Q. I have PIH after erythema multiforme. What can I apply to let the pigments fade?

Answered by
Dr. Shanza Ikram
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 08, 2018

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.



Welcome to

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.

For more information consult a dermatologist online -->

Thank you doctor,

This is the current photo. I believe its the PIH left. Up to now, I still do not know what was the cause of everything. Test had but no one has explained what I need to do.



Welcome to

Well, there are a number of causes of erythema multiforme.

The most common causes are:

  1. Drugs like painkillers or antibiotics.
  2. Viral infection like herpes.
  3. Idiopathic (which means no obvious cause).
  4. 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.

For more information consult a dermatologist online -->

Thank you doctor,

I am seeing a dermatologist and he gave me some Hydroquinone cream. Would it be fine to apply with Tretinoin gel and moisturizer? If yes, then which one should I apply first?



Welcome back to

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.

For more information consult a dermatologist online -->

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
What causes recurrent red patch on face?

.. are having a good day and staying safe. 1) I understand your concern, but please send me a photo of the lesions so that I can rule out various causes that leads to the symptoms. 2) The possible causes are: - Fungal infection - Bacterial Infect...   Read full

I feel pain due to wisdom tooth eruption. What can I do at the earliest to manage the pain?

.. gone through your question I can understand your concern. You need to use Hydrogen peroxidase 3% mouth wash. Make sure the concentration must not be more than that. You can also use antibiotics only after consulting your dentist. You can also pr...   Read full

Stevens-Johnson Syndrome - Causes, Symptoms, and Treatment

Generally, AIDS causes destruction of the whole immune-mediated functions, giving way for a lot of opportunistic infections ... Infections like pneumonia can also be a contributing factor for Stevens-Johnson syndrome ...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

Coronavirus Variant Arcturus: | Omicron XBB.1.16 Variant
Arcturus is an emerging variant of the Omicron virus that causes various symptoms and spreads rapidly across the world. ...  Read more»
Adrenaline Rush - Symptoms, Causes, Effects, and How to Control
Adrenaline is a hormone responsible for fight or flight response. It is also a neurotransmitter and medicine. It is also...  Read more»
Fatty Liver - Types, Symptoms, Stages, and Treatment
The liver is the largest gland in the body. Its primary function is to process the food and drinks we consume. and filte...  Read more»

Ask your health query to a doctor online?

Ask a Dermatologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.