MeetPete/OG/Scorpien Vixen/Robert/Tracy et al

Hi Guys,

I've rustled up a bit of a Post Inflammatory Hyperpigmentation FAQ with the help of the other mods. Content has been gathered from a range of credible sources. If you cann be bothered I would be grateful if you could take a look through and pm me or add to the thread if you feel there are any glaring gaffes or omissions. The non ablative laser/ light section is very very general - because none of us have had any experience with them.

http://www.acne.org/messageboard/forums.html...t=0#entry384814

thanks
Frances

ps- obviously this is about red marks and not scarring - I humbly apologise to all for spamming this board - ha ha

FAQ - Post Inflammatory Hyperpigmentation

Post Inflammatory Hyperpigmentation
(aka red marks, brown marks, purplish marks, macules, psuedo scars, fake scars, inflammatory pigmentation)

Disclaimer: The information below is provided as a courtesy to address general questions. As we are not medical professionals, we cannot be held responsible for the accuracy of this information. By reading this information, you agree not to hold us liable for any damages that may result in your use of this information. This information should not replace information that your Doctor, Dermatologist or Plastic Surgeon provides you.


Q: Are red/brown/purple marks scars?

No. Red marks left on the site of old acne lesions are usually temporary (see picture below). Red marks are simply a normal remnant of the skin’s inflammatory process - Post Inflammatory Hyperpigmentation (PIH). Pigmented areas will fade unassisted, though they can take up to 2 years to disappear.


A quote from SkincarePhysicians.com


(Please note - If treating acne scarring is of concern please also read FAQ on Scar Treatments)


Q: What causes PIH?

Inflammatory Acne lesions. Generally the deeper the original acne lesion or more prolonged the infection, the darker the resulting PIH. The darker the PIH the longer it will take to fade.


Q: What can I do to prevent PIH?

Manage and prevent acne from forming. Do not touch or pick acne lesions as this can worsen infection and inflammation.


Q: What can I do to hasten the fading of PIH?

With all topical and laser treatments for PIH there is a some risk of causing new outbreaks, new pigmentation problems and possibly even new scarring. Risk of these occurences will probably grow with increasing strength or invasiveness of topical or laser procedures. Some treatments are NOT suitable for people with active acne, sensitive skin or darker skin tones. You should investigate and weigh possible side effects against possible benefits. And discuss with your derm or doctor. There is no single treatment that works for everyone. The effectiveness of each treatments varies and treatments may have to be used in conjunction with each other.

If you are on Accutane you should not be using any topicals treatments except under the supervivion of your dermatologist.

Firstly - avoid sun exposure. Ultra Violet light can cause hyper-pigmented areas to darken further and thus prolong them. Use non-comedogenic facial moisturisers or facial sunscreens which contain a high SPF of at least 15+.


Topical Treatments for PIH

Typically treatments for PIH bleach pigment OR block pigment formation OR accelerate the rate of exfoliation OR a combination.

Bleachs pigment OR block pigment formation
Hydroquinone - works by inhibiting the enzyme (tyrosinase) which causes tanning/pigmentation
Kojic Acid – i.e. Vita K for Blotchy skin
Topical Retinoids – Tretinoin i.e: Retin A, Renova (It also stimulates faster cell proliferation and has been clinically proven to be an effective acne treatment)
Azeliac Acid (It also stimulates faster cell proliferation and has been clinically proven to be an effective acne treatment)

Accelerate the rate of exfoliation.
The Tape Method of Exfoliation
The Vinegar Method of Exfoliation
Alpha Hydroxy Acid (i.e. Lactic Acid, Malic Acid, Fruit Enzyme etc.)
TCA (Trichloroacetic acid)
Beta Hydroxy Acid
Mandelic Acid

Many new generation topical treatments combine several agents from the list above in a single topical preparation i.e. TriLuma, Paula's Choice Clearly Remarkable Skin Lightening.

A topical approach usually prescribed by dermatologists is a Retinoid (i.e. Retin-A) & Hydroquinone.

If you want to research other peoples opinions or recommendations about topical PIH treatments and suppliers you could try the following links
http://www.acne.org/messageboard/Recommended-Products-R-t14887.html
http://www.acne.org/rate.php
http://www.makeupalley.com (registration required.)

Non-topical Treatments for PIH

Some non ablative lasers are being marketed specifically for treating pigmentation problems. These treatments may be unsuitable for people who suffer from active acne. Be aware that laser treatment is generally expensive and carries a risk of causing new acne, PIH and scarring. We recommed that you research options throughly and discuss with your Doctor or Dermatologist.

Here are examples and links to information about them:
· N-Lite: http://www.wrinklereduction.com
thread on acne.org: http://www.acne.org/messageboard/forums.html...=9443
· CoolTouch II: http://www.cooltouch.com/products.html
· IPL: http://www.intensepulselight.com/equipment.html
V Beam Pulse Dyed Dye Laser
http://www.candelalaser.com/vbeam/vb_home.asp


Q: How long does it take to see results from treatment?

Results and times will vary widely from one person to the next and from one treatment type to the next. As a very general guide for topical PIH treatments ....
From: Post Inflammatory Hyperpigmentation http://www.emedicine.com/derm/topic876.htm

In the case of peels (i.e: lactic acid) visible improvement may occur within 4-6 applications (spaced at least a week apart).


Q: Who should be cautious about treating PIH?

PIH and active acne?
If you are on Accutane you should not be using any topicals treatments except under the supervision of your dermatologist.

Preventing the formation of inflammatory acne will prevent the formation of PIH. Some topical treatments have attributes which mean they can help active acne AND PIH...particularly topical retinoids, Azelaic Acid, BHA (aka salicylic acid), and some ahas. There are some potential negative interactions between PIH treatments and other conventional Acne medications (e.g. Retinoids and Benzoyl Peroxide, Hydroquinone and Benzoyl Peroxide) Research otc topicals thoroughly and discuss your use/planned use of all prescription and otc topicals with your dermatologist or doctor. Generally invasive peels or procudures are NOT appropriate for people who still have active acne.

PIH and darker skin colours?
People with darker skin tones have a greater prediposition to experience PIH. They are also at a greater risk of reacting adversely to agressive treatments with further pigmentation problems. Treatments typically sited by users and dermatologists as being well tolerated are Mandelic Acid, Lactic Acid, Hydroquinone, combination topicals like TriLuma.

PIH and sensitive skin?
Some topicals for PIH can be irritating for people with sensitive skin typically those sited by users as causing irritation are Topical Retinoids, Glycolic acid, TCA.

Some topicals for PIH typically sited by users as less irritating are Lactic Acid, Salicylic Acid.


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Before posting a new thread, please go to the top of this page try doing a Board Search it is very possible information you want is already here.
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Useful Links

Post Inflammatory Hyperpigmentation
http://www.emedicine.com/derm/topic876.htm

Acne Scarring - (Overview which explains the differences of PIH and Acne scars)
http://www.skincarephysicians.com/acnenet/scarring.html

Treating PIH in darker skin tones
http://www.dermatologytimes.com/dermatolog...l.jsp?id=124881
http://www.freep.com/news/health/mcare5_20041005.htm
http://www.cosmeticsurgery-news.com/article2009.html

Understanding Exfoliants
http://www.cosmeticscop.com/learn/pf.asp?ID=27

Skin Lightening
http://www.emedicine.com/derm/topic528.htm
http://www.cosmeticscop.com/learn/pf.asp?ID=25

Lasers
http://www.emedicine.com/derm/topic517.htm
http://www.cosmeticscop.com/learn/pf.asp?ID=19
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Back on the Wagon

Hello Me

OK, I've been around a long time and I have had much success with the regimen in the past. Actually for the first year up until February this year it worked really well. And either I got cavalier and started slacking off and/or adding in less reliable products OR the regimen stopped working OR the nature of my acne changed OR a combination of the above.

Anyhow - It's July and my skin is looking dry, marked and unhappy. The regression has got me so down that I was even considering goining on accutane - again. Even tho my acne is clearly mild it is like miscreant child that won't be reigned in! This being the situation...I thought it was time to go back to basics and follow the regimen religiously again.

Anyway - I am talking to myself here and just recording that tonight is the night that I start trowling on the bp again.

Love Me.

my gross body

It sounds like you are in a rut - we've all experienced it when nothing seems to be going our way It sucks. Firstly you need to give yourself a break!

I would not jump to the conclusion that you should quit lifting. Many people believe that physical activity clears their skin. Staying involved in different activities gives you something to focus on and feel proud about.

Once you start controlling your acne you will start to feel better about how you look. You mention pads...I'm assuming you mean stridex type products. These are often filled with alcohol which can be drying and irritating and could be responsible for the wrinkle like marks under your eyes.

I suggest you read through the regimen from start to finish.
http://www.acne.org/starthere.html

It is inexpensive and the products are avaliable from your drugstore. Most people see a dramatic improvement in their skin within 4 weeks.

About the bacne - Many users on this board have used the regimen for body acne. Many have also had success using a 10%bp wash on their back (NOT for the face).

My turn to vent!

Hi, my name is Frances, I'm 28 years old and I have been coming to acne.org for nearly a year. I have suffered from acne since I was 14 years old.

I frequently spend my time passing on answers to the questions of others and lending support. I am not alone in this - there are plenty of others who do this. But infrequently does someone say thank-you or acknowledge my effort or the effort of others.

How about saying "cheers" to someone who comes to your aid...since they are not paid to do it. And rather than reaping in some support and sympathy and then just pissing off when you feel better. How about thinking how you can help someone else?

Vent over
Frances