After writing a post about post-inflammatory pigmentation (PIH), I thought I’d dedicate one more post on another very similar post-inflammatory condition and that is post-inflammatory erythema or otherwise known as PIE.
If you’ve read my previous post, you’d know that post-inflammatory hyperpigmentation are those pesky little brown spots that occur when abnormal production of melanin in the skin is triggered as a natural response to inflammation.
A common cause for this is acne, cuts, cold sores or sunburn.
PIH is usually flat and darker than the surrounding skin. Discolouration can range from light to dark brown or even black, depending on the severity of the inflammation and the natural skin tone.
Although they might look very similar and are caused by pretty much the same factors, there are a few minor differences between these two conditions.
What Is Post-Inflammatory Erythema?
Post-inflammatory erythema or PIE are reddish pink blemishes that appear when the blood vessels (capillaries) are damaged or abnormally dilated.
Severe trauma to the skin causes the delicate capillaries under our skin to break and this triggers an increase of blood flow to heal the vascular wound.
PIE can vary from pink, red to deep purple discolouration depending on the severity.
PIE is distinct from PIH because PIE describes residual erythema (redness), while PIH(hyperpigmentation) describes actual pigment change. Both conditions tend to fade over time, thus differing from a true scar that persists on the skin.
While PIH is more obvious in darker skin phototypes, this type of post-inflammatory dyspigmentation tends to appear in lighter skin types.
What Causes Post-Inflammatory Erythema?
This is caused by moderate or severe inflammation and trauma to the skin such as chemical burns or cuts, sunburn, and even over-exfoliating treatments.
The most common cause of PIE is undoubtedly moderate to severe acne inflammation.
Attacking pimples with fingernails is the easiest way to damage and break blood vessels, causing them to dilate and appear more prominent on the surface of the skin.
How Do You Know If You Have Post-Inflammatory Erythema?
Erythema disappears temporarily when you apply pressure to it, while hyperpigmentation doesn’t react the same way under pressure.
This is known as the blanching effect.
You can recognize the difference by pressing a clear piece of glass or plastic to the area and applying light pressure to it.
If the area becomes white or it changes color completely, then the condition should be recognized as post-inflammatory erythema.
If the redness persists during this simple test, this can be a sign of another skin condition, such as rosacea.
How To Treat Post-Inflammatory Erythema At Home?
PIE marks eventually fade – even with no treatment – but the process can take as long as anywhere between three months to a year.
If you are noticing that the process of healing is taking a bit too long for you, there might be things you are doing that are not helping the condition.
1. Avoid picking or popping any new pimples in the area.
In order to heal this pesky condition, it is essential to prevent further inflammation.
By picking your skin with your fingers, you are pushing bacteria further into the wound, and this will contaminate and aggravate the condition.
2. Avoid physical exfoliation.
Physical exfoliation or scrubbing can be a very abrasive procedure and can cause further damage and micro-tearing into the skin, and this may weaken and break the blood vessels.
Opting for a mild chemical exfoliant may be a better solution for the time being while the condition is present.
3. Ditch harsh face cleansers.
Avoid using harsh face cleansers which contain sulfates or high pH levels that will strip the protective barrier off your face.
Opting for a mild cleanser that contains AHAs or BHAs will cleanse and exfoliate your skin by gently dispersing the molecular bonds that keep dead skin cells on your skin’s surface and will leave your skin feeling smooth, fresh and soft without further irritating it.
It is important to understand the function of both AHAs and BHAs before making a decision on which option will be more beneficial for your particular concerns.
4. Topical treatments for PIE.
- Niacinamide – a water-soluble form of Vitamin B3 that can stabilize the skin’s barrier function and improve hydration. Studies have shown moderate improvement in facial erythema after consistent use of Niacinamide after four weeks.
I have personally noticed a fairly significant improvement in my post-inflammatory erythema that was spread over my right cheek after applying Niacinamide every morning for nearly two months.
- Vitamin C – being the most abundant antioxidant in human skin, this powerful agent has proven itself highly effective in reducing facial erythema as well as prominent blood vessels and capillaries.
Due to its anti-inflammatory properties, vitamin C is also effective at decreasing the duration of post-inflammatory erythema.
- Azelaic acid – is a highly effective dicarboxylic acid often used as an acne and rosacea treatments due to its anti-inflammatory and also antibacterial properties.
The anti-inflammatory properties of this agent are what appears to be responsible for the significant reduction of facial erythema.
- Green tea – incorporating products that contain green tea extracts into your skin care routine will result in the beneficial soothing of inflammatory conditions such as acne breakouts and effectively relieve facial erythema.
5. Never neglect to apply sun protection.
Extended and unprotected sun exposure can darken your marks, and make post-inflammatory erythema harder to treat.
It will also prolong the process of the discolored marks to fade on its own.
If you are already treating your post-inflammatory erythema with applying active ingredients, sunscreen is highly recommended.
PIE is not classified as acne-scarring because this is only the result of a temporary inflammatory condition or trauma to the skin.
If you are unsatisfied with the results of at-home treatments of this condition, you can look into professional treatments such as Pulsed Dye Lasers.
Depending on the severity of the condition, micro needling is a cheaper but also effective treatment for post-inflammatory erythema and several other skin conditions.