Why Your Hyperpigmentation Won’t Go Away | Dermatologist Explains

Hyperpigmentation is not always simply a dark mark left behind after inflammation. In this video, board-certified dermatologist Dr. Dray explains why post-inflammatory hyperpigmentation (PIH) may sometimes coexist with ongoing inflammation, even when the skin appears clear on the surface. This is particularly important for people with darker skin tones, where inflammation and erythema may be less visually obvious. Dr. Dray explains how persistent inflammation from acne, eczema, contact dermatitis, rosacea, and other inflammatory skin conditions can contribute to stubborn hyperpigmentation and why treating the underlying condition is an important part of improving dark spots. The video also covers why constantly trying new skincare products can backfire, how irritation can worsen hyperpigmentation, why picking and squeezing acne can lead to darker marks, and why caution is needed with at-home microneedling and IPL devices. Dr. Dray also discusses the rationale behind the Kligman formula and Tri-Luma, including why fluocinolone acetonide is combined with hydroquinone and tretinoin, and how its anti-inflammatory properties can help limit irritation while contributing to the overall treatment approach. Finally, the video explains why sun protection is essential for hyperpigmentation and melasma, including the potential benefits of tinted sunscreens containing iron oxides for visible light protection. Topics covered • Post-inflammatory hyperpigmentation and ongoing inflammat