PIH vs PIE: Understanding Acne Marks and How to Treat Them
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What Are Those Marks Left Behind After Acne?
If you’ve ever had a breakout heal but leave behind dark spots or redness, you’re not alone. One of the most common concerns we see at Esthetics By Cati in Lewiston, NY is not just acne… but what comes after it.
These marks typically fall into two categories:
Post-Inflammatory Hyperpigmentation (PIH) and Post-Inflammatory Erythema (PIE).
Understanding the difference is key to choosing the right treatments and actually seeing progress.
What Is PIH (Post-Inflammatory Hyperpigmentation)?
PIH shows up as brown, tan, or dark spots left behind after inflammation in the skin.
This happens when your skin produces excess melanin during the healing process. It is more common in medium to deeper skin tones, but can affect anyone.
Common causes include:
- Acne breakouts
- Picking or squeezing the skin
- Heat or irritation
- Inflammation from treatments or products
What helps PIH:
- Pigment-correcting serums
- Chemical peels
- Retinoids (like Alpharet)
- Consistent SPF use
PIH is not permanent, but it does require consistency and the right approach.
What Is PIE (Post-Inflammatory Erythema)?
PIE appears as red, pink, or sometimes purplish marks after acne.
Unlike PIH, PIE is not related to pigment. It is caused by damage to small blood vessels (capillaries) in the skin due to inflammation.
It is more commonly seen in lighter skin tones.
Common causes include:
- Inflammatory acne
- Skin sensitivity
- Over-exfoliation
- Barrier damage
What helps PIE:
- Barrier repair products
- Gentle exfoliation (like mandelic acid)
- Hydration-focused skincare
- Treatments that reduce inflammation
PIE can take time to fade, especially if the skin barrier is compromised.
Why Treating Them the Same Doesn’t Work
One of the biggest mistakes we see is clients using “brightening” products on redness or trying to treat dark spots with calming-only routines.
PIH and PIE require different strategies.
Using the wrong products can:
- Delay results
- Cause irritation
- Lead to more breakouts or prolonged healing
This is why a customized approach is so important.
Professional Treatments That Help
At Esthetics By Cati, we take a results-driven approach to treating both PIH and PIE.
Depending on your skin, treatments may include:
- Customized chemical peels
- Microneedling
- Advanced facials targeting inflammation and pigmentation
- Barrier repair protocols
We also use tools like skin analysis to track progress and adjust your plan as your skin improves.
The Most Important Step: SPF
No matter if you’re dealing with PIH or PIE, daily SPF is non-negotiable.
Without it:
- PIH can get darker
- PIE can last longer
- Overall healing slows down
Think of SPF as protecting your results.
Ready to Treat Your Skin the Right Way?
If you’re tired of guessing what your skin needs, we’re here to help.
At Esthetics By Cati in Lewiston, NY, we specialize in acne, pigmentation, and corrective skincare with customized treatment plans designed for real, lasting results.
Book your consultation today and start your clear skin journey with confidence.