How to reverse Post-inflammatory Hypopigmentation


a) What is hypopigmentation?

Post-inflammatory hypopigmentation is a common cause of acquired hypopigmented disorders. It can be a result of skin inflammation, injury or dermatological treatment. Most cases of post-inflammatory hypopigmentation improve spontaneously within weeks or months if the primary cause is ceased; however, it can be permanent if there is complete destruction of melanocytes, the cells responsible for melanin production.

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b) How does post-inflammatory hypopigmention differ from post-inflammatory hyperpigmentation?

Post-inflammatory hyperpigmentation results in the darkening of skin pigment. Dark patches and spots can appear on the skin where inflammation caused by trauma has occurred. Post-inflammatory hypopigmentation occurs in a much similar way, but instead of excess melanin or skin pigment, melanin is destroyed. This leads to lightening as opposed to a darkening of the area. The extent of pigment loss varies.

Post-inflammatory hyperpigmentation, or PIH appears more frequently than hyperpigmentation, but both are a result of stressed skin. Although hypopigmentation occurs less often, it can be trickier to manage and treat.

Post-inflammatory hypopigmentation is not Vitiligo.

Vitiligo is an acquired condition where there is a patchy loss of melanin from the epidermis, causing areas of pale skin. There may also be a loss of melanin in hair follicles resulting in white hair. It is usually seen as an autoimmune disease and is associated with other such diseases. Postinflammatory hypopigmentation is a benign (harmless) process but may have significant cosmetic and psychosocial implications. The condition usually resolves in weeks to months.

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c) Who can get post-inflammatory hypopigmentation

Anyone can acquire post-inflammatory hypopigmentation. The deeper your natural skin, the more stressful the condition can be due to contrast. The pigment loss can be sightly and occur in spots or larger patches.

dark skin hypopigmentation

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d) What aesthetic treatments can cause post-inflammatory hypopigmentation?

Many facial aesthetic treatments involve resurfacing the skin in some way. They're designed to instigate a healing process which ultimately encourages newer skin that is brighter and firmer. Poor aftercare following treatments can cause post-inflammatory hypopigmentation.

Product usage that is too harsh or using them too soon after treatment. Neglecting sun protection following treatment can cause problems, especially during Summer.

Post-inflammatory hypopigmentation is not something that will happen during treatment; it will occur days or weeks following a treatment when the skin has failed to heal properly.

Laser therapy is an aesthetic treatment that can cause post-inflammatory hypopigmentation. Laser resurfacing and laser hair removal. The correct device must be used on the correct skin type. IPL should be avoided on dark skin, even with specific attachments that allow IPL to work ‘safer'.

Post-inflammatory hypopigmentation can occur spontaneously. We can receive successful laser treatments, follow aftercare advice and still develop pigment loss. The condition can be unpredictable. What we can do it take measures that we know are likely to lessen its occurrence.

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e) What can be done to prevent or treat post-inflammatory hypopigmentation?

Sunblock is essential. This applies to all skins. Melanin gives extra benefit against harmful UV rays slowing signs of ageing, but aesthetic treatments can leave skin vulnerable and highly sensitive. Pigmentary changes are more likely. The sun's harmful rays are present all year round. SPF 30-50 is a must to protect against pigment loss due to trauma.

The second thing we can do is adhere to the aftercare provided following treatment. The first 24-48 hours are crucial; however, the skin will continue to heal itself in the background long afterwards.

Avoid exfoliators, alpha hydroxy acids and anything else that can irritate the skin. Such products should not be incorporated too quickly following aesthetic treatments. They are necessary to maintain treatments throughout but must be timed appropriately. Gentle cleansers, toners, serums and moisturisers, preferably with sun protection built-in, should be used.

Hypopigmentation is notoriously difficult to treat. Unlike hyperpigmentation, hypopigmentation is likely to react worse to skin rejuvenating treatments. In fact, additional treatments are not recommended if pigment loss has occurred following treatment.

The best course of action is to treat the skin with care. Avoid harsh or aggressive treatments and products, and overtime time, the pigment should return.

Camouflage makeup for pigment loss

Whilst the skin heals itself, you may want to try camouflage makeup. Colour matching can be a chore but may offer some remedy if right. Regular makeup is unlikely to hide all patches as pigment loss is likely to be still visible. Camouflage makeup typically provides much more coverage and, therefore, is a great choice.

dermablend

There's a great article on Vichy which discusses this kind of makeup with their Dermablend range, a worthy recommendation. Camouflage Makeup: A Step-by-step Beginner’s Guide.