Post-Inflammatory Acne Scars

PIH or post inflammatory pigmentation is the result of acne. It is a form of acne scarring that occurs on the superficial layers of skin. PIH is a common in darker skin types & can persist for over 5 years. Pico lasers can remove dark acne marks within a few treatment sessions.


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in 21 days

Treatment Time

5 minutes



Treatment science score

The science of treating dark marks from acne

  • PIH are marks from acne spots
  • It is frequently seen in ethnic skin types
  • Untreated pigment can take over 5 years to resolve
  • Pico lasers can remove dark marks within a few sessions
  • Chemical peels can achieve faster results, albeit a longer downtime
  • Preventing acne from recurring can lead to long term remission

What is PIH or post-inflammatory hyperpigmentation?

PIH from acne is due to overwhelming inflammation in the skin. This stimulates pigment cells called melanocytes to become active. This results in darkening of areas affected by acne.

As pigmentation lies in the deeper layers of skin, lasers are often required to remove pigment.

What is our signature treatment for post inflammatory acne scars?

We approach PIH with a 3-step program.

  • Step one: treat the source of inflammation & place the process into remission.
  • Step two: carefully select pigment correctors based upon the depth of pigment & your skin sensitivities.
  • Step three: accelerated pigment clearance program of lasers or chemical peels. The ideal treatment depends on the depth & extent of pigment as well as how quickly you would like to see results.

*The ideal skin care formulation & laser program depends on the depth of pigment, your skin colour & sensitivities.

What skin care actives that can reduce PIH pigmentation?

Look for the following ingredients in skin care;

  • Botanicals (plants); liquorice root, ginseng, bearberry, blueberry, green tea
  • Arbutin
  • Azelaic acid
  • Vitamin C
  • Retinol
  • Alpha hydroxy acids.

At The Melasma Clinic we take away the guesswork & formulate a bespoke cream formulation to effectively reduce pigment from acne.

How many laser sessions to remove pigment?

A series of 5 sessions, spaced 2-4 weeks apart will yield optimal outcomes.

*For extensive areas of pigment, a second course of lasers maybe required. For uncontrolled acne

Will pico lasers treat other types of acne scars?

Pico is best for flat dark scars, known as grade 1 scarring. If you have depressed acne scars, pico lasers will give marginal gains. Depressed scars do best with deep focal peels, fractional lasers, subcision & surgery. This treatment algorithm is complex.

Why is acne control essential?

Acne should be in complete remission during your PIH treatment, otherwise new spots will replace treated ones. Our clinical team will guide you as to how to best treat your acne.

We employ chemical peels, prescription topicals, vitamin A & lasers can effectively treat acne to ensure that you are getting the best possible results.

When will I see results?

It takes time to see results from PIH treatments as inflammation needs to be treated before pigment disappears. With the most advanced pico lasers, you can expect to see an improvement within 2-4 weeks. Maximal results may take up to 3 months.

How to treat pigment on the back/chest or body?

Given the area of pigment, you will require more sessions to completely clear PIH on your body. As a guide we employ-

  • Oxidising washes to reduce pigment.
  • Salicylic acid applications nightly (home routine).
  • Pico lasers every 2-4 weeks, 5 sessions in total.

*Home chemical peels are formulated according to your skin type & skin sensitivities.

More of our mostFrequently asked questions

How can I reduce the chances of PIH from acne?

How can I reduce the chances of PIH from acne?

What is a simple skin care routine to treat PIH pigment?

Can I undertake lasers if I am on isotretinoin?

Is microneedling effective for pigmented acne scars?

Is RF microneedling effective for pigmented acne scars?

What other lasers can treat pigmentation from acne?

What types of chemical peels treat PIH?

Should I consider a Cosmelan peel to treat dark scars due to acne?

Why pimple patches?

A SummaryPIH treatment

Dr Davin Lim | Dermatologist
The Melasma Clinic, Brisbane | Sydney

Pigmented acne scars are classed as grade 1 scarring or flat scars. These must be differentiated from atrophic scars (divots) or raised scars (hypertrophic scars). The content of this page refers to scar with no topographical changes. For other scar types, the explanation of treatment options is beyond this website, go to for more information on how dermatologist manage these scar signatures.

90% of patients who visit us for PIH scarring will usually have some acne activity during the consultation, so don’t feel discouraged or stressed, we are here to help treat your acne & your pigment. Throughout the website we have reinforced that mitigation of PIH is vital to achieve good & permanent results. Our clinical team can treat & place acne in remission with our acne treatment programs. We employ the follow methods for acne prone skin-

  • Lasers & light-based devices: PDT (Kleresca), vascular lasers, Healite treatments
  • Chemical peels: Retinoic acid, salicylic acid & Jessner Peels
  • Topical prescription retinoids such as adapalene, tretinoin & retinoic acid
  • Topical anti-inflammatory medications
  • Anti-hormone medications
  • Oral retinoids

Here is the checklist if you are keen on our PIH treatment program-

  • Acne remission is important, especially if you have ethnic skin. 2 or 3 new spots monthly equates to over 30 spots over a year.
  • UV & visible light photoprotection. SPF 50+ twice a day regardless of exposure. Augment HEV protection with tinted oxide mineral make up, or formulations with iron oxide. If a 50 ml bottle lasts longer than 3 weeks, you are not using enough sunscreen.
  • Multiple sessions: At minimum 5 sessions are required, if your PIH is severe, you may require another few more session.
  • Acne scar type: Pico lasers are only useful for flat brown or dark acne scars. They give marginal improvements on established acne scars. You must prioritise treatments based upon what you see & what is important for you. For atrophic or depressed acne scars, other treatments are required. They include peels, surgery, dermal fillers, micro needling, RF, or lasers.

*Disclaimer: our dermatologist, Dr Davin Lim is procedural, namely his work is concentred on lasers, deep peeing, injectables & surgical procedures. For acne management, our cosmetic physician will be involved in management.