How do I get rid of PIH if I am Indian and have dark brown skin?

PIH is indeed a bothersome issue even though they do eventually subside (Weeks to months). Furthermore, Dark-skinned individuals are particularly prone to PIH.

There are several ways to speed up the resolution of PIH:
1. Sun avoidance

2. Sun protection (topical sunscreen, oral sunblocks, UV umbrellas and caps)

3. Topical products such as retins or other depigmenting agents

4. Gentle lasers - we use the Picoplus Picosecond laser to good effect for PIH here at The Aesthetic Studio. PIH does have sometimes have a variable response to lasers, but we have managed to help most patients within a few sessions here. Of note, inappropriate laser use in dark skin tones can itself cause PIH, so do be judicious in the selection and use of lasers for PIH. The picosecond laser is a safer option in dark skin and might better suit you.

Most importantly is to control the agent causing the PIH. Most of the time the culprit is acne and more PIH forms than can clear.

As such, a proper plan should be discussed to manage both issues to maintain a clearer skin tone.

Cheers, and best regards,

Dr Shane Tan

As the name suggests, Post-Inflammatory Hyperpigmentation(PIH) may occur whenever there is an insult/inflammation to the skin, and the skin reacts by producing more melanin. It is temporary, but may take a long time to heal and resolve without treatment. Unfortunately, it also happens more commonly in darker-skinned individuals.

Treating PIH especially in darker-skinned individuals is not easy and takes time and patience. In my practice, I adopt a combination therapy approach to treat PIH when it happens. The most important "treatment" in my opinion, is to prevent them from happening. Hence for you, it would be prudent to find out what has caused your PIH and address that first. A good skincare regime and sun protection is also necessary to prevent worsening of the PIH.

To treat existing PIH marks, the following can be used:

1. Topical therapy - Topical products containing ingredients like tretinoin which increase cell turn over and hence removal of pigmentation, lighteners like hydroquinone, anti-oxidants like vitamin C, as well as cysteamine cream which inhibit melanin production all help with reducing the appearance of PIH marks.

2. Oral supplements like sublingual glutathione, oral carotenoids that can help to inhibit existing melanin synthesis and lighten PIH marks and even out skin tone, as well as oral polypodium leucomotos supplements that can help prevent further damage and darkening of marks from UV radiation.

3. LED light and Laser therapy - Yellow LED light is useful to reduce redness and the Near-Infrared wavelength LED light is useful for melanin pigment destruction and pigment suppression and hence very useful to treat PIH. Lasers like the Dual Yellow Copper Bromide laser, Nd-Yag laser toning and Picolaser toning have all been shown to be useful in the treatment of PIH as well. They are safe to be used in darker skinned individuals but the settings will need to be adjusted accordingly and hence you should visit an experienced doctor who is adept at lasers.

As I mentioned, in my practice, often a combination therapy approach gives very good results in the treatment of PIH. You should get a proper assessment by a certified and experienced doctor who will be able to come up with a customised treatment plan for you.