By RN Laurisa, Founder of Injxu Face + Skin
If you have olive, Mediterranean, Middle Eastern, South Asian, or Latin skin, you already know that pigmentation behaves differently. A small breakout that would fade quickly on fairer skin can leave a dark mark that lingers for months. A scratch, an ingrown hair, a hormonal flare, even a moment of overzealous exfoliation — and suddenly there's a stubborn shadow that no amount of concealer can fully disguise.
This is post-inflammatory hyperpigmentation, or PIH. At Injxu Face + Skin in Gladesville, it's one of the most common concerns I see in consultation — and one of the most rewarding to treat properly. The key word being properly. Olive and deeper skin tones need a more considered approach than the generic advice you'll find on most beauty blogs. Done well, PIH responds beautifully. Done aggressively or with the wrong protocol, it can get worse before it gets better.
This is the honest, science-led guide I wish more of my patients had been given before they arrived at the clinic.
What post-inflammatory hyperpigmentation actually is
PIH is the skin's normal response to inflammation. When the skin is injured or irritated — by acne, a scratch, friction, sun exposure, or a treatment that was too aggressive — the melanocytes (your pigment-producing cells) respond by depositing extra melanin in the affected area. On lighter skin, this often shows up as red or pink marks that fade as the inflammation settles. On olive and deeper skin, those same cells produce more melanin more readily, and the resulting marks are typically brown, grey-brown, or even purple-brown, and they take significantly longer to fade.
It's important to distinguish PIH from two close cousins:
- Melasma — a hormonally-driven pigmentation pattern that often appears symmetrically across the cheeks, forehead, and upper lip. Melasma has different triggers and needs a different protocol.
- Sun-induced pigmentation — freckle-like marks or larger flat patches caused by cumulative UV exposure. Treatable, but again, a different mechanism.
In consultation, the first thing we do is identify which type of pigmentation we're actually looking at — because the treatment plan changes accordingly. It's not uncommon for a single patient to have a mix of all three.
Why olive skin reacts differently
The technical term for this is Fitzpatrick skin type, a scale of one to six that classifies skin by how it responds to sun exposure. Olive and Mediterranean skin typically falls in Types III and IV, and deeper skin tones in Types V and VI. The higher the Fitzpatrick type, the more reactive the melanocytes — meaning the skin is more likely to develop PIH from even minor inflammation, and the resulting pigment is denser, deeper, and more stubborn to fade.
This is also why deeper skin types are more sensitive to certain treatments. An aggressive laser setting or a poorly chosen chemical peel can cause more pigmentation rather than less — a phenomenon called paradoxical hyperpigmentation. This is why I'm so insistent that anyone with olive or deeper skin be treated by a clinician with specific experience and training in higher Fitzpatrick types. It's not the territory for guesswork.
What doesn't work (and what makes it worse)
Before we get to what works, here's what I see going wrong in patient histories every week:
- Aggressive at-home exfoliation. Acids, scrubs, and harsh cleansers used too often inflame the skin barrier — and inflammation is the trigger for more PIH. Patients come to me genuinely believing they've been "treating" their pigmentation, when in fact they've been feeding it.
- Hydroquinone bought online or through unregulated channels. Hydroquinone has a role in clinical pigmentation protocols when prescribed and supervised, but unsupervised long-term use can cause its own problems, including a rare condition called ochronosis. I do not recommend self-prescribing.
- Wrong sunscreen, or no sunscreen. This is the single most overlooked factor. UV exposure activates the same melanocytes that are already over-responding. Without daily, high-quality, broad-spectrum sun protection, no PIH protocol will deliver the results it should.
- Picking, popping, and squeezing. Mechanical trauma is inflammation. Inflammation is a trigger. This one is hard to hear when you're mid-breakout, but it matters.
- Generic laser at the wrong setting. I mentioned this above and it's worth repeating: laser settings calibrated for Fitzpatrick I–II skin can cause real harm on darker skin. Always ask your clinician about their experience with your skin type.
The principles of an evidence-based PIH protocol
A considered protocol for PIH on olive and deeper skin rests on five pillars. We discuss all five in your initial skin consultation at Injxu and design a plan that fits your skin, your lifestyle, and your timeline.
1. Calm the inflammation first
Before we try to fade what's there, we have to stop new pigmentation from forming. That means identifying the root inflammation — whether it's active acne, a compromised skin barrier, an unsuitable routine, or hormonal triggers — and addressing it. Sometimes this means simplifying your routine dramatically for a few weeks. Sometimes it means treating active breakouts with appropriate clinical support.
2. Daily UV defence
I cannot say this loudly enough: broad-spectrum SPF50+, every day, on the face, neck, and any exposed areas. We tend to recommend tinted physical sunscreens for olive and deeper skin because iron oxides (the pigments that make them tinted) also block visible light, which contributes to melasma and worsens PIH. The iS Clinical Eclipse and Extreme Protect All Day Moisturiser sunscreens we stock at Injxu are formulated with this in mind.
3. Targeted topical actives
The active ingredient list for PIH is well-established in dermatology research: niacinamide, azelaic acid, tranexamic acid, vitamin C in stabilised formulations, retinoids (where tolerated), kojic acid, alpha arbutin, and licorice extract. The art is in the combination, the sequencing, and the strength. We typically build out a personalised routine using cosmeceuticals from iS Clinical alongside, where appropriate, prescription-strength formulations.
4. In-clinic treatment, layered carefully
For olive and deeper skin, the safest and most predictable in-clinic options for PIH tend to be:
- Cosmelan by Mesoestetic — a depigmentation system specifically designed for darker skin types, with a six-month structured protocol. This is one of the gold-standard clinical interventions for stubborn pigmentation and one of the systems we use at Injxu.
- pH Formula chemical peels — pharmaceutical-grade resurfacing using their patented PH-DVC delivery system. The barrier-friendly formulations make them well-suited to higher Fitzpatrick types.
- Microneedling with Dermapen 4 — mechanical stimulation that supports skin renewal, often paired with regenerative actives. Done at appropriate depths for darker skin, this is generally well-tolerated.
- Laser, when appropriate — the Cynosure Potenza (RF microneedling) and Alma Harmony (multi-platform laser including IPL and Q-switched modules) we use at Injxu both have settings designed to be safer for darker skin. But laser is rarely the first treatment we reach for in olive skin — we typically establish a strong topical and gentler in-clinic foundation first.
5. Patience and progress tracking
This is the part nobody wants to hear: PIH on olive skin takes time to fade. Mild PIH may improve noticeably in eight to twelve weeks with a strong protocol. Deeper or older marks can take six months or longer. Some patients see substantial improvement; some see partial improvement; results vary depending on skin type, history, hormones, sun habits, and consistency with the protocol.
I always tell patients: do not judge your progress in the mirror every morning. Take a baseline photograph at the start of treatment under consistent lighting, and re-photograph monthly. The cumulative changes are far more visible in photos than they are day-to-day.
Realistic expectations — an honest note
Under Australian Health Practitioner Regulation Agency guidelines, I'm not permitted to make promises about specific outcomes — and frankly, no honest clinician should. What I can tell you is that with a well-designed protocol, consistent home care, daily sun protection, and the patience to follow the plan through, the majority of patients I see with PIH on olive and deeper skin experience meaningful improvement. Results vary for other patients.
When to book a consultation
Pigmentation is one of the most layered skin concerns to assess. What looks like simple PIH to the patient can turn out to be a combination of PIH, melasma, and sun-induced pigmentation — each requiring a different approach. Self-treating from internet advice rarely lands on the right protocol, and on olive skin specifically, the wrong approach can deepen the problem rather than fade it.
A proper skin consultation involves a full skin assessment, a clinical photography baseline, identification of the type or types of pigmentation present, and a stepwise plan that respects your skin's tolerance and your timeline. At Injxu we use Clinical Imaging Systems for consistent, AHPRA-compliant before-and-after documentation, so we can objectively track your progress rather than relying on memory and mirrors.
Frequently asked questions
Can PIH go away on its own?
Yes, mild PIH can fade on its own over many months, particularly if you avoid further inflammation and protect from UV. But on olive and deeper skin tones, this process is significantly slower, and untreated PIH can persist for a year or more. A clinical protocol can support and accelerate the natural fading process.
Is microneedling safe for olive skin?
Generally, yes — when performed at appropriate depths by an experienced clinician using a medical-grade device such as Dermapen 4. The risk is in over-treating or being too aggressive, which can cause more pigmentation. This is one of the reasons we always tailor depth and frequency to each patient's Fitzpatrick type.
What's the difference between PIH and melasma?
PIH appears in localised spots where inflammation has occurred — usually one mark per inflammatory event. Melasma appears as larger, symmetrical patches, typically across the cheeks, forehead, or upper lip, and is hormonally influenced. Many patients have both. They're treated differently, which is why a proper diagnostic consultation matters.
Will pigmentation come back?
It can, if the underlying triggers aren't managed. Sun exposure, ongoing inflammation, and hormonal shifts can all cause new pigmentation even after a successful treatment course. This is why we frame PIH treatment as a long-term skin partnership, not a one-off intervention.
How long until I see results?
Mild PIH typically begins to fade visibly within eight to twelve weeks of a consistent protocol. Deeper or older marks can take six months or longer. Some patients see substantial improvement; some see partial improvement. Results vary.
The Injxu approach to pigmentation
Our philosophy at Injxu Face + Skin is holistic, undetectable, authentically you. For pigmentation that means designing a protocol around your skin — not a one-size-fits-all template — with the patience and continuity of care that real pigmentation work requires. RN-led, evidence-based, and honest about what's achievable.
If you'd like to have your pigmentation properly assessed and a plan built around your skin, you're welcome to book a skin consultation. Bring your skincare products with you — we'll review them too.
This article is general information and not medical advice. Individual results vary. A consultation is required to determine treatment suitability.