The Mechanism: Why PIH Occurs After Peels
Indian skin predominantly falls under Fitzpatrick skin types III to V, which contain highly reactive melanocytes. When a chemical peel causes controlled inflammation, these melanocytes can overreact to the trauma. Clinical scoping reviews demonstrate that this inflammatory response triggers the release of dermal melanophages (macrophages that have ingested excess melanin), depositing pigment irregularly at the exact site of the injury. In contrast, melasma develops slowly over weeks or months due to hormonal fluctuations and UV exposure, not acute trauma.Clinical Diagnosis
If you seek treatment in dermatology clinic settings, a dermatologist will typically utilize a Wood's Lamp test. This ultraviolet light diagnostic tool distinguishes between epidermal pigmentation (which enhances under UV light) and dermal PIH (which shows little to no enhancement). Identifying the depth of the pigment dictates the treatment timeline, as dermal PIH takes significantly longer to clear.Targeted PIH Protocol
To clear post-peel PIH without triggering further inflammation, you must use a protocol that inhibits melanin synthesis and accelerates cellular turnover. Clinical data indicates that significant improvement in pigmentation for Indian skin types takes 12 to 16 weeks of consistent active usage.- Morning - Tyrosinase Inhibition: Apply a 10% Vitamin C serum to the affected area. Vitamin C neutralizes free radicals and inhibits tyrosinase, the core enzyme responsible for melanin production. Follow strictly with a broad-spectrum SPF 50 sunscreen, reapplied every 2 to 3 hours, as visible light and UV radiation rapidly darken PIH.
- Evening - Melanosome Blocking: Apply a 10% Niacinamide serum. Niacinamide works mechanically by blocking the transfer of melanosomes (melanin-filled packages) from the melanocytes to your surface keratinocytes.
- Weekly - Cellular Turnover: Once your skin barrier has fully healed from the peel (typically 4 to 6 weeks post-procedure), introduce a 2% Salicylic Acid serum 1 to 2 times a week at night. Salicylic acid stays superficial, gently dissolving the bonds between dead, pigmented skin cells to accelerate their shedding without causing the deep irritation that triggers further PIH.
Hinglish version: https://thedermaco.com/blogs/faq/melasma-vs-pih-left-cheek-chemical-peel-hinglish
