Post-inflammatory hyperpigmentation

Also known as PIH, this discoloration occurs as a response to inflammation in the skin that can be caused by anything from eczema, acne or bug bites, to burns and surgical incisions. ‘When there’s inflammation, the skin cells are disrupted and melanin spills out,’ says Dr Carqueville. It’s for this reason that Dr Hartman refers to PIH as ‘a stain of inflammation’.

The skin tone factor

PIH shows up differently based on your skin tone. In darker skin, where there’s more melanin that can ‘spill out’, it manifests as dark spots. In lighter skin tones, PIH manifests as red spots – a result of increased red blood cells brought to the area to heal the inflammation, says Dr Carqueville.

Treatment plan

The best way to treat PIH depends on your skin colour. (Though one common denominator is avoiding inciting fire in the first place – eg, not popping spots, picking scabs etc.) Topically, anti-inflammatory niacinamide is a safe bet that may be used for pigmentation in general, says Dr Chang. One to try: Versed Out Of Sight Dark Spot Gel (£13.99, versedskin.com), which combines niacinamide with several other brightening ingredients, such as liquorice root extract and kojic acid. Another ingredient experts recommend to treat hyperpigmentation is tranexamic acid given that it’s suitable for all skin types and skin tones, and safe to use during pregnancy.

Keep in mind that the pigment associated with PIH is found far down in the skin, meaning lasers (which can work on those deep layers) will give the best results. That said, not all lasers are created equal; some can burn and scar darker skin. A safer bet for all skin types dealing with this situation? A Picosure laser treatment, recommends Dr Hartman.