Post Inflammatory Erythema (PIE)
I've been on this sub for almost four months and I'm always looking to learn more about skin esthetics. Over the last four months I have been trying to treat my "Post Inflammatory Hyperpigmentation" with: Vitamin C, Hydroquinone, AHAs, Chemical Peels and everything else I could get my hands on.
I've been reading into some dermatology books (thanks u/yvva) and I've been trying to find a way to combat my PIH because nothing has been working. I stumbled across a something in the book that stood out to me, and that was "Post Inflammatory Erythema". I did some more research and it turns out that my "Post Inflammatory Hyperpigmentation" was actually Post Inflammatory Erythema.
What's the difference between Post Inflammatory Hyperpigmentation and Erythema?
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Post Inflammatory Hyperpigmentation (PIH) is related to brown spots, not red spots. The brown discolorations are caused by an excess production of melanin. Vitamin C, AHAs, Hydroquinone are all great tools for inhibiting melanin which will fade the brown discoloration, but it will not do anything for red or purple scarring - which is something I believe is mistaken on this sub. PIH is more common in darker skin types (Fitzpatrick IV-VI), although it is not limited to any skin type.
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Post Inflammatory Erythema (PIE) is a new term that is starting to pick up awareness in dermatology terminology. PIE is in the process of becoming the new terminology used to describe pink to red discoloration after an inflammatory acne lesion. Patients with lighter skin types (I-III) the postinflammatory dyspigmentation is often not hyperpigmentation, but instead discrete erythematous macules (PIE). Acne may not be the only cause of postinflammatory erythema, as any resolving cutaneous inflammatory process may have residual erythema.
Images of Post Inflammatory Erythema: Example 1, Example 2
Taken from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780804/
What causes Post Inflammatory Erythema?
Erythemas are caused by the bodies response to some kind of trauma. Some examples are:
- Popping / picking pimples
- Skin infections
- Cuts, scrapes, scratches
- Sunburns
- Inflamed acne lesions
- Chemical burns
How to test for Post Inflammatory Erythema
Erythema disappears temporarily when you apply pressure, hyperpigmentation does not, this effect is called blanching. It is possible to tell the difference by finding a clear piece of glass or plastic and applying pressure to the area. If the area becomes white or changes color then you most likely have Post Inflammatory Erythema.
Here is an example. POSSIBLY NSFL (might be gross for you).
How to treat Post Inflammatory Erythema
The links provided here are clinical studies with evidence proving that these methods are effective at treating PIE.
If you can find any scientific research / clinical trials done on the treatment of Post Inflammatory Erythema that have been successful, please let me know and I'll update this post.
Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780804/, http://www.acne.org/messageboard/topic/280830-red-marks-are-not-hyperpigmentation/
Posted Dec 23, 2013, 10:15 PM UTC · edited