Treating Post Inflammatory Hyperpigmentation (Pih)

Post-inflammatory hyperpigmentation (PIH) is one of the most treatable forms of discoloration when the right plan is used consistently. At Danesh Dermatology, we tailor each PIH treatment to your skin tone, depth of pigment, and the underlying trigger causing the dark spots. By combining in-office procedures with targeted topical therapy and strict sun protection, we help fade discoloration faster, prevent recurrence, and restore a smoother, more even complexion.

We treat Epidermal, Dermal, and Mixed PIh

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.

What PIH Is and Why does it Happen

Secretion of melanin into various layers of skin that is caused by injury and/or 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 with varying degrees of severity.

How Long until results

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

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

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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.
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¹⁰ DermNet NZ. Post-Inflammatory Hyperpigmentation Overview.