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Post inflammatory Hyperpigmentation Treatment in Singapore
Achieve Clearer Skin with Customised treatment for Hyperpigmentation.
Effective management of PIH involves addressing the underlying cause of inflammation and implementing strategies to reduce pigmentation.
- Professional | Established | Trusted
- Over 15 years of experience
- Customised treatment to your skin type
- Safe for All Skin Types
What is Postinflammatory hyperpigmentation (PIH)?
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.
OUR APPROACH
HOW DR.NG TREATS PIH
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
- Burns
- Cosmetics
- Trauma
- Post-surgery
- Post-laser and chemical peel treatments (especially in dark skin individuals)
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.
What Does PIH Look Like?
PIH presents as flat, discoloured spots that can range in colour from light brown to black. Dark gray to bluish discolouration suggests a deeper dermal involvement. The spots can be round, irregularly shaped, or linear, depending on the nature of the inflammatory trigger. PIH can occur anywhere on the body but is most commonly seen on the face, neck, and areas frequently exposed to trauma or friction. Unlike other forms of hyperpigmentation, PIH does not cause a change in skin texture. 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.
What is the differnce between post inflammatory erythema vs. post inflammatory hyperpigmentation?
It is important to distinguish between post-inflammatory erythema and post-inflammatory hyperpigmentation. The causes, duration and trigger factors differ hence these would influence treatment options and management plan.
Feature | Post-inflammatory erythema (PIE) | Post-inflammatory hyperpigmentation (PIH) |
|---|---|---|
Definition | Pink, Red or Purple skin discolouration | Light to Dark Brown skin discolouration |
Cause | Small blood vessel dilation and skin thinning | Reactive melanin production from inflammation or injury |
Skin Type Affected | Lighter skin tones | Darker skin tones |
Trigger | Acne, Rosacea, Inflammatory dermatoses | Acne, Eczema, Insect Bites, Psoriasis |
Duration | Can last weeks to months | Can last months to years |
Prognosis | May resolve with time and treatment | Tends to be stubborn and persists longer |
What else it can look like | Rosacea, Seborrheoic dermatitis | Melasma, Lentigines, Rieh’s melanosis |
Treatment of PIH
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 shallower (epidermal) PIH rather than deeper (dermal) PIH.
Topical & chemical postinfammatory hyperpigmentation treatment options include:
- Hydroquinone: A lightening agent that inhibits melanin synthesis. A common lightening agent but long-term use can cause grey dicolouration known as onchronosis.
- Azelaic acid: An effective anti-pigment and anti-inflammatory agent that is well-tolerated.
- Vitamin C: With various formulations, it has combined anti-oxidant, anti-pigment and skin rejuventing effects.
- Triple therapy (Hydroquinone + Retinoid + Steroid): More potent formulation that has a synergistic effect on melanin production and elimination.
- Chemical peels (glycolic, salicylic acid): Able to help eliminate unwanted melanin through chemical exfoliation.
Laser Treatment of Postinflammatory Hyperpigmentation
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 (6-10 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.
Post inflammatory hyperpigmentation insight
While PIH is benign, it can have a considerable impact on patients' emotional and psychological well-being. A multifaceted treatment approach, including topical agents, chemical peels, and laser therapies, along with diligent sun protection, can effectively reduce pigmentation and improve skin appearance.
Schedule a consultation for Postinflammatoy pigmentation removal in Singapore
Early intervention and consistent use of treatments can significantly improve PIH outcomes. Patients should be advised that recurrence is possible if the underlying inflammatory condition is not adequately managed. If you want to explore options on how to remove your pigmentation effectively, contact us to schedule an appointment with Dr.Ng.
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Or give us a call at +65 6769 6007 | WhatsApp us +65 9855 3022
References:
- , , . Management of post-inflammatory hyperpigmentation in skin of color: A short review. J Cosmet Dermatol. 2022; 21: 1837– 1840.
- 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).
- 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.
ABOUT DR MOSES NG
MBBS (London) with distinction
Dip Practical Dermatology (Cardiff) with distinction
Member of American Acne & Rosacea Society
Fellow of American Society for Laser Medicine & Surgery
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Dr. Moses Ng is a distinguished professional in the field of aesthetic medicine, renowned for his expertise in advanced cosmetic procedures. With over 15 years of experience, extensive training and a keen eye for detail, Dr. Ng specializes in a wide range of treatments, including injectables, laser therapies, and acne scar management.
Dr. Moses Ng’s commitment to excellence and patient-centric approach have earned him a reputation as a trusted clinician in aesthetic medicine. His continuous pursuit of the latest advancements in the field ensures that his patients receive the highest standard of care and the most effective treatments available.