How to Treat Post-Inflammatory Hyperpigmentation (PIH) on Indian Skin Tones

Post-Inflammatory Hyperpigmentation (PIH) is one of the most common skin concerns among people with Indian and other darker skin tones. Whether it appears as dark spots after acne, burns, insect bites, eczema, or cosmetic procedures, PIH can be stubborn, frustrating, and slow to fade. The good news is that with the right understanding, ingredients, and patience, PIH can be effectively treated and prevented. This comprehensive guide explains what PIH is, why Indian skin is more prone to it, how to treat it safely, and answers frequently asked questions.

What Is Post-Inflammatory Hyperpigmentation (PIH)?

PIH refers to dark patches or spots left behind after the skin experiences inflammation or injury. Unlike melasma, which is hormonally driven, PIH occurs due to an overproduction of melanin in response to trauma or irritation.

Common triggers include:

• Acne breakouts
• Cuts, burns, or scratches
• Insect bites
• Allergic reactions
• Over-exfoliation
• Laser or cosmetic procedures
• Waxing or threading irritation

PIH can appear as brown, dark brown, grey, or even black spots, depending on skin tone and depth of pigmentation.

Why Is PIH More Common in Indian Skin Tones?

Indian skin typically falls under Fitzpatrick skin types IV to VI, which naturally produce more melanin. While melanin protects against sun damage, it also means that:

• The skin responds aggressively to inflammation
• Even minor irritation can cause pigmentation
• PIH tends to be darker and longer-lasting
• Improper treatments can worsen the condition

This is why gentle, targeted care is crucial for Indian skin.

Types of PIH

Understanding the depth of pigmentation helps guide treatment:

1. Epidermal PIH

• Light to dark brown
• Responds well to topical treatments
• Fades within months with proper care

2. Dermal PIH

• Greyish or bluish-brown
• Deeper and harder to treat
• May take years to fade

3. Mixed PIH

• Combination of both
• Requires long-term, layered treatment

How to Treat PIH on Indian Skin Tones?

1. Sun Protection Is Non-Negotiable

Sun exposure worsens PIH and slows healing.

What to do:

• Use a broad-spectrum sunscreen SPF 30–50 daily
• Prefer gel or lotion sunscreens suitable for Indian weather
• Reapply every 2–3 hours when outdoors
• Wear hats, scarves, or umbrellas when possible

Without sunscreen, even the best treatments will fail.

Gentle Skincare Comes First

Indian skin prone to PIH does not tolerate aggressive treatments well.

Avoid:

• Harsh scrubs
• Daily exfoliation
• Alcohol-heavy toners
• Picking acne or scabs

Focus on:

• Mild cleansers
• Barrier-repair moisturizers
• Minimal routine consistency

Proven Ingredients for Treating PIH

a) Niacinamide (2–5%)

• Reduces inflammation
• Regulates melanin transfer
• Improves skin barrier

Ideal for beginners and sensitive skin.

b) Azelaic Acid (10–20%)

• Gold standard for acne-related PIH
• Reduces pigmentation and redness
• Safe for darker skin tones

Can be used once daily initially.

c) Alpha Arbutin

• Inhibits melanin production
• Gentle and effective
• Works well with niacinamide

d) Vitamin C (L-Ascorbic Acid or derivatives)

• Brightens existing pigmentation
• Boosts collagen
• Best used in the morning with sunscreen

Start with lower concentrations (10–15%).

e) Retinoids (Retinol, Tretinoin)

• Speeds up cell turnover
• Helps fade deep PIH
• Prevents new acne

Use only at night and introduce slowly.

Chemical Exfoliation – Use With Caution

Exfoliation helps remove pigmented cells but must be gentle.

Recommended options:

• Lactic Acid (5–10%)
• Mandelic Acid (best for Indian skin)
• Glycolic Acid (low strength, once weekly)

Avoid overuse, as irritation = more PIH.

Professional Treatments (Dermatologist-Supervised)

For stubborn PIH, professional care may be required:

• Chemical peels (mandelic, lactic, glycolic)
• Q-switched lasers (for dermal PIH)
• Microneedling with brightening serums

Important: Always consult a dermatologist experienced with Indian skin tones to avoid rebound pigmentation.

What Not to Do When Treating PIH?

• Do not use steroid creams without prescription
• Avoid “instant fairness” products
• Do not mix too many actives at once
• Avoid home remedies like lemon, baking soda, or toothpaste
• Never skip sunscreen

How Long Does PIH Take to Fade?

• Mild PIH: 3–6 months
• Moderate PIH: 6–12 months
• Deep PIH: 1–2 years or longer

Consistency and patience are key.

Preventing PIH in Indian Skin

• Treat acne early
• Never pop pimples
• Use post-procedure sun protection
• Avoid over-exfoliation
• Maintain skin barrier health

Frequently Asked Questions (FAQs)

1. Can PIH go away completely on Indian skin?

Yes, most PIH can fade significantly or completely with consistent treatment, sun protection, and time. Deep dermal PIH may not disappear entirely but can lighten considerably.

2. Is PIH permanent?

No, PIH is not permanent, but it can last for years if untreated or worsened by sun exposure and irritation.

3. Which ingredient works fastest for PIH?

Azelaic acid and retinoids are among the most effective, but results depend on skin tolerance, consistency, and sunscreen use.

4. Can home remedies treat PIH?

Natural remedies may soothe skin but cannot effectively treat PIH and may worsen pigmentation if irritating.

5. Is laser safe for Indian skin tones?

Yes, when done by an experienced dermatologist using the correct laser settings. Incorrect treatment can worsen pigmentation.

6. Can PIH come back?

Yes, if the skin experiences new inflammation or sun damage. Preventing triggers is essential.

7. Does acne treatment worsen PIH initially?

Some treatments (like retinoids) may cause temporary purging, but they help reduce PIH long-term when used correctly.

8. Can men get PIH?

Absolutely. PIH affects all genders equally, especially those with acne-prone or sensitive skin.

9. Should I stop skincare once PIH fades?

No. Maintenance with sunscreen, gentle actives, and barrier care prevents recurrence.

10. When should I see a dermatologist?

If PIH is severe, spreading, or not improving after 3–4 months of consistent care.

Final Thoughts

Treating Post-Inflammatory Hyperpigmentation on Indian skin tones requires patience, gentle care, and a science-backed approach. Aggressive treatments often worsen the condition, while consistent, targeted skincare combined with sun protection delivers lasting results.

Remember: calm skin heals better. Focus on reducing inflammation, protecting your skin barrier, and allowing time for pigmentation to fade naturally.