What should be applied to PIH after the erythema multiforme?

Question

Hello doctor,

I had erythema multiforme because of drug allergy and currently left with post inflammatory hyperpigmentation. How long will it last and how and what should I do or apply to let the pigments fade? I have my liver, biopsy test, and I need someone to explain the results.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through the pictures (attachment removed to protect patient identity). Your lesions are not only hyperpigmented (which shows the healing phase) but they are still erythematous (which shows the active phase). So, right now you should not worry about the pigment of these lesions. It will take some time like three months to recover. Even then some pigmentation may remain. But you should keep yourself relaxed as you had a serious condition and that is good you are in the safe phase now.

I did not receive your liver biopsy report. Only CBC (complete blood count) was there.

Kindly update us with your reports.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Well, there are a number of causes of erythema multiforme. The most common causes are:

Drugs like painkillers or antibiotics.
Viral infection like herpes.
Idiopathic (which means no obvious cause).
Any systemic illness like SLE (systemic lupus erythematosus) or Crohn's disease.

Yes, it is post-inflammatory pigmentation. But, the thing is the dark spots or pigmentation will take some time to recover which could be three months. In previous pictures, you have red spots which are remnant of your condition that may take even longer. I can very well understand your mental status. As skin is a very important organ and plays important role in physical appearance and aesthetics. In my opinion, do not upset yourself in finding what happens to you. What is over now for just be thankful and stay relax. Post-inflammatory pigmentation will settle itself. We cannot give any whitening cream right now as it may start irritation and a new lesion may develop. So, please relax.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Both creams are given for hyperpigmented lesions. But, both of them can cause irritation. And frankly speaking, your skin is still in fragile phase. Please try to get my point. Use it after two weeks at least. Anyways, whenever you start, mix Hydroquinone cream with any moisturizer cream in equal amount and apply on lesions which are black only at night.

First, apply for two hours and then apply for three hours. Do not apply in the morning or you will have burning in the sun. Still, I do not recommend you to use Tretinoin as it starts peeling. Tretinoin way of application is also the same and applied only at night.

Hope it helps.

Thank you.