Post-inflammatory erythema (PIE) refers to the pink or red marks left behind after an acne lesion heals. Unlike PIH, which involves excess melanin production and appears as brown or dark discolouration, PIE is vascular in origin. It results from damaged or dilated blood vessels at the site of a resolved inflammatory lesion.
PIE is more common in lighter to medium skin tones. In deeper skin tones, the same post-acne response tends to produce PIH (brown marks) rather than PIE (red marks). Some clients, particularly those with medium tones, present with both simultaneously.
How PIE Differs from PIH
The distinction matters because the treatment approach is different. PIH targets melanin production pathways. PIE requires treatment that addresses vascular changes, specifically the broken capillaries and dilated vessels that cause persistent redness. Using a PIH-focused treatment protocol on PIE, or vice versa, produces limited results.
At your consultation, Shivali will assess whether your post-acne marks are PIH, PIE, or a combination, and build your program accordingly.
How CanStrive Treats PIE
PIE treatment at CanStrive uses the Aerolase Neo Elite laser, which has a strong affinity for oxyhemoglobin in blood vessels. This allows it to selectively target the vascular component of PIE without damaging the surrounding skin. This is particularly relevant for medium to medium-deep skin tones where surface heating must be carefully managed.
Treatment is structured within the corrective protocol framework, with Phase 1 controlling active inflammation before vascular treatment begins, Phase 2 targeting the PIE with appropriate laser parameters, and Phase 3 maintaining results with barrier-supportive homecare and SPF.
Frequently Asked Questions
Q: How do I know if I have PIE or PIH?
PIE marks are pink or red. They are vascular, not pigmentary. If you press on the mark and it temporarily blanches (turns white), it is likely PIE. PIH marks are brown, tan, or grey-brown and do not blanch under pressure. At your consultation, Shivali will confirm which type you have and recommend the appropriate approach.
Q: Does PIE fade on its own?
PIE can fade over time without treatment, but this process can take one to two years for some clients. Clinical treatment significantly accelerates resolution.
Begin Your Post-inflammatory Erythema (PIE) Treatment at CanStrive MedSpa & Wellness Clinic
If you are dealing with persistent redness or pink marks after acne and are unsure whether it is PIE, PIH, or a combination, a consultation with Shivali is the right starting point. She will assess your skin and give you a clear treatment direction. Book online or call (905) 569-3555.