How to Reduce Dark Marks/Post-Inflammatory Hyperpigmentation

June 21, 2020 Kayla Tucker, SSP, NCSP

Hey everybody! I hope that this finds you well amidst all that’s going on in the world. It has been a very, very long time since I’ve written a skincare post. I know.

BUT, I have good reason! Over the last year and a half, I’ve been on quite the journey with my skin. In February of 2019, I had had it. It seemed like nothing I was using was working and everything that I knew was negated. After moving and dealing with a lot of stress, my skin took a major beating. I was suffering from what seemed to be cystic acne (due to stress hormones). You know, the kind of pimple that doesn’t even have a head, is buried deep within multiple layers of the skin, and is sore to the touch? Yeah, that’s what I was dealing with. Even though I didn’t pick it and did everything “right”, I ended up with post-inflammatory hyperpigmentation all over my face. I was annoyed by it as someone who likes to wear her skin more often than not. But beyond how it looked, I honestly felt defeated and incapable. Here I am, someone who feels like they’re mastered their skin and is giving other people tips. But now all of a sudden, I no longer have it under control.

Well, a year and some change later, here I am. Back and indeed, better.

I ended up going to a dermatologist (against my better judgment) and eventually getting back to my regimen and doing what works best for my skin. I’ve learned quite a bit and I’m here to give you tips on reducing your post-inflammatory hyperpigmentation.

The Background

According to the National Center for Biotechnology Information, Postinflammatory hyperpigmentation (PIH) is an acquired hypermelanosis occurring after cutaneous inflammation or injury that can arise in all skin types, but more frequently affects skin-of-color patients, including African Americans, Hispanics/Latinos, Asians, Native Americans, Pacific Islanders, and those of Middle Eastern descent. Basically, it’s darkening of the skin due to an injury (like a cut, bruise, or acne).

My Experience

Like I said, I was really going through it. Nothing tried and true was working. This is what my skin looked like on February 22nd, 2019, when I finally broke down and went to a dermatologist cringes

February 22, 2019

May 6th, 2020

October 31, 2019

I know that some people have it way worse, but this is the absolute worst my skin has ever looked. So if you want to know some of my tips for how to get from there to here, keep reading.

Recommendations

After the skin is damaged, there is no way to bring it back to it’s natural color unless you bleach it. And that’s that on that. You can either bleach the skin until it gets back to its original color, or exfoliate until it’s gone. My recommendations will be for the latter.

Get Back to Basics.

Before you try to slather on the next best thing, always get back to the basics and allow your skin to reset. Perhaps your issue is a little more serious like mine was, or maybe you’re just using too many things on your skin. When you’re in the middle of a flare, reduce your regimen to the basic three steps: cleanse, tone, and moisturize. I cannot stress this enough. After getting off of the medication that the dermatologist gave me, I really took my time nursing my skin back to natural health to wean it off of the heavy duty prescription ingredients. But even if you haven’t been on a prescription, give your skin an opportunity to reset naturally before you jump in with the extras.

Use Vitamin C.

If you’ve already gotten back to basics to no avail, this would be my next step.

One of Vitamin C’s biggest uses is for reducing scars, spots and other hyperpigmentation. It’s a brightening agent (not to be confused with a bleaching agent) as it interferes with abnormal pigmentation through tyrosinase inhibition of the melanin pigment pathway (source). Basically, it can be used topically to fade dark spots without altering normal skin pigmentation.

Use Acids.

They’re not as scary as you think. There are two primary kinds of acids that I think are helpful: AHAs and BHAs.

According the Paula’s Choice, alpha hydroxy acids are a group of ingredients that include glycolic, lactic, malic, tartaric, mandelic, and citric acids. All of them can be effective for exfoliating skin, but among them, glycolic and lactic acids are considered the most effective; citric acid is generally not included in the amounts needed to exfoliate because it’s too acidic (think lemon juice). When properly formulated—meaning within the correct pH range for the acids to be effective—AHAs releases dull skin to the surface which unveils youthful smoothness, even tone, and glow. All skin types can benefit from AHAs, but they’re best for normal to dry skin showing visible signs of sun damage.

There’s only one beta hydroxy acid, and that’s salicylic acid. When properly formulated—meaning within the correct pH range for exfoliation—BHA exfoliates the skin’s surface and hydrates. But because BHA is oil-soluble (AHAs are not), it penetrates into the pore lining, where it works to dissolve clogs that lead to bumps and blemishes on skin’s surface. BHA also has a natural ability to calm skin, so it’s preferred for those struggling with sensitive skin. Its gentleness makes it suitable even for rosacea- or milia-prone skin. All skin types can benefit from BHA, but it’s best for normal to oily or combination skin that has blemishes, bumps, clogged pores, overly sensitive skin, or post-acne marks.

There’s also hyaluronic acid, which isn’t like the other acids at all. It actually aids in balancing moisture in your skin and is a great ingredient to have in your moisturizer.

The Ordinary has some great entry level options if you want to get your feet wet without the hefty price tag.

Use Retinol.

Retinol is a form of Vitamin A that boosts the collagen your body makes and plumps your skin, reducing fine lines and wrinkles. It also improves overall skin tone and color and reduces mottled patches. Retinol is wonderfullll, but it is strong. It’s often recommended that you ease your skin into it, using it only once every other day for the first two weeks or so and then moving up to once a day, and doing that backwards when you’re ready to stop using it. Note: using a retinol-based product may make the top layer of your skin dry and/or flaky, so be ready to give it extra love with the moisture. It also makes your skin more sensitive to the sun, so be sure to protect it with sunscreen. Which brings me to my next point.

Word to the Wise: do not use acids and retinol at the same time! Alternate between day and night or night and night.

Use Sunscreen.

Your skin needs sunscreen, even when you’re not using products that make it sensitive to the sun. Yes, even when you’re inside. UVB rays cannot penetrate through glass (like windows), but most UVA rays can! So your skin always needs protection, but it needs extra protection when it is undergoing major reconstruction like chemical exfoliation (acids and retinol). Limit your retinol use to nighttime when you won’t be going outside in the sun anyway, and be sure to leave the house with sunscreen on every day.

See a Dermatologist.

If your issue is hormonal in ways that you cannot control (aka elevated or depleted estrogen, testosterone, etc.), you need to see a dermatologist. I was able to use topical products only after ruling out other things and coming to the conclusion that is was stress hormone related. So in addition to the topical products I used, I also did things to help keep my cortisol levels where they should be in everyday life.

Exercise Patience.

I wanted to end the post here because this is important. Any product that promises you overnight results is likely a scam. Expecting overnight results does your body a disservice. Your body functions as a whole organism. It needs time for cell turnover. It needs sleep to perform its processes. It needs whole foods to repair and at the end of the day, that’s what your skin is doing. It is repairing itself, recovering from whatever damage it has incurred. You have to be patient. The pictures in this post were taken in February 2019, October 2019, and May 2020. Surface level scars won’t take as long to repair, but scars that are embedded in several layers of skin will take time to repair. You must be patient and gentle and use quality products. It’ll work, I promise.

That’s it for this post! Thanks for journeying with me.