If you’ve had acne before, you may have experienced the frustration of dealing with the aftermath. You know, those long lasting red or dark brown spots, after you just had to deal with pimples!

For the longest time, we referred to these spots as post-inflammatory hyperpigmentation and treated them as such. While that is correct, there’s actually another kind of spot that differs from hyperpigmentation (PIH) that’s caused by inflammation, it’s called post-inflammatory erythema (PIE).

There’s actually an easy distinction between the two: PIH is the dark, brown spots and when it’s red, it’s PIE. 

Here's how to deal with them:

POST-INFLAMMATORY HYPERPIGMENTATION (PIH) 
*Dark-brown pigmentation*

Who:

PIH are more common among darker skin (melanin-rich skin). 

What:

This kind of inflammation is a skin reaction not only from acne, but also from sun exposure, wounds or eczema.

The trauma/injury that the skin goes through causes an overproduction of melanin, creating the dark patches on inflamed skin.

Treatment: 

For treating PIH, you want to focus on treating discoloration, brightening and fighting against pigmentation. 

Ingredients to look for:

Retinoids, Niacinamide, Azelaic Acid, Vitamin C, Arbutin and Hydroquinone.

POST-INFLAMMATORY ERYTHEMA 
*Red-pink pigmentation*

Who:

PIE are more common among lighter skin. 

What:

This kind of inflammation does not involve melanin.

This is a skin reaction due to damage in capillaries - the small blood vessels close to the skin’s surface area). 

Aside from acne inflammation, this is also triggered by picking or popping your pimples.

Treatment:

Treating PIE is similar to treating PIH, focusing on treating discoloration. 

Ingredients to look for: 

Retinoids, Niacinamide, Azelaic Acid, Vitamin C, Arbutin and Hydroquinone.

General Preventative/Treatment Tips

For both inflammation marks, make sure you are applying SPF daily. This will prevent the marks from getting darker. 

There are also laser treatments, chemical peels and microneedling that can fade the appearance of these marks. 

PIE and PIH can take a really long time to fade, be patient and consistent with your topical treatments to see effective results.