#hyperpigmentation - why do some people present dark skin blemishes after healing?

 


What is post-infammatory hyperpigmentation?

It is a hyperpigmented discolouration that is left on the skin after an underlying skin disease has healed. The underlying skin diseases include:

• trauma, 
• skin infections, 
• eczema (dermatitis), 
• acne, 
• photosensitizing plants 
• drug reactions.

In dark-skinned people, the hyperpigmentation (dark coloured patches) tends to be more intense and persists for a longer period. Finally, it tends to fade slowly with time, although in some cases it can last a lifetime.

How is post-inflammatory hyperpigmentation treated ?

Usually, normal skin colour will return slowly over a period of months. The patients should avoid further trauma in the area, e.g. frequent rubbing and sunlight exposure.

Treatment options include bleaching agents such as those containing hydroquinone, although clinical practice shows that these medications are not more rapidly effective than if no treatment is given. Azelaic acid 20% cream can also be tried, twice daily, with beneficial results.

Creams containing derivatives of vitamin A (retinol, tretinoin, retinoic acid) are not recommended as they induce an inflammation which worsens the problem.