Persistent dark lip discoloration after inflammatory reaction (8 months) — PIH vs smoker’s melanosis?

Hi doctors, I’m a **29-year-old male** looking for guidance on persistent lip pigmentation. # Timeline / History Around **July 2025**, I developed a sudden inflammatory-type reaction affecting multiple areas: * **Lips:** redness/swelling → peeling → dark discoloration afterward * **Foreskin:** mild swelling and irritation, itching initially, some peeling * Other areas: small red itchy spots on **toe, elbow, finger, leg**, which also later left dark marks There was **no significant pain**, no burning urination, and no recurrent blisters. # Current Situation The acute reaction resolved, but I have been left with: * Persistent **dark discoloration on my lips** * Similar dark post-inflammatory marks on my **elbow and toe** * No new lesions, no active itching, no flaking, no pain This has been ongoing for about **7–8 months** with little improvement. # Dermatology Visit I recently saw a dermatologist who prescribed: * **Tacrolimus ointment 0.1%** Other Factors * I am a **smoker**, which I understand may contribute to lip pigmentation # Main Questions 1. Does this sound most consistent with **post-inflammatory hyperpigmentation** vs **smoker’s melanosis** or another condition? 2. Is tacrolimus an appropriate treatment for persistent lip pigmentation? 3. How long can lip PIH realistically take to fade? 4. Should i consider PICO laser? I would also like to know what is this condition called and is it common? Thank you for any insight. [https://imgur.com/a/V48T6cW](https://imgur.com/a/V48T6cW)