Postinflammatory Hyperpigmentation Follow-up
- Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD more...
Deterrence/Prevention
Patients with postinflammatory hyperpigmentation (PIH) should use sunscreen on a daily basis to prevent any further darkening of lesions.
Prognosis
Postinflammatory hyperpigmentation tends to fade with time and therapy, as previously discussed. Remnants of epidermal hyperpigmentation may persist for indefinite periods, typically 6-12 months, after the initial inflammatory process resolves. Dermal postinflammatory hyperpigmentation may even persist for years.
Patient Education
Educate patients about the cause of postinflammatory hyperpigmentation, prolonged therapy, and persistence of hyperpigmented lesions.
Graber EM, Tanzi EL, Alster TS. Side effects and complications of fractional laser photothermolysis: experience with 961 treatments. Dermatol Surg. Mar 2008;34(3):301-5; discussion 305-7. [Medline].
Harari Z, Sommer I, Knobel B. Multifocal contact dermatitis to nitroderm TTS 5 with extensive postinflammatory hypermelanosis. Dermatologica. 1987;174(5):249-52. [Medline].
Breathnach AS. Melanin hyperpigmentation of skin: melasma, topical treatment with azelaic acid, and other therapies. Cutis. Jan 1996;57(1 Suppl):36-45. [Medline].
Pandya AG, Guevara IL. Disorders of hyperpigmentation. Dermatol Clin. Jan 2000;18(1):91-8, ix. [Medline].
Burns RL, Prevost-Blank PL, Lawry MA, Lawry TB, Faria DT, Fivenson DP. Glycolic acid peels for postinflammatory hyperpigmentation in black patients. A comparative study. Dermatol Surg. Mar 1997;23(3):171-4; discussion 175. [Medline].
Yoshimura K, Harii K, Aoyama T, Shibuya F, Iga T. A new bleaching protocol for hyperpigmented skin lesions with a high concentration of all-trans retinoic acid aqueous gel. Aesthetic Plast Surg. Jul-Aug 1999;23(4):285-91. [Medline].
Yoshimura K, Harii K, Aoyama T, Iga T. Experience with a strong bleaching treatment for skin hyperpigmentation in Orientals. Plast Reconstr Surg. Mar 2000;105(3):1097-108; discussion 1109-10. [Medline].
Del Rosso JQ. The use of topical azelaic acid for common skin disorders other than inflammatory rosacea. Cutis. Feb 2006;77(2 Suppl):22-4. [Medline].
Grimes P, Callender V. Tazarotene cream for postinflammatory hyperpigmentation and acne vulgaris in darker skin: a double-blind, randomized, vehicle-controlled study. Cutis. Jan 2006;77(1):45-50. [Medline].
Shah SK, Alexis AF. Acne in skin of color: practical approaches to treatment. J Dermatolog Treat. May 2010;21(3):206-11. [Medline].
Katsambas AD. RALGA (Diacneal), a retinaldehyde and glycolic acid association and postinflammatory hyperpigmentation in acne--a review. Dermatology. 2005;210 Suppl 1:39-45. [Medline].
Kasraee B, Handjani F, Parhizgar A, et al. Topical methimazole as a new treatment for postinflammatory hyperpigmentation: report of the first case. Dermatology. 2005;211(4):360-2. [Medline].
Erbil H, Sezer E, Tastan B, Arca E, Kurumlu Z. Efficacy and safety of serial glycolic acid peels and a topical regimen in the treatment of recalcitrant melasma. J Dermatol. Jan 2007;34(1):25-30. [Medline].
Choi H, Ahn S, Lee BG, Chang I, Hwang JS. Inhibition of skin pigmentation by an extract of Lepidium apetalum and its possible implication in IL-6 mediated signaling. Pigment Cell Res. Dec 2005;18(6):439-46. [Medline].
Abu Ubeid A, Zhao L, Wang Y, Hantash BM. Short-sequence oligopeptides with inhibitory activity against mushroom and human tyrosinase. J Invest Dermatol. Sep 2009;129(9):2242-9. [Medline].
Hantash BM, Jimenez F. A split-face, double-blind, randomized and placebo-controlled pilot evaluation of a novel oligopeptide for the treatment of recalcitrant melasma. J Drugs Dermatol. Aug 2009;8(8):732-5. [Medline].
Sadick NS, Palmisano D. Novel synthetic oligopeptide formulation offers nonirritating cosmetic alternative for the treatment of melasma. Cosmet Dermatol. Apr 2010;23:175-9.
Rokhsar CK, Fitzpatrick RE. The treatment of melasma with fractional photothermolysis: a pilot study. Dermatol Surg. Dec 2005;31(12):1645-50. [Medline].
Rokhsar CK, Ciocon DH. Fractional photothermolysis for the treatment of postinflammatory hyperpigmentation after carbon dioxide laser resurfacing. Dermatol Surg. Mar 2009;35(3):535-7. [Medline].
Kim S, Cho KH. Treatment of procedure-related postinflammatory hyperpigmentation using 1064-nm Q-switched Nd:YAG laser with low fluence in Asian patients: report of five cases. J Cosmet Dermatol. Dec 2010;9(4):302-6. [Medline].
[Guideline] Morton CA, McKenna KE, Rhodes LE. Guidelines for topical photodynamic therapy: update. Br J Dermatol. Dec 2008;159(6):1245-66. [Medline].
Perez-Bernal A, Munoz-Perez MA, Camacho F. Management of facial hyperpigmentation. Am J Clin Dermatol. Sep-Oct 2000;1(5):261-8. [Medline].
Smit N, Vicanova J, Pavel S. The hunt for natural skin whitening agents. Int J Mol Sci. Dec 10 2009;10(12):5326-49. [Medline]. [Full Text].
Leyden J, Wallo W. The mechanism of action and clinical benefits of soy for the treatment of hyperpigmentation. Int J Dermatol. Apr 2011;50(4):470-7. [Medline].
Winhoven SM, Ahmed I, Owen CM, Lear JT. Postinflammatory hyperpigmentation in an Asian patient: a dramatic response to oral isotretinoin (13-cis-retinoic acid). Br J Dermatol. Feb 2005;152(2):368-9. [Medline].
Momosawa A, Kurita M, Ozaki M, et al. Combined therapy using Q-switched ruby laser and bleaching treatment with tretinoin and hydroquinone for periorbital skin hyperpigmentation in Asians. Plast Reconstr Surg. Jan 2008;121(1):282-8. [Medline].

