Submit your skincare questions to Dr. Agnes, CEO of Herborium and natural medicine expert
especially large and chronic cysts or pimples and blackheads that we
squeeze or pop, may damage skin tissue permanently, forming acne scars.
The only real way to make sure that you do not get acne scars is to PREVENT acne from forming and to break the acne cycle.
There is however a condition that may follow acne, but is NOT permanent, that sometimes is confused with acne scars; this condition is known as Post Inflammatory Hyperpigmentation (PIH).
is the medical term for skin discoloration resulting from an
inflammatory injury to the skin tissue. It is the skin's natural
response to inflammation. PIH is a flat area of discoloration on the
skin ranging from pink to red, purple, brown or black, depending on your
skin tone and depth of the discoloration.
forms when a wound, rash, pimple, or other skin damage causes skin
inflammation, which triggers the skin to produce too much melanin.
Melanin is the protein in the skin that gives the skin its color. Too
much melanin darkens and discolors the skin in the area of former
inflammation. This discoloration stays on the skin even after the
pimple, cyst or other skin "injury" has healed.
is very common among acne sufferers, both men and women. It can occur
in all skin types, although it is more common with darker skin
complexions. PIH is not however a true acne scar. For acne
sufferers, PIH can follow both severe cysts and relatively minor pimples
and papules, but usually more inflammation produces larger and darker
PIH. As we said, picking, squeezing or popping pimples increases the chances of developing post inflammatory hyperpigmentation.
can identify post inflammatory hyperpigmentation by carefully examining
the skin. PIH can be a range of colors, however, the skin will not be
wrinkled or depressed. PIH may look like a large freckle or as a large,
dark discoloration or spot and sometimes it may even look like new skin.
Scars can be recognized for their texture whereas PIH is more about
discolorations, and scars also involve indentations.
is good to know that PIH is not scarring, and in most cases it will
fade away over time, even without treatment, but it can take anywhere
from 3-24 months (sometimes even longer) for most of the PIH spots to
fully disappear. The time it takes for PIH to fade depends on how dark
the PIH spot is compared to your skin tone. The bigger the contrast
between the PIH and your natural skin tone, the longer it will take to
There are treatment options available to help fade Post Inflammatory Hyperpigmentation quicker. However, your acne should be under control before beginning any treatment for PIH. Otherwise, each new pimple could cause another PIH, reducing the effectiveness of treatment. So treating your PRESENT ACNE and PREVENTING NEW ACNE from coming are the first conditions to treat and prevent PIH.
treatment option you choose, understand that improvement will take
time, requires persistence and patience and may cost a lot of money.
Think in terms of months rather than weeks. Also, if you have PIH be
especially diligent in applying a broad-spectrum sunscreen daily. The
sun may darken the discolorations and increase fading time.
cases of PIH may respond well to natural lightening agents such as
lemon juice and some over-the-counter "lightening" products. Many of
them use a combination of alpha and beta hydroxy acids (including
glycolic acid), vitamin A, vitamin C, and other ingredients to exfoliate
the skin and speed up the growth of new cells. Some products include
lightening agents to "bleach" discolorations. If you have a darker
complexion beware of " bleaching" products as they may actually leave
you with another type of spots. Also, you don't want to expose your skin
to all of these chemicals.
is a common treatment for post inflammatory hyperpigmentation. It is
available over-the-counter at 1% to 2% strength, and in 3% to 4%
prescription creams. Hydroquinone works by blocking the enzyme
responsible for melanin production, thereby lightening the skin.
creams often contain additional lightening ingredients, such as kojic
acid, glycolic acid, tretinoin and other retinoids, or vitamin C. These
combinations of creams can give you better results than using
hydroquinone alone BUT THERE IS A SERIOUS WARNING HERE.
products should be used with caution and sparsely on affected areas
only, to prevent the unwanted lightening of your natural skin color.
Hydroquinone may also cause irritation in sensitive skin.
that exfoliate the old skin cells are often prescribed to treat PIH.
Obvious results may not be apparent for several weeks to several months
and topical retinoids may cause excessive dryness, redness, and/or
irritation, which may in turn increase hyperpigmentation.
acid is an alpha hydroxy acid found in many skin care products. It
effectively exfoliates the skin, helping to lighten post inflammatory
hyperpigmentation. Available in cleansers, creams, and gels, glycolic
acid not only helps improve postinflammatory hyperpigmentation, but also
leaves your skin smooth and soft.
gels, pads, and lotions containing glycolic acid are available
over-the-counter. Higher concentrations are available with a
prescription only. As, with all products improvement may not be seen for
acid is used in prescription only products that attempt to treat PIH.
It works by decreasing inflammation and speeding up cell turnover rates.
It is an alternative for those who may be unable to use hydroquinone. Since
azelaic acid has not been tested on those with dark complexion so it
may actually be responsible for hypopigmentation. It may also irritate,
burn and sting the skin. Azelaic acid is available in cream and
gel form, and is sometimes used in conjunction with glycolic acid or
retinoids. As always, monitor your skin for redness and irritation and
let your doctor know right away if you experience these side effects.
persistent cases of post inflammatory hyperpigmentation can be attended
to with the use of professionally done chemical peels and
series of treatments is needed to adequately fade PIH and some side
effects may be associated with those treatments. None of them may be
used when you still have active acne.
always, we support a search for natural ingredients being used to help
improve skin conditions. The products mentioned above may take time and
patience to help brighten your skin, but they are chemical based
solutions you certainly should be careful about.
of those natural ingredients should also be used on skin that still
have active acne, and since they all exfoliate the skin, sun protection.
Here are some ingredients you need to look out for as they certainly
may speed up the healing of PIH: Raw honey, lemon juice (fresh from a
lemon contains citric acid that will both lighten the skin and speed up
skin regeneration), yogurt (contains lactic acid that works similar to
citric acid but will also moisturize the skin), wheat germ oil (natures
collegian helper), rosehips oil, aloe vera juice and of course raw sugar
cane sugar (produces glycoloc acid, praised by the cosmetic industry
now). None of these natural ingredients however should be used on skin
that still has active acne and since they all exfoliate the skin, sun
protection is necessary.
Use organic and non-GMO ingredients when possible.
well in a small bowl. Use fresh applying on freshly cleaned skin with
clean fingers or a clean natural hair brush. Avoid eye area. Keep on
for 5-10 minutes. Wash with luke warm water. If stinging occurs, wash
off immediately. Use 2-3 times per week. Follow with chamomile astringent and non comedogenic moisturizer.
Always follow this with sun protection and do NOT use on active acne
or before you go outdoors. Evening is the best to do this.
With a promise of clear skin,