What is PIH?
Post-Inflammatory Hyperpigmentation (PIH) occurs when inflammation or an injury to the skin causes an increase in the production of melanin. The most common cause of PIH is acne, but it can also occur as a result of physical injury to the skin, burns, allergic reactions, other inflammatory skin conditions, laser treatments, and chemical peels.
How is treating PIH In Compromised Skin different from other skin types?
The usual first-line treatment is topical triple therapy of hydroquinone, retinoid, and steroids. The usual second-line treatment options include chemical peels with salicylic acid (SA) or glycolic acid combined with topicals and lasers.
But WAIT!…clients with compromised skin cannot use these more aggressive treatments and ingredients that could cause immediate irritation, further damage, or worsen skin conditions.
Is there an alternative to lifting PIH in compromised skin clients?
Yes, there are more natural ingredients that can help with PIH and not affect barrier function or cause any further skin irritations or reactions. These treatments and products may take longer to lift and reduce PIH but are still very effective. The first goal toward getting rid of PIH involves treating the underlying inflammation to prevent further PIH from occurring.
Contribution by Shawna Rocha
Shawna Rocha is the owner of Awaken Day Spa in California and Washington. She quickly developed a love for helping clients with compromised and sensitive skin and constantly strives to gain additional knowledge and education. Since becoming an esthetician, she has completed multiple advanced courses in Oncology Esthetics, Immuno-Esthetics, and has specialized training in sensitive skin and holistic therapies. Shawna holds several certifications, including a NCEA certification, and has recently become the Director of Education for Hale and Hush Skincare. Shawna won two awards in the Skin Games 2018 (People’s Choice & Acne/Problematic Skin) and became a judge for two categories in 2019. Shawna’s current passion is writing blogs and articles regarding the skincare industry and has recently become a Dermascope Ambassador. She is truly loved by her clients and colleagues and her passion for the industry is apparent in all that she does.
8 Natural Ingredients to Lift PIH in Compromised Skin
1 Vitamin C
Known to be a powerful antioxidant that inhibits tyrosinase, thereby decreasing melanin production and reducing PIH. It is terrific for reducing the appearance of scarring, brightening uneven skin tone, and protecting from free radical damage. It is essential for collagen production and can help prevent premature aging and skin cancers due to sun overexposure.
2 Azelaic Acid
Azelaic acid is a natural acid found in barley, wheat, and rye. This ingredient can help prevent breakouts, decrease inflammation in the skin, and speed up cellular turnover rates. Azelaic acid inhibits tyrosinase, as well as inhibiting DNA synthesis of abnormal melanocytes. It also contains anti-inflammatory, antimicrobial, and anti-keratinizing properties.
Also known as “retinol or retinal”, vitamin A is another excellent option for breaking up excess melanin, fading dark spots, and reducing discoloration. Retinoids help heal your skin by increasing cell turnover rates and clearing up acne that leads to PIH. In the case of hyperpigmentation, this increase in cell turnover facilitates the distribution and removal of melanin. Using a product that contains retinaldehyde (retinal) is the perfect ingredient for compromised skin.
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Niacinamide is a water-soluble form of vitamin B3 that has a wide range of benefits for the skin, including improving skin hydration, acne, rosacea, and skin rashes. In addition, niacinamide has also shown anti-pigmentation effects.
5 Kojic Acid
Kojic Acid is a potent tyrosinase inhibitor that is effective at reducing pigmentation when combined with other AHAs and BHAs. Kojic acid is also an antimicrobial and a potent antioxidant.
6 Licorice Extract
Licorice Extract contains several active agents that inhibit tyrosinase, including glabridin licochalone, and liquiritin which reduces pigmentation by dispersing melanin. Licorice extract is also antimicrobial and anti-inflammatory and can scavenge free radicals.
Resveratrol is a natural polyphenol that is found in various fruits and vegetables (particularly red grapes and giant knotweed). It can inhibit melanin synthesis by directly inhibiting tyrosinase by acting as an alternative substance for tyrosinase. Indirectly, resveratrol can inhibit the transcription of tyrosinase and regulate it.
Zinc possesses antioxidant and sun protection properties and can act as an anti-inflammatory. It is thought that these properties are the main reason that zinc can reduce PIH and it is also possible that zinc plays a role in tyrosinase metabolism.
Treatments To Reduce PIH in Compromised Skin
Hydroxy Acids (AHAs/BHAs)
Hydroxy acids, such as glycolic acid, lactic acid, and salicylic acid act as chemical exfoliants that can help remove dead skin cells and loosen the top layer of skin. Hydroxy acids generally fall into three main categories; alpha-hydroxy acids (glycolic, mandelic, and lactic acid), beta-hydroxy acids (salicylic acid), and poly-hydroxy acids (lactobionic acid) and can be used in any facial treatments. AHA’s have larger molecular form and do not penetrate into the skin so they are the best options for compromised skin. Mandelic, Lactic and Malic are three of the best AHAs for sensitive skin.
Using AHAs in the treatment to lift PIH for compromised skin is quite effective in conjunction with a great home regime. AHAs can speed up the resolution of PIH and other pigmentary disorders by increasing skin cell turnover. This means that skin pigment is brought to the surface of the skin faster where it is shed as part of normal epidermal desquamation. Home care including a variety of these ingredients and professional brightening treatments is the key to successfully lifting PIH.