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  • Brindley Brooks

Dark Areas Around HS: Post-Inflammatory Hyper-Pigmentation

Have you ever wondered what the darkened and discoloration on or around you Hidradenitis Suppurativa areas is? Well, wonder no more. Post-inflammatory hyper-pigmentation is very common with many inflammatory skin conditions, especially with Hidradenitis Suppurativa.

This occurs following skin injury or inflammation, when skin is left darkened and discolored after the wound has healed. With Hidradenitis Suppurativa and reoccurring abscesses, this can be an ongoing process. The wound does not have to drain in order to cause post-inflammatory hyper-pigmentation (see first image below, the abscess in this photo never opened or drained).

Post-inflammatory hyper-pigmentation (also known as PIH and hyper-pigmentation caused by inflammation) is a type of hyper-pigmentation that can affect any part of the body and usually appears as flat spots of discoloration. These range in color from pink, purple, red, brown or black, depending on skin tone and the depth of the discoloration. Men and women are equally susceptible, as are all skin types.

PIH often affects people with acne and can sometimes be triggered by skin treatments such as dermabrasion, chemical peels, laser therapy, an injury, abscesses, rash, or anything that causes skin to become inflamed. This inflammation triggers melanocytes, the melanin producing cells, to release excessive melanosomes (pigment granules). The excessive pigment granules darken and discolor the wounded area which can remain long after the wound has healed.

The main cause of PIH is increased melanin production. Melanin is the pigment that defines the color of skin and the increase in melanin is triggered by the way skin heals after inflammation or injury. The more inflammation there is, the more discoloration there will be, both in size and color. In cases where PIH is caused by Hidradenitis Suppurativa, picking can worsen the condition.

While the sun is not the cause of PIH, it can aggravate symptoms and darken the affected patches and prolonging the time it can take for them to fade. The sun is closely associated with other forms of hyper-pigmentation such as age spots and melasma.

Post-inflammatory hyper-pigmentation is harmless, but melanoma can be life-threatening. If you have any concerns about your pigment spots – if they change shape, size and color or if they become itchy and start to bleed – it’s important that you consult a doctor.

What can I do to prevent PIH?

  • Doing what you can to control your Hidradenitis Suppurativa reduces the chances of post-inflammatory hyper-pigmentation

  • Avoid treatments such as dermabrasion, chemical peels, and laser therapy

  • If you're getting laser treatments find out the best way to care for your skin after treatments

  • Sun protection helps prevent or reduce the severity of post-inflammatory hyper-pigmentation

  • Limit the time you spend in the sun

  • Keep out of the sun during the most intense hours

  • Wear sunscreen, protective clothing, and sun hats

Content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking treatment because of something you have read on this website.

Written by Denise Panter-Fixsen

Edited by Brindley Kons


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