Post-Inflammatory Hyperpigmentation Causes

What is Hyperpigmentation?

Hyperpigmentation (a.k.a. sun or age spots) is a skin pigmentation disorder in which melanin (the coloring agent in skin) is overproduced.  The overactive melanocytes (the skin cells responsible for giving skin its color) are hyperactive.  They produce too much pigment in the skin.  Which leads to the unsightly blotchy brown spots.

Hyperpigmentation has many possible underlying causes and origins which may be internal, external or a combination of both.


What are the Post-Inflammatory Hyperpigmentation Causes?

Post-Inflammatory Hyperpigmentation (PIH) may can be the result of skin inflammation caused by: an injury (i.e., cut, scrape, or burn); chemical exposure; or other skin disorders such as acne, eczema or psoriasis. Skin damage from insect bites and chicken pox may also be to blame.

The area around the injury or other skin disorder darkens as it heals, much like a scar, leaving post inflammatory hyperpigmentation. That is why reddish or brown marks remain on the skin even long after acne inflammation has subsided. The skin has become damaged at the cellular level and the melanocytes become hyperactive.


Post Inflammatory Hyperpigmentation from AcneThe Number One Cause of Hyperpigmentation?

In both men and women, is unprotected sun exposure.  From the time we are born we are exposed to the sun (often without proper protection).  Over the years this sun exposure increases the development and appearance of blotchy brown or ashy-colored spots across the skin.

These spots may seem to appear out of nowhere.  However, they have actually been years in the making, finally emerging to the skin’s surface. These spots most commonly appear on the face, neck, chest, shoulders, and forearms, all of which are most susceptible to the sun’s damaging rays, because they are most frequently exposed (sometimes on a daily basis) unlike the rest of the body, which is protected from clothing.


Sun damage plays a major role in the onset of hyperpigmentation, but so does artificial sunlight from tanning beds and sun lamps. While a tan may look nice, it is actually more damaging than a sun burn. A suntan is the result of prolonged sun exposure, in which the body is no longer able to heal itself from the sun’s damaging rays. The melanin in the skin has gone into overdrive and keeps the skin permanently brown, later becoming ugly brown spots on the skin, as it emerges to the surface.


While natural and artificial sunlight are the lead cause of hyperpigmentation, they are not the only potential causes. Even those who have been diligent in protecting their skin from the sun may experience hyperpigmentation.


What Else Can Cause PIH?

Another major role-player in hyperpigmentation is hormones. Hormonal changes may play a part in the appearance of sun spots for both men and women, but more so for women. Women who are: pregnant; taking birth control pills or hormone replacement therapy; or going through menopause, are all prone to sun spots.


Melasma (another name for hyperpigmentation) usually occurs at the onset and for the duration of pregnancy in many women. It is often referred to as the “pregnancy mask,” appearing across the forehead, cheeks, nose, chin, and upper lip and may or may not fade after pregnancy.


Illness and medications are another potential cause of hyperpigmentation. Birth control pills are the second most common cause of sun spots due to the high number of women who take them. Birth control pills affect hormones (estrogen and progesterone levels) similarly to pregnancy, because they trigger melanin to become over-productive in much the same way that the sun does.


Women with darker complexions who are taking birth control pills have an even higher risk of developing sun spots. They already have a naturally higher amount of melanin in their skin, which gives them a darker skin color. In combination with taking hormone-altering birth control pills they are even more susceptible to greater amounts of spots. However, these spots are most noticeable on lighter skin tones. Similarly, hormone replacement therapy and the onset of menopause can trigger hyperpigmentation.


Other medications that may cause hyperpigmentation include antibiotics, anti-seizure medications and others. Certain autoimmune disorders, such as the rare Addison’s disease, may also be an underlying cause of hyperpigmentation. It affects the adrenal gland, which excretes hormones, that when diseased causes over-production of melanin in the skin.


Genetics may also play a role in the origin of hyperpigmentation. Those born with or who develop freckles can thank genetics. Freckles are evidence of over-production of melanin in the skin and are an example of how these spots can be passed on from generation to generation. As mentioned previously, those with naturally darker skin tones are more likely to suffer from hyperpigmentation.


There is no one, absolute cause of hyperpigmentation; it may be one of the above or a combination of several factors. Furthermore, sunlight can worsen sun spots caused from any of the aforementioned causes further contributing to evidence that it is the number one offender.


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