Postinflammatory Hyperpigmentation

Key Points
Skin condition which affects skin which has been previously injured or diseased
Caused by elements of the healing process which affect the activity of pigment cells in the skin
Consists of discoloration in the affected area, which may be black to light brown in color

Postinflammatory hyperpigmentation is a condition which affects skin that has been previously injured or affected by disease. It typically consists of discoloration (Hyperpigmentation) in the area which was traumatized. Discoloration may be black to light brown in color, and may darken when exposed to sunlight or if the affected person is taking certain medications. In some cases, hyperpigmentation may affect the dermis, the lower layer of skin, which tends to resist treatment.

Postinflammatory hyperpigmentation is caused when elements of the healing process affect the activity of pigment producing cells in the skin, causing a buildup of pigment which causes discoloration. The condition may affect anyone regardless of age, gender or ethnic groups, but is more common in those with darker skin.

Differential Diagnosis (Other conditions with similar appearance)
Pityriasis rubra pilaris
Secondary Syphilis
Parapsoriasis
Lichen simplex
Dermatitis

Diagnosis
Key Points
Initial diagnosis based on clinical appearance of the affected area
Skin biopsy may be performed to confirm diagnosis and rule out other conditions

Postinflammatory hyperpigmentation is initially diagnosed based on the appearance of the affected area in clinical examination. A skin biopsy may be performed to confirm the diagnosis and to rule out similar appearing conditions.

Treatment
Condition is typically self-resolving, though this may take up to a year
Use of sunscreen is recommended to prevent further pigmentation of affected areas
Several therapies are available which may improve discoloration
OTC Options: sunscreen

Postinflammatory hyperpigmentation is typically self-resolving, though the process may take up to one year. Use of sunscreen is strongly recommended to prevent further Pigmentation of the affected area. Several therapies are available which may improve discoloration, including hydroquinone, topical tretinoin and corticosteroids, glycolic acid peels, and azelaic acid. These treatments are often used in combination to maximize effectiveness.