As if active acne wasn’t annoying enough, we can’t forget about the discoloration that’s often left behind. After years of treating my personal discoloration as post-inflammatory hyperpigmentation (PIH), through @rubysacne and a visit to the dermatologist, I learned what I actually have is post-inflammatory erythema (PIE). Knowing the differences can help you in your post-acne journey to not only achieve clear skin, but also even skin.
Post-Inflammatory Erythema
These marks are caused by damaged capillaries beneath the skin and appear as pink to red marks after an inflammatory blemish heals.
How to Identify:
- Pink to red in color
- More common in fair skin tones
- Temporarily turns white when pressed (check out this quick test)
- Usually follows inflammatory acne
Treatments:
- Azelaic Acid: Reduces inflammation and redness
- Lasers: Pulsed dye laser and IPL can target blood vessels
- Time: Will fade naturally, but it can take months to years
Post-Inflammatory Hyperpigmentation
These marks are caused by an increase in melanin production after inflammation and appear as brown, tan, or dark spots.
how to identify:
- Brown, tan, or dark purple in color
- More common in deeper skin tones
- Doesn’t turn white when pressed
- Can follow any inflammatory process, not just acne
Treatments:
- Vitamin C: Brightens skin and inhibits melanin production
- Tranexamic Acid: Reduces pigmentation and inflammation
- Retinoids: Increase cell turnover to fade marks faster
- Chemical Exfoliants: AHAs like glycolic acid help shed pigmented cells
No matter which post-inflammatory response you have, prevention is key
The best way to prevent both PIE and PIH is to:
1. Treat acne promptly to reduce inflammation.
2. Never pick or squeeze pimples. Use pimple patches instead.
3. Use sunscreen daily. UV exposure darkens both PIE and PIH.
While PIH + PIE can be frustrating, try to remember to be patient with and kind to yourself. You’ve gone through the hard part of healing the active acne, so now you can let time do its thing. Remember that genetics play a role in how your skin responds, and focus on a consistent, gentle approach rather than aggressive treatments that might trigger more inflammation.
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