PIE vs. PIH: Which Is It? How Should You Treat It?


Post-inflammatory hyperpigmentation (PIH). Post-inflammatory erythema (PIE). Both happen as the result of inflammation often in the wake of pimples. What is the difference? And how can you deal with these unwanted post-breakout souvenirs?


Both PIH and PIE are responses to inflammation and irritation. PIH is a melanin response that leaves a dark mark on the skin. It can happen when a pimple is irritated by picking or squeezing. It can be the result of an injury to the skin from a scratch, heat, UV exposure, or chemical burn. PIH tends to be more common in darker skin tones because of the abundance of melanin.


PIE appears as pink or red marks on the surface of the skin. It’s a vascular response to inflammation or irritation. Capillaries just under the surface of the skin are stimulated by the inflammation creating a surge of blood in the area as a healing mechanism. Like PIH, it’s caused by picking at pimples, UV exposure, chemicals, injury, or irritation. PIE is more common in lighter skin tones. The lighter the skin tone, the longer the marks will remain.


Neither PIH or PIE is permanent but, in both cases, fading them takes time, patience, and strategy. We can help with the strategy part.


UV Protect Required For Both

For both PIH and PIE, UV protection is imperative. Sun will darken PIH and further inflame PIE.  Light-weight, non-greasy, and non-comedogenic sunscreen helps with this



The dark spots of PIH begin in the deep layers of the skin. A combination of exfoliation, which brings excess pigment to the surface and out, plus topical brighteners to fade dark marks.


Top Pick for PIH: Mandelic acid line is tailor-made for treating PIH. This almond-derived alpha hydroxy acid exfoliates to bring pigment to the surface and clear impactions. It has antibacterial properties to guard against future breakouts. It’s a melanin inhibitor and natural brightener. And because it has a larger molecular size than most AHAs, it’s absorbed more slowly by the skin and won’t trigger post-inflammatory hyperpigmentation. It’s particularly good for skin of color.

Best ingredients for fading PIH and restoring even tone: mandelic acid, vitamin A, niacinamide, kojic acid, lactic acid, vitamin C, hydroquinone.



Because the PIE reaction happens close to the surface of the skin, the inflammation remains in an active state. You don’t want to do anything to aggravate it further. Concentrate on reducing inflammation and strengthening the skin barrier to get the skin to balance and the redness to recede.


Top Picks for PIE: Cleanse, calm, and protect with anti-inflammatory toner, a barrier-strengthening, anti-inflammatory, like a  cell-regenerating vitamin A propionate with collagen-boosting, redness-reducing peptides making this the perfect corrective serum for putting PIE in the rearview mirror.

If you want more information about PIE or PIH, book a consultation and see how I can help you. Use the BookNow button on this page.



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