What Causes Hyperpigmentation After Breakouts
When a breakout heals, your skin sometimes ends up with dark spots. This is called post-inflammatory hyperpigmentation, or PIH. It happens because inflammation from acne makes special skin cells called melanocytes produce too much melanin, the pigment that colors your skin. These spots are flat and only change color, not texture like real scars.
The process starts with acne inflammation. Bacteria in pimples irritate the skin, triggering immune responses that release chemicals like cytokines. This signals melanocytes to ramp up melanin as a defense, much like how skin darkens from sun exposure to protect itself. Deeper, more inflamed acne like cysts causes worse spots because the damage goes further into the skin.
Your skin type plays a big role. People with darker skin tones, like Fitzpatrick types IV to VI, get brown or black marks more easily due to higher natural melanin levels. Lighter skin might show pink or red marks instead, from dilated blood vessels, but both can lead to dark spots if melanin overproduces.
Sun exposure makes it worse. UV rays hit inflamed skin and boost melanin even more, turning temporary marks into lasting ones. Picking or squeezing pimples spreads inflammation, inviting more pigment buildup. Genetic factors also matter, as some people heal with more discoloration based on family history or how their body handles inflammation.
Other triggers include harsh skincare products that irritate healing skin or conditions like eczema alongside acne. Even improper extractions or cosmetic treatments can spark the same response. Hormones and certain medications might add to the risk, but acne inflammation is the main spark after breakouts.
Sources
https://worldofasaya.com/blogs/acne/post-acne-hyperpigmentation-your-complete-guide
https://www.kins-clinic.com/blogs/post-inflammatory-erythema-from-acne-a-guide-to-causes-and-treatments
https://www.atlantaskinandaesthetics.com/hyperpigmentation/
https://www.clinicbe.com/skin/acne-pigmentation/
https://www.kavimd.com/effective-treatments-for-hyperpigmentation-how-to-even-skin-tone
https://www.serenityrejuvenationcenter.com/services/post-inflammatory-hyperpigmentation-pih-treatment-in-seattle/
https://www.youtube.com/watch?v=Ro1j61PZYKQ
