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Post-inflammatory hyperpigmentation (PIH) is the darkening of skin that follows inflammation or injury, including from energy treatments. It is the single most important risk to manage in darker skin types.
Post-inflammatory hyperpigmentation (PIH) is the appearance of flat, darkened patches of skin after an inflammatory event—acne, injury, or an overly aggressive energy treatment. It happens when inflammation stimulates melanocytes to overproduce melanin, which then deposits in the skin.
PIH is the central safety concern in treating higher Fitzpatrick types, because melanin-rich skin is far more prone to it. Any treatment that creates heat or injury—lasers, IPL, aggressive peels, even microneedling—can trigger PIH if settings are too aggressive for the skin type. The defences are familiar: choose melanin-sparing wavelengths (1064nm Nd:YAG), lower fluence, longer pulses, robust epidermal cooling, conservative test patches, and diligent sun protection afterward. Unlike a burn scar, PIH usually fades over months, but prevention is far better than waiting.
For clinics, understanding and proactively managing PIH is what makes treating skin of colour safe, inclusive and reputation-protecting.
PIH is the reason 'safe on dark skin' is earned through wavelength, low fluence and cooling—never assumed.
Melanin is the pigment that gives skin and hair their colour.
The Fitzpatrick scale classifies skin into six types (I–VI) by how it responds to sun—from
Epidermal cooling is any method—contact plate, cryogen spray or cold air—used to protect t
Post-inflammatory hyperpigmentation (PIH) is skin darkening after inflammation or treatment—the key risk in darker Fitzpatrick types, managed with melanin-sparing wavelengths, lower fluence and cooling. Essential knowledge for safe laser practice on skin of colour.
