Acne ranges from very mild breakouts to very severe cystic acne. More severe cases often cause permanent scars, such as indented boxcar scars and raised keloid scars. However, any acne severity can cause inflamed spots that linger long after the acne clears. These spots are commonly mistaken for scars but are much more treatable than severe acne scarring.
Identification
Sometimes when inflammatory acne clears, red spots linger where pimples used to be. These spots are called postinflammatory hyperpigmentation. The spots may be pink or reddish in people with lighter skin and tan or brown in people with darker skin, according to the American Academy of Dermatology's AcneNet. The spots may look like pimples, but they are flush with the skin instead of raised like active blemishes. Postinflammatory hyperpigmentation can make breakouts look worse than they are.
Causes
Acne begins when bacteria travel into the pores. Dead skin cells and oil clog the pores. The bacteria trapped inside the pores begin to multiply; the body responds by sending white blood cells to fight the infection. This creates a reaction that causes the skin to produce more melanin, or pigment, at the infected area, according to the New Zealand Dermatological Society. Once the infection heals, the pigmented spot may linger for a few weeks to several months.
Sun Protection
Excessive sun exposure can darken hyperpigmentation spots, which makes the spots more noticeable and may cause them to fade more slowly. The American Academy of Dermatology's AcneNet recommends applying a broad-spectrum sunscreen 20 minutes before going outdoors. Sunscreen should have an SPF of at least 30 for effective sun protection. An oil-free sunscreen labeled "non-comedogenic" or "won't clog pores" can help prevent additional breakouts and more hyperpigmentation. While tanning may temporarily improve breakouts, it dries out the skin, which eventually results in increased oil production. Tanning also darkens hyperpigmentation just like natural sunlight.
Acne Prevention and Treatment
Effective acne treatment remains the best way to prevent and reduce postinflammatory hyperpigmentation. Each acne breakout often causes additional hyperpigmented spots. Without proper acne treatment, new spots occur as old spots fade. New hyperpigmentation spots can take up to a year to fade completely, depending on severity and skin color. Consult with a dermatologist to find effective treatment. Certain acne creams, such as retinoids, can even help reduce hyperpigmentation and treat both conditions simultaneously.
Postinflammatory Hyperpigmentation Treatment
Dermatologists have several techniques for treating postinflammatory hyperpigmentation. Skin lighteners containing hydroquinone can help fade tan or brown spots. Hydroquinone may be prescribed, or purchased over-the-counter in concentrations of up to 2 percent. In addition, a series of light chemical peels, consisting of four to six peels, may help fade hyperpigmentation, according to the American Academy of Dermatology's AcneNet. If more indented scars are also present, a dermatologist may recommend laser resurfacing to fade permanent scars which may reduce or fade hyperpigmentation. However, with adequate sun protection and no additional treatment, hyperpigmented skin eventually fades back to its normal color.
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