Acne is a difficult skin condition for anyone to deal with, but people with more deeply pigmented skin have a unique set of challenges. They can develop a condition called post-inflammatory hyperpigmentation when they use acne treatments – even common ones such as benzoyl peroxide.
What is Post-Inflammatory Hyperpigmentation?
Post-inflammatory hyperpigmentation occurs when pigment-producing melanocyes produce too much melanin. This causes dark brown or black spots to appear on the skin in areas where acne lesions were. Needless to say this can be disturbing to the person unfortunate enough to have it. What causes post-inflammatory hyperpigmentation, and how do you treat it?
Causes of Hyperpigmentation Due to Acne
Post-inflammatory hyperpigmentation isn’t unique to acne sufferers. It can come from taking certain medications, allergic reactions, skin infections, burns and as a manifestation of some skin diseases. In people with acne, it can be caused by skin irritation from using acne treatment medications.
Even common acne treatments such as benzoyl peroxide cause skin irritation that can lead to pigmented areas on the skin. Up to one out of twenty people is sensitive to benzoyl peroxide, which makes them prone to developing skin irritation and post-inflammatory hyperpigmentation especially if they have dark skin.
Many doctors prescribe retinoids to treat patients with acne. Retinoids cause skin irritation in people when they start using it, which predisposes them to post-inflammatory hyperpigmentation. Because of this risk, some doctors don’t prescribe retinoids for people with lots of pigment in their skin. Interestingly, retinoids are sometimes used to treat inflammatory pigmentation.
Can Post-Inflammatory Hyperpigmentation Be Reversed?
Pigmentation that comes from using retinoids may go away once they’re stopped, but this isn’t necessarily the case with hyperpigmentation that comes from other acne treatments. The key is to stop whatever treatments are causing the irritation, and wear a high SPF sunscreen to block out the sun’s rays. Irritation and ultraviolet light are two enemies of hyperpigmented skin.
Most doctors prescribe a topical cream called hydroquinone that helps lighten the pigmentation by reducing pigment production. Hydroquinone is not without problems though. According to some animal studies, it may increase the risk of cancer, and some people who use it long-term experience skin darkening rather than the desired lightening effect. Some people are also allergic to the preservatives in hydroquinones.
The safest way to use hydroquinone is to use a small amount and apply it only to the pigmented areas. Using a heavier make-up such as Derma-blend helps to hide the pigmented areas until they lighten, which may take up to a year. Other treatments for post-inflammatory hyperpigmentation are glycolic acid and chemicals peels. Always consult with a dermatologist before using these treatments if you have pigmented areas on your skin.
The good news? Post-inflammatory hyperpigmentation isn’t permanent like a scar and will usually resolve over months to years even without treatment. Talk to your dermatologist if you believe you have this problem.
Family Practice News. October 15, 2010. page 57.