ConditionSkin, hair & nails
Post-Inflammatory Hypopigmentation
Post-inflammatory hypopigmentation is lightening of the skin in areas that were recently inflamed or injured, such as after eczema, psoriasis, a burn, cryotherapy or a laser treatment. The inflammation temporarily disrupts the pigment cells (melanocytes). It is more noticeable on brown and Black skin. It is harmless, and in most people the color returns gradually over a few months to a year once the underlying skin problem is controlled.
Also called: Inflammatory hypopigmentation, post-inflammatory leukoderma, light spots after rash, PIH (hypopigmentation type)
At a glance
- What it is
- Lighter patches of skin left behind after inflammation or injury.
- Common causes
- Eczema, psoriasis, seborrheic dermatitis, burns, blisters, cryotherapy, lasers and chemical peels.
- Who notices it most
- People with medium to dark skin tones.
- How long it lasts
- Usually weeks to months; up to a year or more after deeper injury. Rarely permanent.
- Treatment
- Control the original skin problem, protect from sun, and use cosmetic cover; phototherapy for stubborn cases.
When to get help
See a doctor within a day or two
- Light patches that are numb, especially with thickened nerves or weakness (possible leprosy in people from endemic areas)
- Light patches appearing after a burn that is blistered, oozing or infected
Book a routine appointment
- Light patches that keep spreading, appear without any previous rash, or turn completely chalk-white
- Light patches that do not improve after 6 to 12 months
- Patches with fine scale on the chest and back that get more obvious after a tan
- Persistent light or pink patches on covered areas such as the buttocks or trunk in an adult (rarely a skin lymphoma)
Usually safe to manage at home
- Faint light spots where eczema or a rash has recently healed
- Lighter patches on a child's face in winter with mild dryness
Why skin gets lighter after inflammation
Melanocytes sit at the base of the outer skin layer and pass pigment (melanin) to surrounding skin cells. Inflammation and injury can:
- Damage or temporarily stun melanocytes
- Block the transfer of melanin to skin cells
- Speed up skin turnover, so pigment is shed faster than it is made
The same inflammation can cause darkening instead, in post-inflammatory hyperpigmentation. Which happens depends on the skin type, the cause and how deep the injury was. Some people have both in the same area.
Most cases are hypopigmentation (reduced but not absent pigment). When the damage destroys melanocytes completely, as after a deep burn or freezing, the skin can become fully white (depigmentation), which is more often permanent.
Common causes
Skin diseases
- Eczema (atopic dermatitis), the most common cause in children
- Psoriasis, especially after plaques clear with treatment
- Seborrheic dermatitis around the nose, eyebrows and scalp
- Lichen planus, discoid lupus, chickenpox and other blistering conditions
Injury and procedures
- Burns, abrasions and blisters
- Cryotherapy (freezing) for warts or skin lesions; melanocytes are very sensitive to cold
- Laser treatments, dermabrasion and deep chemical peels
- Strong steroid creams or injections, which can lighten skin directly
Hypopigmentation vs vitiligo and other light patches
| Condition | Clues |
|---|---|
| Post-inflammatory hypopigmentation | Follows a known rash or injury in the same shape; off-white, not chalk-white; edges blurred |
| Vitiligo | Chalk-white, sharp edges, often symmetrical (hands, around eyes and mouth); no preceding rash; glows bright under a Wood's lamp |
| Pityriasis alba | Children; faint light, slightly scaly patches on cheeks; linked to dry skin and mild eczema |
| Tinea versicolor | Fine scale on chest, back and shoulders; more obvious after tanning; yeast seen on scraping |
| Idiopathic guttate hypomelanosis | Small, white, round spots on shins and forearms of older adults; sun-related |
| Leprosy | Light patches with numbness; rare in the US |
| Hypopigmented mycosis fungoides | Persistent patches on covered skin; diagnosed by biopsy |
How it is diagnosed
A dermatologist usually diagnoses it from the history and appearance. A Wood's lamp (ultraviolet light) helps: hypopigmentation shows only mild accentuation, while vitiligo glows bright white. A skin scraping checks for fungal infection. A small biopsy is taken only if the patches are unexplained, persistent or atypical.
Treatment
Treat the cause first
Getting eczema, psoriasis or seborrheic dermatitis under control is the most important step, since ongoing inflammation keeps suppressing pigment. Moisturize regularly and follow the treatment plan for flares. Do not stop prescribed steroid creams because of light spots: untreated eczema is a bigger cause of lightening than appropriate steroid use.
Help the color return
- Sun protection: daily broad-spectrum sunscreen of SPF 30 or more. It protects the light patch from burning and stops the surrounding skin tanning, which makes the contrast less obvious.
- Time: most patches repigment gradually from the edges and from hair follicles.
- Topical calcineurin inhibitors (tacrolimus or pimecrolimus), which calm inflammation without steroid side effects and may help pigment recover.
- Phototherapy: narrowband UVB or targeted excimer laser for stubborn areas, under dermatologist care.
- Camouflage: tinted moisturizers, cosmetic cover creams or self-tanners to even out tone.
Avoid bleaching creams to lighten surrounding skin and harsh scrubs, which can cause more inflammation.
Outlook
Post-inflammatory hypopigmentation usually fades over 3 to 12 months. Lightening after superficial rashes recovers fastest. After deep burns, freezing or scarring, some white areas can remain permanently, though phototherapy or cosmetic options can reduce their visibility.
Frequently asked questions
How long does post-inflammatory hypopigmentation last?
Most light patches after rashes improve within a few months and fully even out within a year, provided the original inflammation is controlled. Patches after deeper injuries such as burns, cryotherapy or laser treatment can take longer and occasionally remain permanently lighter.
Is post-inflammatory hypopigmentation the same as vitiligo?
No. Post-inflammatory hypopigmentation follows a rash or injury and is usually partial lightening that recovers. Vitiligo is an autoimmune condition that destroys melanocytes, causes chalk-white patches without a preceding rash, and can spread. A Wood's lamp exam helps tell them apart.
Why does eczema leave white spots?
Eczema inflammation interferes with melanocytes and with how pigment moves into skin cells, so healed areas look lighter, especially in darker skin. The spots are not scars and usually repigment over months. Keeping eczema well controlled with moisturizers and prescribed treatments is the best way to prevent them.
Can hypopigmentation be treated?
Yes. The main treatments are controlling the underlying skin condition, daily sun protection and time. Topical calcineurin inhibitors and narrowband UVB phototherapy can speed repigmentation in persistent cases. Cosmetic cover creams or self-tanners can even out skin tone while you wait.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Pigmentation problems and Eczema in skin of color
- DermNet: Postinflammatory hypopigmentation
- Skin of Color Society: Pigmentary disorders patient education
- MedlinePlus: Skin - abnormally dark or light
- British Association of Dermatologists: Pigmentation patient information