What is the best treatment for post-inflammatory hyperpigmentation in Singapore?

Doctor's Answers 5

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Dr Tzeyeong Teng

General Practitioner

Hi Tan SP,

I fully agree t hat you most likely have post-inflammatory hyperpigmentation (PIH), which commonly occurs after inflammation or injury to the skin. This condition is more common in darker skin types.

Some common precipitating factors include acne or trauma, but may also be caused by previous laser therapy, dermabrasion or chemical peels. It can affect patients of all ages and gender, but is more severe usually in darker skinned individuals.

Depending on the underlying cause, the pigment may be deposited in the epidermis (superficial layer of the skin) or dermis (deeper layer of the skin).

PIH usually resolves over a few months, although dermal hyperpigmentation may not improve significantly with time.

Treatment options include:

1. Topical treatment with medications containing hydroquinone, a skin bleaching agent, or retinoids such as Triluma. These options typically require weeks to work.

2. Chemical peels containing alpha hydroxy acid or beta hydroxy acid. A series of superficial peels may be required, as deeper peels themselves MAY result in hyperpigmentation

3. Lasers, utilising Q switched or fractional resurfacing modalities

Your physician will be able to diagnose your PIH and advise on treatment options!

Thank you for your question. I agree with Dr Ethan, your diagnosis is PIH ( Post inflammatory hyperpigmentation). This happened as a result of your abrasion which is an injury to your skin.

Your options include

1. Medical grade lightening creams, hydroquinone based

2. QS ND Yag laser toning at 2 weekly intervals. Your PIH will improve over the next 6 months.

3. Watchful waiting. With time and sun protection, this improves.

Hope this helps!

Hi SP Tan,

You are suffering from Post-Inflammatory Hyperpigmentation.

For fast results, I highly recommend a combination of the following (the non-cream methods are more costly) :

  1. De-pigmenting creams like Hydroquinone / Arbutin. Daily application twice a day is recommended.
  2. Q-switched ND:Yag laser in PTP laser toning mode or Chemical Peels. Highly recommended to do it every 2-3 weeks for the laser and 4-6 weeks for the chemical peel.

You have to balance the cost of treatment vs your urgency to remove the patch. With a good de-pigmenting cream, you can lighten or remove the pigments in 6-9 months time anyway and that’s way more cost-effective.

Hi Tan SP,

What you’ve described sounds like post-inflammatory hyperpigmentation (PIH), a very common occurrence after your skin recovers from a injury. It can take up to 3-6 months to resolve completely.

For brown PIH scars, topical retinoid creams and hydroquinone bleaching cream can work quite well.

Otherwise, q-switched Nd:Yg laser treatments and chemical peels can both also be pretty effective.

My advise would be to see a doctor at the soonest instance! Usually the earlier you start these treatments (as appropriate), the more effective they will be.

Cheers

From your brief description, you may be having post-inflammatory hyperpigmentations (PIH for short) after the abrasion of your face. PIH usually will fade but it may sometimes take several months or longer to do so, especially for the darker skin types.

Patients can be quite disturbed by the appearance of PIH on the face, so treatments to hasten its resolution is important. Treatment modalities for PIH include topical lightening creams, chemical peels and pigmentation lasers, while sun protection measure are also equally as important.

For some patients with PIH, sometimes just topical lightening creams and sun protection measures alone can be sufficient to see good results in a few weeks time.

So I would recommend you to first verify with an experienced doctor on the diagnosis and the most suitable treatment options available for you.

For more information on PIH and its treatment, you can read more about them in my "Ultimate Guide to Pigmentation Treatment in Singapore".

Hope this helps!

Cheers!

Dr David Ng C H

Similar Questions

Is the laser treatment for PIH the same as for mole removal?

Hello Maine Thank you for your question. Post inflammatory hyperpigmentation (PIH) or post inflammatory erythema (PIE) from acne is usually treated with q-switched laser or long-pulsed laser. You can expect gradual lightening of the marks with repeated treatments. You can also combine laser treatment with topical retinoids and chemical peels for better results. There shouldn't be any scabbing from treating PIH or PIE. Moles are usually removed with an ablative laser such as the CO2 or erbium laser. Hope this helps!

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How to remove scar from mole removal?

It is unfortunate that you should scar after the mole removal. Treatment of the resultant scar will depend on the type of scar left after the initial mole removal. Most people who have undergone ablative or burning procedures can be left with a brown or darkened area, known as post-inflammatory hyperpigmentation (PIH). This could be due to a few things, including the excessive heat of the procedure, sun exposure in the few weeks preceding and post-procedure, infections of the wound during the healing phase or poor wound care.

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