The Pathogenesis and Management of Acne-Induced Post-inflammatory Hyperpigmentation

Am J Clin Dermatol. 2021 Nov;22(6):829-836. doi: 10.1007/s40257-021-00633-4. Epub 2021 Sep 1.

Abstract

Acne vulgaris is a common inflammatory disease. Among patients with darker skin phototypes (Fitzpatrick III-VI), the inflammatory processes of acne stimulate excess melanogenesis and abnormal melanin deposition, leading to pigmentary sequelae known as post-inflammatory hyperpigmentation and post-inflammatory erythema in all skin tones, although post-inflammatory hyperpigmentation is more common in darker skin and post-inflammatory erythema in lighter skin. These pigmentary alterations can be long lasting and are often more distressing to patients than the active acne lesions. This article discusses what is known about acne-related pigmentation, much of which is extrapolated from general study of nonspecific pigment deposition. Because dyspigmentation poses both a significant clinical concern to patients and a therapeutic challenge to clinicians, we formed a working group consisting of pigmentary experts with the aim of increasing awareness and education of acne-related pigmentary sequelae.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / complications*
  • Acne Vulgaris / immunology
  • Anti-Inflammatory Agents / therapeutic use
  • Combined Modality Therapy / methods
  • Dermabrasion / methods
  • Dermatologic Agents / therapeutic use
  • Humans
  • Hyperpigmentation / immunology
  • Hyperpigmentation / pathology
  • Hyperpigmentation / therapy*
  • Low-Level Light Therapy / instrumentation
  • Low-Level Light Therapy / methods
  • Melanins / antagonists & inhibitors
  • Melanins / biosynthesis
  • Skin / immunology
  • Skin / pathology
  • Skin Pigmentation / drug effects
  • Skin Pigmentation / immunology*
  • Skin Pigmentation / radiation effects

Substances

  • Anti-Inflammatory Agents
  • Dermatologic Agents
  • Melanins