You’ve spent a bit too long in the sun without SPF, and discovered that some darker patches have appeared on your skin? Squeezed a spot, only for it to heal and leave a pink mark in it’s place? Sounds like you may have PIH and PIE. Thankfully, you haven’t ruined your skin forever. I’ve written a post all about the two, how they occur and what you can do to restore your skin tone.
Like all of my Skincare Session posts, please be aware that everyone’s skin is different. If you’re a fan of Reddit’s r/SkincareAddiction, you’ll know the acronym YMMV – your mileage may vary – meaning just because a product worked for someone else (or a million people), it doesn’t mean it will work for you.
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Table of Contents
How To Tell The Difference Between PIH And PIE, And Which One You Have
There’s a quick ‘test’ to see if you have PIH or PIE, but this should be taken with a pinch of salt, and not determine an actual diagnosis.
Get yourself a clean, clear glass, and apply pressure to the area of your skin that you believe has PIH/PIE present in.
If the marks turn white and disappear when there is pressure, it usually tends to mean that it is PIE.
If the marks don’t change once pressure if applied, that’s usually leading towards PIH.
This test is done in pretty much the exact way that doctors may ask you to preform if they suspect meningitis. These two conditions are completely different, so please don’t panic if you still see visible marks after applying pressure to your skin with the glass.
Post Inflammatory Hyperpigmentation (PIH)
What is PIH?
PIH stands for Post Inflammatory Hyperpigmentation. To break the word down:
- Post = indicates that something takes place after a particular date, period, or event.
- Inflammatory = relating to or causing inflammation of a part of the body.
- Hyperpigmentation = excessive pigmentation of the skin.
Post Inflammatory Hyperpigmentation causes brown or black marks on the skin (face and body).
These brown or black marks are caused by an overproduction of melanin, which is the pigment that is responsible for your natural skin colour, eye colour, hair colour freckles, sunspots, the lot.
Because of this, those with darker skin types are more likely to develop PIH due to them having more active cells that creates melanin (melanocytes).
What Causes PIH?
- Pregnancy/Hormones
- Inflammation in the skin – acne, injury, burn etc.
- Ageing
- Sun exposure
- Occasionally, strong skin treatments such as lasers and chemical peels
How To Avoid PIH?
Even though sometimes PIH cannot be helped, there is a way to try and keep PIH to a minimum.
Exfoliation can help to lighten PIH marks. Most commonly, people use physical exfoliators (creams with ‘gritty bits’ in to physically remove the dead skin), but chemically exfoliating works better for PIH. Just make sure that you start off slow with acids until your skin adjusts to them.
Daily SPF to your face and body is going to help to protect your skin, and also stop any pigmentation you already have becoming darker. It’s definitely not the first time someone will tell you that you need to wear SPF every single day (yes, even when you’re not going out, as the rays can still pass through windows), and I can guarantee it won’t be the last time either. Lastly, if you’re using acids in your routine, it’s going to make your skin more sensitive to the sun. Another reason to get yourself a daily SPF!
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How To Treat PIH?
To treat PIH, you’re going to want to slow down the rate that your skin produces melanin and increase cell turn over. Luckily, it’s a lot easier than it sounds.
There’s now multiple products on the shelves to help treat PIH, however they can sometimes be a little difficult to spot since these products rarely contain the word PIH.
When looking for products, always read the ingredients of them first. PIH healing ingredients to look out for are:
- Retinoids – retinol, retinal, tretinoin (retinoic acid), isotretinoin, and alitretinoin.
- Vitamin C – Ascorbic Acid (L-Ascorbic Acid), Ascorbyl Palmitate, Sodium Ascorbate, Sodium Ascorbyl Phosphate and Magnesium Ascorbyl Phosphate (MAP).
- Azelaic acid
- Corticosteroids
- Hydroquinone
- Kojic acid
There’s also a few different cosmetic procedures that will help reduce PIH. Please make sure you get these treatments done professionally and do your research on them first.
- Chemical Peels
- Skin Resurfacing/Laser Peel
- Intense Pulse Light Therapy (IPL)
- Microdermabrasion
- Dermabrasion
How Long Will It Take Before It Goes?
Unfortunately, it can take up to 2 years before there is no longer any sign of PIH, however you should be seeing some improvement after 3 months. Treating PIH is a huge waiting game, and no matter what treatments or products you use, your PIH is not going to vanish overnight.
Product Recommendations For PIH
Post Inflammatory Erythema (PIE)
What is PIE?
PIE is short for Post Inflammatory Erythema. Again, to break the word down:
- Post = indicates that something takes place after a particular date, period, or event.
- Inflammatory = relating to or causing inflammation of a part of the body.
- Erythema = superficial reddening of the skin, usually in patches, as a result of injury or irritation causing dilatation of the blood capillaries.
Whilst PIH shows up on the skin as brown or black marks, PIE leaves red, pink or purple spots.
What causes PIE?
The main cause of PIE is damage to the skin and capillaries. Squeezing spots, picking dry skin, surgery, over exfoliation and injury are all ways that can develop PIE.
PIE tends to effect more lighter skin types, but can also effect darker skins too. It’s also possible to suffer from both PIH and PIE at the same time.
How to avoid PIE?
Since PIE is caused by damage, the best way to avoid PIE is to avoid damage to your skin.
That’s right. Leave. Your. Skin. Alone. That means no picking, squeezing, scratching at your skin.
I’m the worst when it comes down to leaving my acne alone. The first thing I do in the mornings is run to the mirror to see what’s appeared overnight, and inevitably, I always end up popping them.
If you’re having a hard time leaving your spots alone, get yourself a pack of Hydrocollid patches to put over them. Not only do they help to suck out all the nastiness in your spot, but they also protect it, leaving you unable to mindlessly fiddle with it.
How To Treat PIE?
Since PIE isn’t caused by an overproduction of melanin, you need to treat both PIH and PIE in different ways.
I hate to say it, but out of both PIH and PIE, PIE is the most difficult to treat.
Currently, there’s only two proven ways to treat PIE – Vascular lasers and silicone sheets.
Vascular lasers target the hemoglobin in blood, meaning that they’re going to work really well at reducing any redness in the skin. Unfortunately, vascular laser sessions can be quiet pricey and you’re going to need more than one session to get the best results.
Silicone gels are definitely more of an affordable way to help treat PIE. They work by hydrating your skin and improving your moisture barrier, which improves the erythema associated with wound healing.
Personally, I’d recommend testing out the silicone gel first, and if you’re still struggling with PIE after 90 days, book in for a consultation for a vascular laser.
Many people also suggest the following has helped to heal their PIE:
- Hydration – healing your moisture barrier, using Hyaluronic Acid, using an occlusive at night
- Vitamin C
- Niacinamide
How Long Will It Take Before It Goes?
PIE does eventually fade even without treatment, but obviously with treatment, it’s going to fade a lot faster.
Again, everyone’s skin is different, but you should start to see it starting to fade after 3 months, and huge improvements after a year.
Product Recommendations For PIE
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