Once you’re free and clear of acne, dark spots will often linger on your skin, causing you to continue wearing more makeup than you should which in turn creates even more acne. That’s why you need to learn how to get rid of dark spots so you can end the vicious cycle of skin abuse. So what are those dark spots exactly?
These dark marks can be one of two things:
- Post Inflammatory Hyperpigmentation (PIH)
- Post Inflammatory Erythema (PIE)
What is Post Inflammatory Hyperpigmetation (PIH)?
Post inflammatory hyperpigmentation (PIH) are brown or black marks caused by an overproduction of melanin. Think freckles, birthmarks, and sunspots. Melanin is the pigment that gives color to human hair, skin, and eyes.
What causes PIH?
PIH is triggered by an inflammatory response that initiates melanin production. (1) Possible causes include: getting a pimple, aging, pregnancy (melasma), hormones, and sun exposure. Because the sun causes your skin to produce more melanin in order to protect itself, sun exposure is the driving factor behind hyperpigmentation issues. This is why sunscreen is so important! It works by absorbing UV radiation, so melanin doesn’t have to. It’s doing the heavy lifting so your melanocytes can take a break, and as a result, less melanin is produced — therefore, less hyperpigmentation.
What is Post Inflammatory Erythema (PIE)?
Post Inflammatory Erythema (PIE) are the red or purplish marks left behind from inflammation (usually acne).(3) PIE spots are red, not brown (like PIH). The redness is a result of damage or dilation done to capillaries near the surface of the skin resulting in red spots. PIE falls on the lighter spectrum of skin tones, and is less likely to affect people of color.
What causes Post Inflammatory Erythema (PIE)?
PIE is the result of inflammation caused by trauma. This includes, but is not limited to — inflamed acne, picking at pimples, popping pimples, dry or dehydrated skin, chemical burns, over-exfoliation, cuts, scrapes, scratches, sunburn, sun exposure etc.
How to test for Post Inflammatory Erythema (PIE)
Post inflammatory erythema disappears temporarily when pressure is applied to the area. PIH does not. To do this test on yourself, find a clear container like a glass cup and press down against the area you might suspect is PIE. If the mark becomes white and disappears, that’s a good indication you have PIE and not PIH.
How to Treat Post Inflammatory Erythema (PIE)
PIE requires a much different treatment than PIH, because you can’t just shed the marks off like PIH.
Addressing PIE requires a 2 step approach:
- Sunscreen
- Treatment
Sunscreen
It’s possible for PIE to turn into PIH, so for this reason it’s important to continue to wear a 30+ sunscreen all day everyday to minimize this risk.
Treatment
Ingredients to look for in at-home skin products:
- Tretinoin
- Adapalene
- Tazarotene
- Niacinamide
- Green tea
Professional treatments:
- Micro-needling performed by a Dermatologist (avoid at home micro-needling due to risk involved to introducing infection to the skin and further damage the PIE)
- Vascular lasers
How to Treat Post Inflammatory Hyperpigmentation (PIH)
The idea behind treating PIH is twofold: inhibit tyrosinase (an enzyme that catalyzes the production of melanin), and increase cell turnover rate so the spots fade faster. (7) Oh, and use sunscreen! LOTS and LOTS of sunscreen!
Addressing PIH requires a 3 step approach:
- Sunscreen
- Exfoliation
- Treatment
Sunscreen
UV rays from the sun trigger increased melanin production in the skin. This worsens PIH. Diligent sunscreen use prevents the aforementioned. So…If you’re not using sunscreen diligently, all of your PIH-fading efforts are for naught.
Exfoliation
Exfoliation with alpha hydroxy acids results in faster, more even shedding of hyperpigmented areas of skin. Also, exfoliation with AHAs increases the efficacy of certain PIH treatments. It’s best to go slowly with AHA exfoliants – start at a low % and frequency of use (every three days for a week, every other day for a week, etc.).
Treatment
Use Products that contain Vitamin C and Niacinamide. Vitamin C is an antioxidant that is commonly recommend to get rid of dark spots and sun damage because of its ability to brighten the skin. Niacinamide will assist in the reduction of uneven pigmentation by slowing down the transfer of melanin to your skin’s epidermis.