Postinflammatory Hyperpigmentation

Background: Postinflammatory hyperpigmentation (PIH) commonly occurs in Fitzpatrick skin types III to VI and can have a considerable impact on quality of life. The majority of cases will improve spontaneously, but this can take months or even years to resolve and in some cases can be permanent. Treatment may be prolonged, lasting 6 to 12 months or longer for adequate restoration of normal pigmentation. Objective To review the etiology, pathogenesis, and current therapy options for patients with PIH. Methods: This review is the outcome of a workshop that discussed literature reports of research and developments in the treatment of PIH and associated disease and current clinical practice. Results: Combination products containing hydroquinone and retinoids appear to be the most beneficial treatment options, although there are few evidence-based studies for PIH. Conclusion: More randomized controlled clinical studies in large numbers of PIH patients are needed to provide standardized measurable outcomes in this indication.