Emerging treatment for post-inflammatory hyperpigmentation in dark skinned individuals: a review of the current literatures

Abstract

Post-inflammatory hyperpigmentation (PIH) is a prevalent and psychologically distressing condition, particularly for individuals with dark skin (Fitzpatrick types III-VI). The heightened susceptibility and severity in this population are linked to unique molecular and structural skin characteristics, including a predisposition to inflammation, which can be exacerbated by conventional treatments like high-concentration chemical peels and aggressive laser therapies. This paper presents a narrative literature review that synthesizes current research on emerging and optimized treatment strategies for PIH in dark-skinned individuals. A focused search of peer-reviewed articles and clinical abstracts revealed that successful management relies on a multi-faceted approach. Key findings include the efficacy and favorable safety profiles of new topical agents such as azelaic acid, adapalene, and cysteamine cream, which possess dual anti-melanogenic and anti-inflammatory properties. Procedural advancements emphasize conservative, low-fluence laser techniques (e.g.,1064-nm Nd:YAG) combined with robust pre- and post-procedure regimens. Most importantly, a consistent, daily photoprotection regimen with broad-spectrum sunscreen is confirmed as the single most effective preventive measure. The review concludes that moving beyond conventional monotherapies to a nuanced, combination-based approach is essential for enhancing outcomes, minimizing adverse effects, and improving the quality of life for individuals with PIH in dark skin.