What PIH Is and What Causes It

Your skin makes pigment in cells called melanocytes. When skin is inflamed or injured, inflammatory signals tell those cells to make more melanin and hand it to the surrounding skin. The inflammation settles. The extra pigment stays. That leftover patch is PIH.

Acne is the most familiar trigger, but eczema, burns, bug bites and cosmetic procedures do the same thing. Picking matters more than most people want to hear. Traumatized lesions are a recognized risk factor, which is why the spot you squeezed is so often the spot that leaves a mark.

Why It Hits Deeper Skin Tones Harder

PIH is a common aftermath of inflammatory skin conditions, and it tends to affect darker skin more often and more severely. One 2026 review reports that up to 85% of people with Fitzpatrick phototypes IV to VI develop it after inflammatory acne.

Several things raise the odds: darker skin, more severe acne, breakouts on the face, sun exposure and, in that same review, being female. None of them is a personal failing, and the response to an ordinary pimple can be out of proportion to the pimple.

It also changes how treatment should be chosen. Inflammation is what drives PIH, so anything harsh enough to irritate the skin is a poor bet. Start gently and protect the skin from the sun while it recovers.

Acne Marks: Brown or Red?

Not every post-acne mark is pigment. Brown or dark marks are PIH. Pink, red or purplish marks are post-inflammatory erythema, which reflects changes in the small blood vessels rather than in melanin. The 2026 acne review describes the two as separate problems, and both can last for months or even years.

The difference matters because the products are different. Anything aimed at pigment will not touch a vascular mark. A simple check: press a clear glass or fingertip against the mark. If it blanches and comes back red, it is more likely erythema. If the color holds, it is more likely pigment. Many people have both at once.

How Long Dark Marks Last

Honest answer: it varies, and it is rarely quick. The 2026 acne review describes marks that can persist for months or even years, and a 2024 systematic review of PIH in skin of colour describes its course as chronic once it has developed. The 2026 consensus stratifies treatment by how deep the pigment sits, which is one reason a clinician's assessment is worth having for a stubborn mark.

The same acne review notes that these marks can weigh on people more than the active acne did. If you find that a flat mark bothers you more than seems proportionate, that is a documented and common experience.

What Helps

The order of operations in the reviews is consistent.

1. Control the cause. Treatment starts with managing the original inflammation, whether that is acne, eczema or something else.
2. Protect from the sun, every day. Excessive sun exposure is a recognized risk factor for acne-related PIH, and photoprotection is central in the sources cited here. The 2026 consensus gives special emphasis to broad-spectrum protection and to access to tinted sunscreens.
3. Add a gentle topical. The 2026 acne review lists azelaic acid, retinoids, antioxidants and hydroquinone among the topical options. In a 2024 systematic review of 48 studies in skin of colour, topical retinoids were the most commonly reported treatment, with partial improvement in most of the people who used them. Which one is right depends on your skin and your history, and a dermatologist can choose and monitor it.
4. Consider a procedure for stubborn marks. Chemical peels and lasers are used for marks that do not respond to topicals, with mixed results. In the same 2024 review, laser gave complete resolution in some people, and worsening of PIH after treatment was also reported.
5. Do not pick. It is the cheapest step and the most ignored.

Where Primer+™ Fits

Antioxidants, a category that includes vitamin C, are on those lists of topical options, which is where InviCible Primer+™ comes in. A 2016 randomized trial in periorbital pigmentation and a 2025 review of topical melasma treatments both report improvement with topical vitamin C, but data specific to PIH are limited. Those reviews did not study Primer+™, and it is a primer, not a treatment for PIH. What it offers is a daily, low-effort step: 17% Stabilized Vitamin C with the ProBiosyn-4™ complex (aloe vera, safflower, licorice root and sunflower), formulated to support a more even-looking tone and to fade the look of dark spots with consistent use alongside sunscreen.

It was formulated with sensitive and reactive skin in mind, which matters for PIH-prone skin. No parabens or other preservatives. No synthetic fragrances. No phthalates. It is backed by a 30-day money-back guarantee. If the mark is new, changing or looks different from your other spots, have it checked first; our guide to telling hyperpigmentation from melanoma explains why.

Frequently Asked Questions

References

1. Passeron T, Desai SR, Abdallah M, Al-Niaimi F, Dlova N, Grimes PE, et al. Global consensus on the management of melanin hyperpigmentation disorders. J Eur Acad Dermatol Venereol. 2026;40(5):760-772. doi.org/10.1111/jdv.70185
2. Lopez-Estebaranz JL, Lopez-Pando M, Mitsunaga K. Practical Therapeutic Strategies for Acne-Induced Hyperpigmentation Across all Skin Types. Am J Clin Dermatol. 2026;27(4):697-707. doi.org/10.1007/s40257-026-01044-z
3. Mar K, Khalid B, Maazi M, Ahmed R, Wang OJE, Khosravi-Hafshejani T. Treatment of Post-Inflammatory Hyperpigmentation in Skin of Colour: A Systematic Review. J Cutan Med Surg. 2024;28(5):473-480. doi.org/10.1177/12034754241265716
4. Dayal S, Sahu P, Jain VK, Khetri S. Clinical efficacy and safety of 20% glycolic peel, 15% lactic peel, and topical 20% vitamin C in constitutional type of periorbital melanosis: a comparative study. J Cosmet Dermatol. 2016;15(4):367-373. doi.org/10.1111/jocd.12255
5. Suliman RS, Alhuwayshil J, Almuflehi AA, Al Zaghir AK, Alateqi HA, Mohamedin HE, et al. Emerging topical therapies for melasma: a comparative analysis of efficacy and safety. J Dermatolog Treat. 2025;36(1):2591502. doi.org/10.1080/09546634.2025.2591502