Post inflammatory Erythema Treatment

Treat post acne erythema, redness and scars today.

Post inflammatory erythema (PIE) is a common dermatological condition  following inflammation or injury.

post inflammatory erythema
Severe post inflammatory erythema on the cheeks

What is Post Inflammatory Erythema?

Post inflammatory erythema (PIE) is a common dermatological condition that is characterised by red marks or spots following injury or an inflammatory process. One of the most common cause is acne.  Many patients recovering from acne find the appearance of post-acne erythema or PIE to be undesirable. While some cases of PIE will slowly improve over time, many patients seek treatment to address the discolouration and associated scarring.


Post Inflammatory Erythema

The treatment of post-inflammatory erythema requires a multifaceted approach tailored to the individual’s skin type and the severity of the condition. Combining topical treatments, advanced dermatological procedures, and preventative measures can effectively reduce erythema and improve skin appearance. With extensive experience in treating skin of colour, Dr. Ng aims to lighten the appearance of your scars, promote healing, and enhance your confidence.

What Causes Post Inflammatory Erythema?

Post inflammatory erythema (PIE) is a believed to arise from the dilatory changes to the small blood vessels within the dermis during the healing phase. As these microvascular structures are filled with haemoglobin, they appear red in colour (hence the term erythema). There is often associated thinning of the epidermis makes the redness more apparent as light is reflected off these microvascular structures. In addition, there is often damage to the dermis, leading to co-existence of atrophic acne scars

Treatment Approach

The treatment of post inflammatory erythema requires a multi-modal approach that is customised to the individual skin type and severity of your condition. Combining topical treatments, advanced dermatological lasers and energy-based devices can effectively reduce skin redness, scars and improve overall skin appearance. It is essential to consult with a qualified healthcare professional to develop a individualised treatment plan that considers your skin condition, severity and associated scarring.

Topical treatment

  • Tranexamic acid: Known to inhibit plasmin, tranexamic acid reduces inflammatory mediators, leading to a decrease in redness. In addition, it has potent anti-inflammatory and melanin reducing properties.
  • Brimonidine: Through its anti-inflammatory and vasoconstriction effects, brimonidine reduces diameter of blood vessels to decrease blood flow to the affected areas. 
  • Vitamin C: As a potent antioxidant, vitamin C can help reduce inflammation and improve skin tone by enhancing collagen synthesis and protecting against photodamage.
  • Oxymetazoline (OXZ): Established treatment that reduces the appearance of PIE by its vasoconstriction effects.

Laser treatment for PIE

laser treatment for post inflammatory erythema PIE
  • Vascular Laser: Lasers in the pulsed dye laser range targets blood vessels at the skin’s surface, reducing redness and promoting collagen production to improve skin texture. 
  • Nd:YAG Laser: Nd:YAG lasers in the nano-second and pico-second laser range may be beneficial at addressing erythema, hyperpigmentation and atrophic acne scars.
  • Fractional Laser Treatments: These lasers create micro-injuries in the skin, stimulating the body’s natural healing process and reducing erythema over time.

Fractional RF Microneedling treatment for PIE

fractional RF microneedling for acne scars

Fractional Radiofrequency (RF) Microneedling is an advanced dermatological treatment that combines microneedling with radiofrequency energy to improve skin texture, tone, and appearance. This treatment is particularly effective for addressing post-inflammatory erythema (PIE) and acne scars.

  • Reduction of erythema: The heat generated by the RF helps in the resorption of unwanted blood vessels through its ablative effect.
  • Acne scar resurfacing: By inducing controlled micro-injuries and delivering RF energy, fractional RF microneedling stimulates the production of new collagen. This helps to fill in atrophic acne scars, resulting in a smoother skin surface.
  • Minimal Downtime: Unlike more invasive procedures, fractional RF microneedling has minimal downtime, allowing patients to resume their normal activities relatively quickly.
  • Safety and Efficacy: The treatment is safe for all skin types and has been proven effective in clinical studies for both PIE and acne scars.
  • Customizable Treatment: The depth of needle penetration and the intensity of RF energy can be adjusted to suit the specific needs of the patient, ensuring personalized and effective treatment.

Combination treatment for PIE

From experience, Dr Ng believes that the management of post-inflammatory erythema requires a multifaceted approach tailored to the individual patient’s needs. By combining advanced dermatological treatments with diligent patient care and education, we can achieve significant improvement in the appearance of erythema, thereby enhancing patient satisfaction and quality of life.

Frequently Asked Questions

PIE is characterized by red or pink spots due to blood vessel changes, while PIH appears as brown or black spots caused by excess melanin. PIE results from vascular changes, whereas PIH results from pigment changes.


Laser therapy, such as pulsed dye laser (PDL) and intense pulsed light (IPL), targets the hemoglobin in blood vessels. This helps reduce redness and improve the appearance of PIE by promoting the reabsorption of dilated blood vessels and reducing inflammation.

The time to see results varies depending on the treatment and the individual’s skin condition. Topical treatments may show improvement in a few weeks to months. Laser therapies and microneedling may require multiple sessions, with noticeable results typically seen after a few treatments.

Most PIE treatments have minimal side effects. Topical treatments may cause mild irritation or dryness. Laser therapies and microneedling can result in temporary redness, swelling, or bruising, which usually subsides within a few days. It is essential to follow post-treatment care instructions to minimize side effects.

While it may not be possible to prevent PIE entirely, taking steps to manage skin inflammation can help reduce its occurrence. This includes:

  • Proper skincare: Using gentle, non-irritating products and maintaining a consistent skincare routine.
  • Sun protection: Applying broad-spectrum sunscreen daily to prevent further skin damage.
  • Acne management: Effectively treating acne and other inflammatory skin conditions to minimize the risk of PIE.


Good candidates for PIE treatments are individuals with red or pinkish spots on their skin following an inflammatory event, such as acne. It is essential to consult with a experienced and qualified laser surgeon to determine the most appropriate treatment based on skin type, condition, and medical history.

To maintain the results of PIE treatments, it is crucial to:

  • Follow a proper skincare regimen: Use products recommended by your dermatologist.
  • Protect your skin from the sun: Apply sunscreen daily.
  • Manage underlying conditions: Treat acne and other inflammatory skin conditions promptly to prevent recurrence.

Schedule a consultation for Post Inflammatoy erythema treatment in singapore

Education about the nature of PIE, expected treatment outcomes, and the importance of adherence to treatment regimens is vital for successful management. Regular follow-up appointments should be scheduled to monitor progress and make any necessary adjustments to the treatment plan. Dr. Ng has helped numerous patients achieve a more natural and beautiful complexion. If you want to explore options on how to treat your PIE effectively, contact us to schedule an appointment with Dr.Ng.

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