Anyone who has ever had acne knows that when the pimple is finally gone, the skin where it was can be left with a red appearance. The technical term for this annoying condition is post-inflammatory erythema, often referred to as PIE. And it can often be as persistent and frustrating as the original acne itself.
What Is Post-Inflammatory Erythema?
PIE, or postinflammatory erythema, refers to pink or reddish patches that appear as a result of trauma that causes inflammation to the skin. This is often due to an injury or inflamed acne.
Mild, non-inflamed acne, which includes blackheads and whiteheads is not typically a cause of PIE. Acne with inflamed papules and pustules is more likely to lead to PIE.
Papules are red, inflamed bumps that are usually less than 5 mm or a tenth of an inch in size while pustules that have a white or yellow tip.
Post-inflammatory erythema can vary in severity. In some cases ,it appears in a faint pink, while in others it appears more like a deep red.
As the post-inflammatory erythema fades and begins to go away, the colour may also change.
In addition, post-inflammatory erythema can affect the face and body. Basically, anywhere acne occurs, including common areas such as the neck, chest and back.
PIE vs. postinflammatory hyperpigmentation (PIH)
While people of all ages can be affected by postinflammatory erythema, is generally more common in people with fair skin.
Individuals with darker skin types are more prone to postinflammatory hyperpigmentation (PIH).
In this case, rather than affecting the capillaries, the inflammation or trauma triggers the over-production of melanin.
Post-inflammatory hyperpigmentation (PIH) occurs when skin damage causes an overproduction of melanin. PIH is typically brown in color and can last longer than PIE.
PIH is also most common in people with darker skin tones, such as IV, V and VI on the Fitzpatrick skin phototype scale. That being said, both PIE and PIH can occur simultaneously in many skin types. To learn more about why pigmentation comes onto the face visit this article.
Top Factors that Excarbate Post-inflammatory Erythema
Excessive oil production
People who suffer from acne usually have increased oil production. This oil builds up in the follicles and clogs the excretory ducts, causing inflamed acne to form.
Bacteria
While all skin has bacteria, acne sufferers tend to have higher levels of P. acnes bacteria than others. P. acnes feed on the excess oil and cause inflammation, redness and infection that manifests as acne.
When the bacteria digest the trapped oil, fatty acid waste is produced, causing the irritation.
This very irritation can then manifest as post-inflammatory erythema, which often leads to pink or red patches on the skin.
Popping Pimples
You have probably heard that you should not touch your pimples, as tempting as that may be.
Picking, pricking or squeezing acne can increase the risk of PIE as it can trigger more inflammation, which in turn can lead to more redness and scarring.
Hormonal fluctuations
If you have been following our series on the skin vs hormones, you probably know that any drastic changes in hormone levels can lead to acne.
Pregnant and menopausal women can attest to how annoying this is!
Harsh products
As much as we may want acne to disappear immediately, it's important not to overdo it with skincare products. Avoid using harsh soaps and abrasive scrubs.
This often leads to an undesirable effect by disrupting the skin barrier and causing skin irritation. This in turn can aggravate redness and post-inflammatory erythema.
So how can you treat post-inflammatory erythema? Read on and find out!
How Do You Combat Post-inflammatory Erythema
Microneedling
Microneedling uses tiny needles to create a superficial, controlled skin injury. This induces the skin to produce new collagen-rich tissue, causing surface red patches to disappear.
Microneedling also helps break up acne-related scars. These results can be further enhanced by combining microneedling with topically applied stem cell growth factors.
This procedure should only be conducted under the guidance of a medical aesthetician. While there are DIY dermaroller you can use at home can easily lead to significant irritation, redness and scarring.
Remember that you may need to have microneedling done several times to achieve complete healing, especially if you are suffering from extensive PIE.
Sunscreen
If you are prone to skin breakouts, applying thick, sticky and greasy sunscreen is probably last on the list of things you want to do. We get it.
But did you know that sunscreen can help reduce the overall appearance of scars and red patches? Yes! Too much sun exposure can worsen the appearance of blemishes and cause them to take longer to subside.
You just need to find a sunscreen that's right for your skin.
Our top recommendation is Clear Shield Broad Spectrum SPF 42, a lightweight, non-comedogenic broad-spectrum sunscreen to protect sensitive, redness and acne-prone skin and Moisture Matte Broad Spectrum SPF 40, which has a matte finish and can also double as your daily primer.
Chemical Peels
Chemical peels involve applying an acid to the skin to lower the pH level. This loosens the bonds between dead skin cells, inducing exfoliation and stimulating the growth of new cells.
This process removes superficial layers of dead skin, revealing a smoother and more radiant complexion. Chemical peels can also thicken the epidermis, increase dermal volume and stimulate collagen.
All of this helps to reduce the appearance of post-inflammatory erythema.
Note that chemical peels vary in strength from mild to deep. As deeper peels can sometimes exacerbate PIE, it is safer to start with more superficial peels.
We offer light to medium depth chemical peels from AlumierMD, which are known for their excellent results and safety profile.
Pimple Patches
Pimple patches are small stickers made of a slightly rubbery wound-healing gel called hydrocolloid. Larger versions are marketed as "blister bandages, but they all have the same purpose - to help your skin heal faster.
Pimple patches absorb the discharge from the pimple and cover the wound to prevent further trauma to the area. They work best on open, draining, healing pustules, papules and cysts.
Some even incorporate active ingredients like hyaluronic acid, niacinamide and vitamin C to help improve the appearance of blemishes and post-acne marks.
And don't worry, it is now fashionable to walk around with pimple patches, and some versions are also so inconspicuous that they can be worn during the day!
By protecting the skin, pimple patches prevent further inflammation and irritation, which can reduce the risk of post-inflammatory erythema.
Dapsone
Dapsone is a bacteriostatic antibacterial sulfonamide (antibiotic) used to treat many systemic and dermatological conditions, including acne.
It also has an anti-inflammatory effect and is therefore particularly helpful in preventing post-inflammatory erythema.
Dapsone is available in both ingestible and topical forms, including the popular dapsone gel.
Dapsone gel can help reduce the number and severity of acne pimples and speed up the healing of pimples that do appear. Be sure to wash your hands and face before applying this medication to the affected skin.
