It is important to understand the difference between PIH and scarring, as they are commonly confused. PIH is a pigment change in the skin caused by certain cells called melanocytes. Scarring, on the other hand, is the formation of abnormal collagen in the skin. When touching a scar, you can feel an elevation or depression in the skin or a difference in the texture. This is not the case for PIH, where the skin remains flat and smooth. The reason to differentiate scarring and PIH is because the treatments are different.
PIH tends to occur on those with darker skin, namely those with Fitzpatrick skin types IV - VI. These skin types are common in certain groups such as Africans, African-Americans, Hispanics, Asians, Middle Easterners, and Mediterraneans. For this reason it is recommended that these people start a skin care regimen for several weeks prior to cosmetic treatments to minimize the risk of PIH. Recommended skin care products include brightening creams, exfoliants, antioxidants, and sunscreens. Without pre-treatment the risk for PIH is higher.
Fortunately PIH is temporary and treatable. It will usually go away on its own and the length of time it takes for this varies from person to person but can range anywhere from one week to over one year. Treatment for PIH includes a skin care regimen with brightening creams to lighten the discoloration. These products usually include ingredients such as hydroquinone (the strongest), kojic acid, alpha-arbutin, azeleic acid, and licorice extract. Sunscreen use with SPF at least 30 with UVA and UVB protection is mandatory to prevent the discoloration from becoming worse. Retinoids, antioxidants, and other products may be added for further benefit. Treatments such as photofacials, fractional lasers, and chemical peels may also help. The best way to treat PIH is by preventing it in the first place; this means knowing your Fitzpatrick skin type and getting on a good skin care regimen for several weeks prior to cosmetic treatments.
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