun; melasma, often as a result from birth control hormones or pregnancy; and post-inflammatory hyperpigmentation, which happens after a pimple, bug bite, or other trauma to the skin once it heals and leaves a mark behind. The most misunderstood idea about hyperpigmentation is that it melts away instead of coming up and out,” says Dayle Breault, of Goddess of Skin and facialist to Tracee Ellis Ross, Lenny Kravitz (plus Zoë and Lisa Bonet) and Britt Morgan Saks.
“People think it’s going to fade—which it will do—but it won’t do that without scrubbing away the cells and working on it. And sometimes it’ll get darker before it gets lighter,” As with the night, it seems. When thinking about hyperpigmentation, it's best to break it down into two categories: prevention and treatment. As always, knowledge is power. It goes without saying, but we'll type it anyway: Stop picking at your skin and don't just apply sunscreen—remember to reapply every two hours. Dayle continues that people of color also have to be particularly careful when it comes to hyperpigmentation. “Though black skin would appear thicker and stronger than Caucasian skin, it’s actually much thinner and much more sensitive,” she says. “So you have to be much more careful around heat, with the sun, with any type of extractions, or anything that could make a change in the epidermis.” Men have to be especially careful of ingrown hairs on their face and women with facials.
“Even a hot yoga class or some time in a sauna can bring out pigment,” Dayle warns. “And as soon as you put a chemical lightener on your skin, you become a magnet for the sun. You have to wear a hat.” Adding in an antioxidant or vitamin C serum doesn't hurt either—we're fans of the newly released 111Skin Space Antioxidant Booster. First things first, scrub, as Dayle mentioned earlier. It doesn't have to be fancy, and it doesn't have to be chemical. Dayle recommends something physical—her Bonafide Scrub has a mix of granules (made from amber and microdermabrasion crystals) and is safe enough for sensitive skin too. If you’re an ingredient-list reader, be on the lookout for hydroquinone. Often used as a prescription-strength brightener, it’s available over the counter in lower—though still powerful—percentages. “You have to be careful with it,” Dayle says. “You can’t use it if you’re pregnant or trying to get pregnant—and you can only use it for six weeks at a time, and then you have to get off of it.
It’s that toxic…but it works.” Murad's Post-Acne Spot Lightening Gel has 2 percent hydroquinone, and while the directions instruct on massaging it over your whole face and neck, Dayle recommends using any product along these lines just as a spot treatment. Otherwise, you'll bleach out the rest of the skin and the spots will continue to look dark in comparison. As an alternative, SkinCeuticals' Advanced Pigment Corrector is hydroquinone-free (it's got salicylic acid and hydroxyphenoxy propionic acid instead). On the higher end, there's the RéVive Perfectif Even Skin Tone Serum that illuminates the face and is simply a dream to swipe on for $325 a pop. On the natural side of things, Dayle now works with willow bark and licorice root extracts when formulating her products for a natural lightening solution. The Indie Lee Brightening Cleanser capitalizes on strawberry fruit extract and hydrolyzed wheat protein for some moderate complexion control that you don't have worry about concentrating on a specific spot.
For more serious cases, there's chemical peels, lasers, and microneedling (which Dayle calls “the poor man's Fraxel"). They can help renew cells faster and reveal non-hyperpigmented skin. Microneedling in particular also allows product to go deeper in to the skin, as opposed to simply sitting on top. However, these are all best left to the professionals, so consult your dermatologist if considering. Then there’s the most frustrating, but often very reliable, cure of patience. Spots caused by trauma—say, a badly done home extraction—can go away on their own. You might just have to give it a year—or three.we're sorry, but you appear to be a bot and we've seen too many requestswe enforce a hard speed limit on requests that appear to come from bots to prevent abuse. if you are not a bot but are spoofing one via your browser's user agent string: please change your user agent string to avoid seeing this message please wait 8 second(s) and try again. as a reminder to developers, we recommend that clients make no
request every two seconds to avoid seeing this message.Now that you’ve successfully cleared your acne, you may staring at some stupid pesky red or brown marks that your breakouts left behind. Those stubborn little critters is what we’ll be focusing on in this article. Let me start off by bringing you up to speed about the differences between Post Inflammatory Hyperpigmentation (PIH), and Post Inflammatory Eythema (PIE). If you’re unfamiliar with these terms, allow me to blow your mind away. The pesky red spots on your face from old acne you’ve been trying to treat aren’t post inflammatory hyperpigmentation (PIH) marks, and the products you’re using to target them may be ineffective. Okay, what the hell am I talking about? Table of Contents1 Differentiating Between Types of “Acne Scars.”2 What is Post Inflammatory Hyperpigmetation (PIH)? What causes PIH?3 What is Post Inflammatory Erythema (PIE)? What causes Post Inflammatory Erythema (PIE)? How to test for Post Inflammatory Erythema (PIE).4 Atrophic Scars.5 The Takeaway.6 How to Treat Post Inflammatory Erythema (PIE).
How much does a v-beam laser session cost? Is there anything else that will treat my PIE?7 How to Treat Post Inflammatory Hyperpigmentation (PIH).8 Product Recommendations. Subscribe to My Newsletter Popular Guides My Holy Grail Products See All Posts Recent Posts The term “acne scars” has sort of become an umbrella term to describe three very different things: Post inflammatory hyperpigmentation (PIH) are brown or black marks caused by an overproduction of melanin. Think freckles, birthmarks, and sunspots. If you don’t know what melanin is, it’s simply the pigment that gives color to human hair, skin, and eyes. The cells that produce this melanin are called melanocytes. And the process of melanin production is called melanogenesis. Were all those terms confusing? Here they are again. Darker skin types (IV-VI) are more susceptible to PIH because they have overactive melanocytes. PIH is triggered by an inflammatory response that initiates melanin production.
(1) Possible causes include: getting a pimple, aging, pregnancy (melasma), hormones, and sun exposure. Melanin protects your skin from the sun by absorbing 50-75% of UV radiation. (2) Ever wonder why dark skinned people don’t burn as easily? It’s because they have more melanin to protect themselves. More melanin means less susceptibility to sunburn. Why is this important? Because the sun causes your skin to produce more melanin in order to protect itself. Melanin is the driving factor behind hyperpigmentation issues. The less work we give to our melanocytes, the better our prospects are in treating PIH. This is why sunscreen is so important! It works by absorbing UV radiation, so melanin doesn’t have to. In other words, it’s doing the heavy lifting so your melanocytes can take a break. As a result, less melanin is produced — therefore, less hyperpigmentation. Post Inflammatory Erythema (PIE) is a recently coined term gaining traction in the dermatological world referring to the red or purplish marks left behind from inflammation (usually acne).
(3) I have a lot of experience with this personally. Here’s the photo posted above again, so you can get a visual. Notice how the spots are red and not brown? That’s one of the main ways of distinguishing PIE from PIH. The redness you see is a result of “discrete erythematous macules.” In other words, damage or dilation done to capillaries (small blood vessels) near the surface of the skin resulting in cute little red spots (sarcasm). This is how I really feel about PIE: PIE falls on the lighter spectrum of skin tones, and is less likely to affect people of color. It’s possible to have a mix of both PIE and PIH. In fact, PIE can sometimes turn into PIH if left untreated. I suspect that most people have a combination of both. Treatments geared towards treating PIH (brown spots) focus on inhibiting melanin production, which unfortunately does nothing for PIE because it’s not a melanin-induced problem. PIE is the result of inflammation caused by trauma. This includes, but is not limited to — inflamed acne, picking at pimples, popping pimples, dry or dehydrated skin, chemical burns, over-exfoliation, cuts, scrapes, scratches, sunburn, sun exposure etc.
Post inflammatory erythema disappears temporarily when pressure is applied to the area. This is known as “skin blanching.” Here’s a visual of what that looks like. To do this test on yourself, find a clear container like a cup of glass or something similar and press down against the area you might suspect is PIE. If the mark becomes white and disappears, that’s a good indication you have PIE and not PIH. Hyperpigmentation (brown spots) are unaffected by this test. However, using this method isn’t always the most accurate and should be used more as a guideline than diagnosis. Atrophic scars are the actual indentations left behind in the skin after acne or inflammation has occureed. There are three different kinds: boxcar, icepick, and rolling. I also have a lot of experience with this too. The photo on the left shows what I’m talking about. That was my atrophic scarring at it’s worst. Shameless plug: subscribe to my newsletter by using the right sidebar to stay updated on a future post I’ll make all about getting rid of acne scars from home.
For the purposes of this article, we won’t be discussing atrophic scarring any further. At this point in time there are only two viable methods of treating PIE (as far as the research is concerned): vascular lasers (e.g. v-beam) and perhaps silicone sheets (you can find these on amazon). Remember how I said PIE is the result of damaged or engorged capillaries near the surface of the skin? That’s what makes vascular lasers such an incredibly effective treatment. They work by penetrating the skin deep enough to reach, break down, and disperse the damaged blood vessels that are causing PIE. The mechanisms behind silicone sheets are less understood but are known to increase the hydration of the stratum corneum (outer most layer of skin), protect from bacterial invasion, and maintain skin barrier integrity. This is completely anecdotal, and I have no scientific evidence to back this up but from my personal experience — products containing Vitamin C (either ascorbic acid or sodium ascorbyl phosphate) and Niacinamide help tremendously.
For product recommendations that contain these ingredients, scroll down to the table included at the bottom of this post. Vaseline (petroleum jelly) or Aquaphor also helped my PIE fade faster. My suspicion is that it works by creating a barrier itself (like silicone sheets) that induces a moist wound healing environment to expedite the PIE-fading process. I have a very strong suspicion that post inflammatory erythema (PIE) is worsened by a damaged moisture barrier or acid mantle, so like I mentioned in my how to get rid of acne article, you need to be really focusing on the moisturizing aspect of your routine and reduce irritation whenever possible. When I began doing those two things I shit you not, my PIE went from a deep red to lighter pink tone within a couple weeks and overall ended up fading significantly faster. I’ve also noticed that whenever I get a pimple now, the redness subsides within a couple weeks to a month, when before it use to take upwards of a year!
So yeah, hydrate hydrate hydrate. There’s a lot of ways to do this. For me, it meant double oil cleansing, adding a very basic hyaluronic acid toner (I like the Hada Labo HA lotion), sometimes skipping my morning cleanse altogether, and a hydrating essence/gel (my favorite is the Benton Snail Bee High Content Essence — has a SEXY ASS ingredient list). But find what works for you! It depends on your location and dermatologist. I’ve seen estimates as low as $150 all the way up to $500. If you decide to invest in vascular laser treatments, do your research first and compare prices. These things are expensive, so don’t allow yourself to get ripped off! Patience and time, my friend. I know you don’t want to hear this, but the difference in the photos above took several months. I understand that not everyone has a budget to afford laser treatments (heck, me included), so most of us will have to play the waiting game. Rest assured though, the pesky red marks will eventually go away on their own given you don’t do anything silly like pick at your face or forget to wear sunscreen.
A lovely reddit user (u/MissPicklesMeow) said it best: “Patience is cheaper, but sometimes harder to come by.” The idea behind treating PIH is twofold: inhibit tyrosinase (an enzyme that catalyzes the production of melanin), and increase cell turnover rate so the spots fade faster. (7) Oh, and use sunscreen! LOTS and LOTS of sunscreen! As mentioned earlier, melanin production is the driving force behind post inflammatory hyperpigmentation. The more we can limit melanin production, the less hyperpigmentation problems we will have. Luckily for us, there are a slew of products that inhibit melanin by telling tyrosinase to chill out. “Just chill out dude!” I can hear them confronting him already. The concept behind increasing cell turnover to help PIH is pretty straight forward. The faster your cells renew and shed off old skin, the less time we’ll have to wait for PIH to go away. Here’s an extensive list of ingredients and products that either inhibit tyrosinase or increase cell turnover rate. F