Post Inflammatory Hyperpigmentation (PIH) is a common skin response that can occur after aesthetic treatments, such as lasers, chemical peels, or RF microneedling. It appears as darkened spots or patches on the skin due to excess melanin produced in response to inflammation. Though PIH typically fades over time, proactive care and tailored treatments can accelerate the process and enhance your skin’s radiance.

Why Does PIH Happen After Treatments?

PIH results from an inflammatory response that activates melanocytes, the cells responsible for producing melanin. This response can be triggered by laser resurfacing, chemical peels, or RF microneedling, especially in darker skin tones (Fitzpatrick skin types III-VI). Contributing factors include aggressive treatment settings, inadequate aftercare, and sun exposure.

Preventing PIH Before Treatment

1. Prepare Skin Pre-Treatment
   For those prone to PIH, using melanin-suppressing topicals like hydroquinone or retinoids beforehand can even out skin tone by reducing melanocyte activity.
2. Customized Treatment
   A skilled provider tailors laser and RF microneedling settings to your skin type, minimizing inflammation and the likelihood of PIH.
3. Sun Protection
   Sun exposure can intensify PIH, so avoiding it two weeks before and after treatment is essential. A broad-spectrum SPF 30+ sunscreen should be applied daily.

Managing PIH After Treatment

1. Topical Treatments to Lighten Pigmentation
   • Hydroquinone: Known for reducing melanin production, hydroquinone is often recommended by providers to treat hyperpigmentation.
   • Vitamin C: As an antioxidant, vitamin C brightens skin and fades PIH when applied regularly.
   • Retinoids: Encouraging cell turnover, retinoids speed up the shedding of pigmented cells (use only on fully healed skin).
   • Tranexamic Acid: Known for its gentle, melanin-suppressing effects, tranexamic acid is a good option for sensitive skin.
2. In-Office Treatments for Persistent PIH
   • Mild Chemical Peels: Peels like glycolic or lactic acid encourage cell turnover, lightening dark spots.
   • Microneedling (Without RF): Traditional microneedling promotes collagen production with minimal risk of further pigmentation.
   • Low-Intensity Laser Treatments: Targeted lasers like Nd

or Q-switched can address pigmentation safely.

1. At-Home Care Routine
   • Moisturize: Keep the skin hydrated with a gentle moisturizer to support healing.
   • Reapply SPF: Sun protection is essential to prevent PIH from darkening; reapply throughout the day.

When to Consult with a Provider

If PIH persists or worsens after three to six months, consider a follow-up with your provider. Additional treatments or prescription-strength options may be recommended for more effective care.

Expert Care with Dr. Roland Kafuuma

Our Medical Director Doctor Roland Kafuuma, MD at Aesthetics and Medical Lasers of Colorado is a highly experienced physician specializing in safe and effective aesthetic treatments. If you’re considering laser, chemical peel, or RF microneedling and are concerned about PIH, schedule a consultation with Dr. Kafuuma. Call us at 720-818-0533 to create a tailored treatment plan that prioritizes both your skin’s health and beautiful, lasting results.