What it is
These are the flat brown marks the skin leaves behind after it has been inflamed: after acne, eczema, folliculitis, an ingrown hair, an insect bite, threading or waxing, cupping or traditional cautery, a reaction to black henna, or a previous device session. They are not scars — the surface of the skin is intact and the colour fades on its own, but slowly. Treatment means finding and stopping whatever is still inflaming the skin, then supporting the fading with prescribed topicals and daily sun protection, keeping any procedure deliberately gentle.
What this page covers
- Post-inflammatory hyperpigmentation management, with the trigger named and treated first
- Post-inflammatory hyperpigmentation as the presenting complaint in acne, before scar work
- Separating post-inflammatory erythema (flat red marks) from brown pigment, because they need different treatment
- Frictional melanosis from loofah scrubbing, tight clothing and habitual rubbing
- Post-cupping and post-cautery pigmentation and scarring
- Black henna and PPD allergic contact dermatitis
- Pigmented contact dermatitis (Riehl's melanosis) with patch testing
- Underarm, groin, knee and elbow darkening, after excluding steroid-modified tinea with a scraping and acanthosis nigricans with a metabolic assessment
- Acne mechanica and folliculitis under a prolonged face covering
- Post-inflammatory hyperpigmentation risk assessment before any device, peel or needling
- Pre-treatment priming and photoprotection protocol
- Test spot before laser or peel on skin of colour
- Post-procedure pigmentation rescue protocol, including for treatment done elsewhere
- Management of device complications: burn, blister, dyspigmentation
- Post-inflammatory and post-procedure hypopigmentation
- Topical retinoids, azelaic acid, niacinamide and other pigment-directed topicals
- Gentle superficial peels and conservative microneedling once the skin is calm
Honestly
Nothing fades while the inflammation underneath is still running, picking or scrubbing at the marks restarts the cycle, fading is measured in months rather than weeks, and continuing laser or aggressive lightening through active pigmentation usually deepens it.