Red Acne Scars

Treating Red Acne Scars at a glance

  • Best Results2-5 sessions
  • Treatment Recovery1-4 days
  • Procedure Time5 minutes
  • Skin SpecialistDavin Lim, nurses, dermal therapists
  • Duration of ResultsPermanent
  • AnaestheticSkin Cooling
  • Back to Work1 day
  • Cost$

Red Acne Scars

Red acne scars are termed PIE or post inflammatory erythema. Macular erythema refers to the same condition. By definition these scars have not contour changes. The majority of PIE will fade within 3 to 6 months. 20% can linger on for many years. Simple vascular lasers can treat redness associated with old acne spots.

FactsFacts on Red Acne Scars

  • Red marks are termed Post Inflammatory Erythema
  • PIE marks are flat- unlike acne scars which have contour changes
  • Some cases of PIE have mixed pigment, this is known as post inflammatory hyperpigmentation
  • PIE can last beyond 2 years
  • Vascular lasers give the best results
  • Fractional & Pico lasers can give added clearance
  • Most cases require 2-5 sessions
  • The prognosis for PIE is excellent- if acne is controlled

What causes post inflammatory erythema?

The most common cause is acne. PIE or post inflammatory erythema is a term used to describe red acne scars that linger after pimples. Redness is due to both increased blood vessels & in some cases pigment. By definition PIE is flat, unlike true scarring which has contour changes.

How do I treat PIE?

For true cases of PIE, the stand out treatment is vascular laser. This laser targets red marks, without breaking the surface of the skin. For mixed pigmentation, addition of a nano Q switch laser or better still a Pico laser can give faster clearance.

This type of scarring is classed as grade one, or ‘mild scars’. Book a consultation with my nurses for laser options. As a guide, I manage objectively severe forms of acne scars. Fortunately PIE can fade with a series of simple laser sessions. On average 3-4 sessions are required, spaced 2-4 weeks apart.

Does post inflammatory erythema go away?

In some situations, PIE can fade within 3 to 6 months. If inflammation is severe it can take up to 2 years to resolve. In some cases it can be permanent.

What skin products can treat PIE?

If you would like to try to fade PIE with over the counter products & skin care, try the following-

  1. The foundation of management is a good sunscreen. Use twice a day.
  2. Vitamin C in the AM, along with anti-oxidants such as vitamin E & ferulic acid.
  3. Niacinamide or Vitamin B3 is a good, low irritant anti inflammatory topical.
  4. Option for retinol or prescribed retinoid

Find the correct combination for your skin type, as this is dependent on your skin irritant threshold as well as the extent of active acne.

Disclaimer: I am a procedural dermatologist, I do not prescribe skin care. My work is focused on lasers, surgery & injectables. For information on products please discuss with your treating therapist, nurse or dermatologist.

Davin’s Viewpoint on treating PIE

Fortunately the majority of cases can be managed with simple vascular lasers. I prefer a bruising setting with the V Beam as it can accelerate treatments & reduce visits. Simple cases of acne scarring can be managed by my clinical team. For associated contour changes (depressed scars), simple fractional energy devices such as Tixel, RFM, nano-RF (eMatrix), pico lasers, Fraxel, C and B, LaseMD, & other devices can markedly improve outcomes.

I am not a fan of microneedling in the context of PIE, as other treatments are more effective & less invasive. (I do use microneedling for dermal drug delivery in cases of hypertrophic scarring)

By far the biggest mistake I see is active acne prior or during the course of PIE treatments, if you do not treat the source of PIE, you will never be cleared. For cases of active acne, my medical colleagues at Clinic Cutis can discuss treatment options with you.

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