Treatments We Use in the Office

Hydroquinone (HQ)
A gold-standard brightening cream (2–4%) used in short cycles to reduce melanin production. Visible lightening usually begins in 8–12 weeks.

Chemical Peels
Glycolic and salycilic peels. Performed every 2–5 weeks with most patients seeing results after 3–5 sessions.

Laser (Low-Fluence 1064-nm Nd:YAG)
Targets stubborn pigment safely, especially in deeper skin tones. Studies show good to excellent improvement after ~3 sessions, often lasting 6+ months.

 

What PIH Is (and Why It Happens)

Integer tempus, elit in laorpigment from inflammation. More common and longer lasting in darker skin tones.

Types:

  • Epidermal PIH: Brown, sits in the top layer, fades fastest.

  • Dermal PIH: Gray or blue-gray, deeper and slower to fade.

  • Mixed PIH: A combination of both layers.eet posuere, lectus neque blandit dui, et placerat urna diam mattis orci. Nulla lectus ante, consequat et ex eget, feugiat tincidunt metus.

How Long Results Take

Hydroquinone: improvement in 8–12 weeks, stronger fading by 3–6 months. 

Chemical Peels: brightening after 3–5 peels (1–3 months).

Laser: noticeable improvement after ~3 sessions, often lasting 6+ months.

Without treatment: epidermal PIH may take 6–12 months to fade; dermal PIH may take years, sometimes not fully clearing.

Best Results Come From Combination Therapy

PIH fades fastest when treatments are combined, not used alone.

Our standard plan:

  • Treat the trigger (acne, eczema, ingrowns).

  • Daily SPF 30–50 to prevent darkening.

  • Short cycles of hydroquinone + a retinoid.

  • Peels to speed surface clearance.

  • Laser for deeper or resistant spots.

¹ Lawrence E. Postinflammatory Hyperpigmentation. StatPearls.
² Davis EC, Callender VD. Postinflammatory Hyperpigmentation: Epidemiology and Treatment Options. J Clin Aesthet Dermatol.
³ Moolla S. How to Manage Facial Hyperpigmentation in Skin of Colour. Br J Gen Pract.
⁴ Adebusoye OC. Combination Therapy for Acne and PIH. Cosmoderma.
⁵ Sarkar R. Chemical Peels for Pigmentation Disorders. J Cutan Aesthet Surg.
⁶ Cho SB. Low-Fluence 1064-nm Q-Switched Nd:YAG Laser for PIH. J Eur Acad Dermatol Venereol.
⁷ Li YH. Axillary PIH Improvement with 1064-nm Nd:YAG Laser. J Drugs Dermatol.
⁸ Hexsel D. Cysteamine 5% for PIH and Melasma. Clin Exp Dermatol.
⁹ Rodrigues M. Pharmacologic Treatment of Hyperpigmentation (Hydroquinone review). J Am Acad Dermatol.
¹⁰ DermNet NZ. Post-Inflammatory Hyperpigmentation Overview.