What is PIH
Post-inflammatory hyperpigmentation (PIH) is the darkening of skin that occurs after an inflammatory event. When skin experiences trauma, whether from acne, a cut, eczema, an allergic reaction, or an aggressive cosmetic treatment, the inflammatory response triggers melanocytes to produce excess melanin. This excess melanin deposits in the epidermis or dermis, leaving behind a dark patch or mark at the site of the original inflammation.
PIH is not a scar. It is a pigmentary response. And it is one of the most common skin concerns in people with medium, deep, and very deep skin tones because melanin-rich skin has a more reactive melanocytic response to inflammation.
Why PIH is harder to treat in deeper skin tones
In deeper skin tones, the melanocytes that produce pigment are more easily triggered and more prolific in their response. This means PIH forms faster, tends to be more pronounced, and is more difficult to resolve without careful clinical management.
It also means that treatments which would be appropriate for lighter skin tones can make PIH worse in darker skin. Aggressive lasers, strong peels, and harsh exfoliation applied without melanin-safe parameters can trigger new inflammation and new PIH, creating a cycle that sets clients back further than where they started.
Effective PIH treatment in deeper skin tones requires a practitioner who understands this cycle and has built their protocol around it. That is precisely what the CanStrive Corrective Protocol was designed to do.
How CanStrive treats PIH
Treatment of PIH at CanStrive follows the three-phase Corrective Protocol, adapted for pigment conditions:
- Phase 1 focuses on calming the inflammatory activity that perpetuates melanocyte stimulation, and repairing the barrier before any corrective procedures begin.
- Phase 2 targets pigment pathways directly: tyrosinase inhibition, melanin dispersion, and reduction of melanocyte signaling, using Aerolase Neo Elite laser, clinical peels calibrated for deeper skin tones, and targeted brightening actives.
- Phase 3 establishes a maintenance protocol to prevent recurrence and suppress the triggers that reactivate PIH.
Homecare is integral to every phase. In-clinic treatments alone are not sufficient for durable PIH resolution. Your homecare protocol is reviewed and adjusted throughout the program.
Treatment tools used
- Aerolase Neo Elite: A 1064nm Nd:YAG laser with a unique pulse duration that targets melanin without triggering thermal injury in surrounding tissue. Safe for all skin tones including Fitzpatrick V and VI when operated with appropriate parameters.
- Clinical peels: Selected and dosed specifically for deeper skin tones. We use mesoestetic, AFA, Primera Labs, GlyMed, and Perfect Dermapeel formulations depending on skin condition and phase.
- SkinPen microneedling: Used in the corrective phase to stimulate collagen and support melanin breakdown in post-inflammatory marks.
- Targeted homecare: Tyrosinase inhibitors, retinoids, barrier repair actives, and SPF protocols selected for melanin-rich skin.
What to expect from PIH treatment
PIH treatment is a process, not a single session. Visible improvement typically begins within four to eight weeks for epidermal PIH. Dermal PIH, where pigment has deposited deeper in the skin, takes longer and may require a more intensive approach.
Shivali will assess the depth of your PIH at your initial consultation and give you a realistic timeline based on your skin’s specific presentation.
Frequently Asked Questions
Q: How long does it take to clear PIH?
Epidermal PIH (closer to the surface) typically responds within 8 to 12 weeks of consistent treatment. Dermal PIH takes longer and may require a more extended program. At your consultation, Shivali will assess the depth and severity of your PIH and give you a realistic timeline.
Q: Will the dark spots come back after treatment?
PIH recurs if the inflammatory triggers are not managed. The maintenance phase of the Corrective Protocol is specifically designed to suppress the conditions that reactivate PIH. With proper homecare and periodic maintenance treatments, most clients maintain their results long term.
Q: Can I treat PIH at home without in-clinic treatments?
Homecare alone can produce some improvement in mild PIH, but significant or deep PIH requires in-clinic intervention to produce meaningful results. The combination of in-clinic treatments and a properly calibrated homecare protocol is what delivers durable improvement.
Q: I have very dark skin. Are laser treatments safe for me?
Yes, when performed by a practitioner with training and protocols specific to darker skin tones. The Aerolase Neo Elite laser we use has a pulse duration that makes it safer for Fitzpatrick V and VI skin than many other laser technologies. Shivali will assess your skin at consultation and determine the appropriate treatment parameters.
Begin Your Post-inflammatory Hyperpigmentation (PIH) Journey at CanStrive MedSpa & Wellness Clinic
PIH is one of the conditions we treat most frequently and most effectively at CanStrive. If you are dealing with dark spots, discolouration, or marks left by acne or other inflammation, a consultation with Shivali is the right starting point. She will assess your skin, identify the type and depth of your PIH, and build a program around your specific presentation. Book online or call (905) 569-3555.