post inflammatory hyperpigmentation on forehead

Post inflammatory Hyperpigmentation Singapore

Achieve Clearer Skin with FDA-approved Pico laser for pigmentation.

Pico laser uses ultrashort pulses to break down your pigments into smaller particles.

a woman touching her face

Postinflammatory Hyperpigmentation (PIH) is an acquired condition of the skin due to an increase of melanocytic activity in response to inflammation. Persistent PIH can cause distress and negatively impact your quality of life. Postinflammatory hyperpigmentation treatment options takes into account your skin type and managing factors that contribute to it.



Hyperpigmentation is a term used to describe darkened skin tone. There are several distinct types of hyperpigmentation that causes different types of skin discolouration and uneven skin tone. While not harmless, hyperpigmentation may cause you to feel self-conscious. With extensive experience in treating skin of colour, Dr. Ng aims to lighten your hyperpigmentation, promote healing, slow the progression of dark patches and enhance your confidence.

What Causes PIH?

The initiating inflammatory process causes melanocytes (pigment producing cells) to produce excess melanin. This triggers off oxidation of a variety of chemicals within the skin to stimulate melanocytes. The excess melanin are then deposited into normal skin cells. The deposition of melanin may involve the epidermal (superficial) layer, dermal (deep) layer or epidermo-dermal layers (mixed) of the skin. Inflammatory that is prolonged, severe or relapsing will increase the risk of postinflammaotory hyperpigmentation.

Common causes of PIH include Acne vulgaris, Atopic eczema, infections and burns.

Who is at risk of pih?

Although postinflammatory hyperpigmentation PIH can occur in just about anyone, it is more common in individuals with darker skin tone. In addition, it can occur at any age, any body part and affects both men and women equally.

PIH is also more common in individuals with sun-induced skin conditions and if on certain medications e.g. tetracyclines, anti-malarials, bleomycin.

woman with post inflammatory hyperpigmentation
Facial PIH
post inflammatory hyperpigmentation
Severe PIH
Back PIH

What Does PIH Look Like?

Patches of light to dark brown colour will be observed at the site of existing or previous injury or inflammation. Dark gray to bluish discolouration suggests a deeper dermal involvement. Postinflammatory hyperpigmentation darkens after sun exposure and can persists for months to years. 

How Is it Diagnosed?

Most cases of postinflammatory hyperpigmentation can be diagnosed through a history and examination of the affected area. On occasion, a skin biopsy may be needed in cases of uncertainty.


Any existing inflammation or infection must be dealt with promptly and effectively. For example, acne is a common cause of postinflammatory hyperpigmentation. Treating acne early and aggressively to reduce the inflammatory component is necessary to treat the cause and effect of the disease.

A regular use of sunscreen, protective clothing and sun avoidance behaviours are essential in Singapore. Steps should be taken to avoid picking at your skin to reduce further skin irritation and inflammation.

Topical treatments & Chemical Peels

Topical lightening treatments for PIH work by blocking further pigments, fading excess pigments and increasing skin turnover. Topical therapies are more successful at treating epidermal PIH rather than deeper dermal PIH.

Topical & chemical postinfammatory hyperpigmentation treatment options include:

  • Hydroquinone
  • Azelaic acid
  • Vitamin C
  • Triple therapy (Hydroquinone + Retinoid + Steroid) 
  • Chemical peels (glycolic, salicylic acid)

Laser Treatment of Postinflammatory Hyperpigmentation

postinflammatory hyperpigmentation laser removal
Laser treatment for PIH

Laser treatment of postinflammatory hyperpigmentation can be considered in cases that are long-standing, PIH refractory to topical treatments or dermal PIH involvement. Pigment specific lasers such as the Q-switched and Pico-second lasers work by breaking down melanin into smaller fragments which are subsequently cleared by your body. Pico-second lasers causes less collateral skin damage and are safer in darker skin types. However, laser treatments for PIH must be done cautiously, high energy laser treatments may potentially darken your PIH.

As each case is different, Dr Ng. will discuss with you the best postinflammatory hyperpigmentation treatment option that is unique for your skin type and condition to reach your aesthetic goals.

Frequently Asked Questions About Post-inflammatory Hyperpigmentation

Postinflammatory hyperpigmentation is not an easy condition to manage. The first step would be to address any existing inflammation, infection or injury to the skin.

While some cases of PIH do resolve by themselves without treatment, many cases of PIH can persists over months to years causing emotional distress, affecting self-esteem and confidence.

While lasers are effective for many pigmentation conditions such as freckles, lentigenes and Nevus of Ota, it is considered second-line therapy for PIH. Laser treatment has to be performed cautiously as it may sometimes darken the pigmentation further. 

Any existing inflammation, infection or injury to the skin makes you unsuitable for laser treatment. The underlying cause of your PIH should be managed and treated before considering any laser treatment.

This depends on the severity of PIH, duration and how deep the melanin extends below your skin. Multiple treatments (4-10 sessions) may be required to see an improvement in your PIH

Postinflammatory hyperpigmentation treatment can be a long and challenging process. Even with treatment, it may take at least 6-12 months or even longer to see an improvement. 

PIH is due to excess melanin that is deposited within the skin. Atrophic Acne scars are due to a loss of collagen within the dermal layer of the skin. Acne scars are classified as ice pick, rolling and boxcar according to their appearance. As a result, the treatment for PIH and acne scarring is different.

schedule a consultation for Postinflammatoy pigmentation removal in singapore

Dr. Ng has helped numerous patients achieve a more natural and beautiful complexion. If you want to explore options on how to remove your pigmentations effectively, contact us to schedule an appointment with Dr.Ng.

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  1. Anvery, NChristensen, REDirr, MAManagement of post-inflammatory hyperpigmentation in skin of color: A short reviewJ Cosmet Dermatol2022211837– 1840
  2. Elbuluk, N., Grimes, P., Chien, A. et al. The Pathogenesis and Management of Acne-Induced Post-inflammatory Hyperpigmentation. Am J Clin Dermatol 22, 829–836 (2021).
  3. Feng, J. and Huang, L. (2022), Treatment of permanent post-inflammatory hyperpigmentation with medium-fluence medium-spot-size setting in Q-switched Nd: YAG 1064 nm laser: A novel treatment parameters setting strategy. J Cosmet Dermatol, 21: 1300-1302.