Abstract
Post-inflammatory hyperpigmentation (PIH) is a common dermatosis most often seen in those with skin of color. PIH results when cutaneous inflammation or injury promotes activation of cytokines that induce melanin production and dispersion in the epidermis. Damage to the basement membrane results in pigment incontinence and eventual phagocytosis by melanophages in the upper dermis. The most common causes of PIH include acne, lichen planus, contact dermatitis, mechanical trauma, and skin-directed physical therapy such as dermabrasion, chemical peels, and laser surgery. PIH is a clinical diagnosis with light–dark brown macules or patches at the site of inflammation or trauma. Prevention is critical given the well-documented adverse effects on quality of life as well as the management challenge that it presents. PIH can take months to years to fade away. Diverse treatment modalities have been documented with variable success and include topical preparations, chemical peels, and laser therapy. Currently, the gold-standard treatment for PIH is 4% hydroquinone in combination with photoprotection.
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