Inflammation Causes Hyperpigmentation
Inflammation and Pigmentation of Skin
If your skin is reactive and sensitive with redness, flushing, or rosacea, you have inflammation which leads to many skin concerns that affect skin health such as dehydration, hyperpigmentation, and aging. For this reason, inflammation is the most important thing your skin care routine should focus on if you have dark spots on your skin.
If you have inflammation, you are at a higher risk of getting dark spots from post-inflammatory hyperpigmentation and melasma.
Your skin care routine should focus on the causes of inflammation and contain soothing an calming ingredients.
Knowing which of the 16 skin types you are will help you understand your skin's issues and how to treat them so your skin will be healthier.
Table of contents
Inflammation and Hyperpigmentation
Inflammation causes hyperpigmentation of the skin. This is why dark spots often occur on the skin after acne, eczema, injury, a skin rash, or a burn.
This means that if you have sensitive skin which is characterized by inflammation, you are at a higher risk of developing uneven skin pigmentation due to hyperpigmentation.
Inflammation can be caused by many inflammatory different skin issues and is most commonly seen in sensitive skin types. Inflammation, regardless of the cause, can lead to hyperpigmentation. This occurs because, during inflammation, the immune system is activated which sends signals to the melanocytes to make the pigment melanin.
Darker Skin Types Have A Higher Risk of Hyperpigmentation
Fitzpatrick Skin Types 3 and higher have skin cells that are more easily stimulated to make melanin pigment. This means that brown and black skin tones are at a high risk of developing dark spots after pimples, a cut, or a rash.
Darker melanized skin types are particularly susceptible to getting post-inflammatory hyperpigmentation (PIH).
Dark inflamed skin may be referred to as "black rashes" because the skin where the rash is gets darker from inflammation and scratching.
Brown and black skin must be vigilant about sunscreen, sun avoidance, and their skin care routine to avoid getting these "dark rashes".
Click here for advice on how to treat dark spots and black rashes on darker skin.
Scratching and Pigmentation
Dark skin from scratching occurs because of inflammation. Scratching the skin causes a wound or injury to the skin. This turns on various inflammatory cascades that signal melanocytes to make melanin. The hyperpigmented skin from scratching remains even after the wound has healed and can be difficult to treat.
Using the right anti-inflammatory ingredients can help reduce itch and prevent scratching which will reduce the skin injury that causes skin to darken.
Eczema Causes Skin To Darken
Eczema, also called atopic dermatitis, is an inflammatory skin condition that is very itchy. The inflammation causes hyperpigmentation in many eczema suffers and the pigment can last long after the eczema rash goes away. Scratching eczema can cause skin to darken. Brown and black skin tends to turn very dark in areas of eczema. These dark patches should be treated with both an eczema cream and skin lightening products.
Dark Skin From a Rash
Know Your Skin Type
In order to effectively treat hyperpigmentation caused by inflammation, you must first identify what is causing your inflammation and skin sensitivity and reactivity.
Causes may include:
- Acne
- Allergy
- Dryness
- Eczema
- Over-exfoliation
- Psoriasis
- Rosacea
- Sun sensitivity
- Using the wrong skin care products
Many times you do not realize you are causing your own inflammation by using the wrong skin care products! A common issue I see in my patients is over-exfoliating and using products that are wrong for their skin type.
This is one of the many reasons I developed a skin type quiz that helps you design a custom skin care routine that identifies and targets all of your skin issues. It identifies you as 1 of 16 skin types.
Once you identify your skin type, you will receive educational material, product suggestions, and be able to read reviews from others with the same skin type as you.
You can even come to Reddit r/skintypesolutions and ask others with the same skin type which products they like and dislike.
Products To Treat Inflammation and Pigmentation
If you have acne or rosacea and dark spots- products with ingredients that block inflammatory pathways and melanin production are key.
These are the prodcuts I recommend ot my patients who have sensitvie skin and hyperpigmentation:
Derma Made Azelaic Acid Cream 15% has azelaic acid in it which is almost as strong as 20% prescription strength. It was made by a dermatologist to treat dark spots from acne and to use as part of a skin care rotuine for rosacea and melasma.
Azelaic acid has these benefits:
- Soothing and calming
- Blocks melanin Production
- Exfoliant
Vichy LiftActiv B3 Serum Dark Spots & Wrinkles Anti-Aging Serum has both niacinamide and tranexamic acid that target both inflammation and pigmentation. Vitamin C is an antioxidant and tyrosinase inhibitor, while allantoin is soothing.
SkinCeuticals Discoloration Defense has niacinamide and traxeamic acid that soothe skin and prevent dark spots. It also contains kojic acid which is an exfoliant and a tyrosianse inhibitor that blocks melanin prodcution.
Alastin A-Luminate Brightening Serum is one of our favorite dermatologist-recommended skin lighteners for sensitive skin. It uses high tech ingredients which are discussed in the interview with the creator of Alastin Skincare Dr. Widgerow below.
This product features these ingredients:
- Niacinamide
- Tranexamic Acid
- Gallic Acid
- Hesperidin
- Thermus Thermophillus Ferment
- Silybum Marianum (Milk Thistle) Extract
- Withania Somnifera (Ashwagandha) Root Extract
- Vitamin C
In addition to its well known TriHex technology.
Skin Care Routines
When a dermatologist prescribes a skincare routine to help prevent dark skin after rashes, pimples, burns and injury, they will focus on 3 types of skin care products:
- Sunscreen
- Products that block melanin production or transfer like tyrosinase inhibitors and PAR-2 blockers
- Soothing ingredients
In a skin care routine to prevent skin from getting darker after inflammation, you need anti-inflammatory ingredients and skin-lightening ingredients. Our dermatologists have designed regimens that block inflammation from occurring and discourage melanocytes from making melanin. We use ingredients that will calm the skin while inactivating melanocytes to block pigment production.
Conclusion
Reducing skin inflammation is the most important step in a skin care routine. If it's not under control, the other barriers to skin health are hard to control because inflammation causes hyperpigmentation, skin aging, and can injure the skin barrier.
So make sure your entire skin care routine is correct for your Baumann Skin Type. Take our skin care routine quiz and we can help you customize a routine that targets inflammation and hyperpigmentation and any other skin issues you have.
Dr. Leslie Baumann MD, FAAD
Are there any anti-redness treatments that also prevent pigmentation?
Yes, inflammation plays a key role in both inflammation and pigmentation, so finding a product that addresses both redness and pigmentation is helpful if you have both sensitive skin and melasma. Derma Made Azelaic Acid Cream 15% does this by calming inflammation and acting as a tyrosinase inhibitor, which helps reduce dark spots caused by hyperpigmentation.
Why does brown and black skin get darker after acne or a rash?
After acne, a rash, or any skin injury, people with brown and black skin often develop darkened spots in the affected areas. This condition is called post-inflammatory hyperpigmentation (PIH). When the skin becomes inflamed due to acne, rashes, or trauma, melanocytes (the cells responsible for producing melanin, which gives skin its color) are triggered. In response to inflammation, these cells overproduce melanin, leading to darker spots in areas where the skin was affected.
How does inflammation cause darker skin after an injury or rash?
Inflammation plays a key role in the darkening of skin following acne or a rash. When the skin is damaged or irritated, immune cells release inflammatory signals like cytokines, prostaglandins, and other chemicals as part of the body’s defense mechanism. These inflammatory signals not only combat injury but also stimulate melanocytes to increase melanin production. Melanin, the pigment that provides skin with its color, accumulates in the damaged area, causing the skin to appear darker. This is why inflammation from acne, rashes, or even sunburn can lead to hyperpigmentation, especially in darker skin tones.
What are the best ways to prevent darkening of the skin after an injury?
To prevent darkening after acne or a rash, it is essential to manage inflammation quickly and take proactive steps to reduce the risk of post-inflammatory hyperpigmentation (PIH). Begin by examining your skin daily and paying attention to any pink or inflamed areas. At the first sign of darkening, such as when the pink starts turning brown, it’s important to immediately start using a skin-lightening cream that contains tyrosinase inhibitors, which help prevent further melanin production. Sun protection is also crucial, as UV rays can worsen hyperpigmentation.
What do dermatologists recommend for inflammation and hyperpigmentation?
Ingredients that target both the inflammation pathways and melanin production are best. Dermatologists often use products with tranexamic acid, azelaic acid, ferulic acid, and niacinamide. These treat both pathways.
Which ingredietns are best to treat inflammation and pigmentation?
These ingredietns are both soothing and brightening: azelaic acid, niacinamide, and tranexamic acid.
Best References and Scientific Publications on Inflammation and Pigmentation:
- Baumann L. Anti-inflammatory Ingredients in Ch. 38 of Baumann's Cosmetic Dermatology Ed 3. (McGraw Hill 2022)
- Baumann L. Depigmenting Ingredients in Ch. 41 of Baumann's Cosmetic Dermatology Ed 3. (McGraw Hill 2022)
- Baumann, L. Cosmeceuticals and Cosmetic Ingredients (McGraw Hill 2015)
- Hossain, M. R., Ansary, T. M., Komine, M., & Ohtsuki, M. (2021). Diversified stimuli-induced inflammatory pathways cause skin pigmentation. International journal of molecular sciences, 22(8), 3970.
- Fu, C., Chen, J., Lu, J., Yi, L., Tong, X., Kang, L., ... & Zeng, Q. (2020). Roles of inflammation factors in melanogenesis. Molecular medicine reports, 21(3), 1421-1430.
- King, S., Campbell, J., Rowe, R., Daly, M. L., Moncrieff, G., & Maybury, C. (2023). A systematic review to evaluate the efficacy of azelaic acid in the management of acne, rosacea, melasma and skin aging. Journal of cosmetic dermatology, 22(10), 2650-2662.
- Zhang, J., Gu, D., Yan, Y., Pan, R., Zhong, H., Zhang, C., & Xu, Y. (2024). Potential Role of Tranexamic Acid in Rosacea Treatment: conquering Flushing Beyond Melasma. Clinical, Cosmetic and Investigational Dermatology, 1405-1412.
