ABSTRACT
Postinflammatory hyperpigmentation (PIH) is an acquired hypermelanosis occurring after cutaneous inflammation or injury that can be seen in all skin types, but more frequently affects patients with Fitzpatrick skin types IV through VI. This chapter describes the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment options for PIH. PIH appears as spots of discoloration. These macules can range in colour from pink to red, brown, or black, depending on skin tone and depth of discoloration. PIH typically manifests as macules or patches in the same distribution as the initial inflammatory process. Diagnosis of PIH is usually made clinically. The importance of photoprotection should not be underestimated because it prevents disease progression. Treatment of PIH includes topical agents, surgical therapy, and cosmetic camouflage. Therapeutic efficacy of topical agents is higher in cases of epidermal PIH, and for significant improvement, topical creams are often combined with chemical peels and sunscreens.
