If you’ve ever felt with acne, breakouts, or skin irritation, you may have noticed dark spots or lingering redness that sticks around long after the blemish has healed. These marks are often confused with one another, but they actually fall into two separate categories: post-inflammatory hyperpigmentation (PIH) and post-inflammatory erythema (PIE).
At The Injectables Lounge, we see these concerns daily- and the good news is, with the right treatment plan, both can be significantly improved.
What is Post Inflammatory Hyperpigmentation (PIH)?
- Definition: PIH occurs when inflammation in the skin (like acne, cuts, burns, or rashes) triggers an overproduction of melanin. This leads to flat brown, black, or gray patches that linger after the skin heals.
- Who gets it: PIH is more common in medium to deeper skin tones but can occur in all complexions.
- Common causes: Acne breakouts eczema, psoriasis, waxing, or even aggressive picking at blemishes.
What is Post Inflammatory Erythema (PIE)?
- Definition: PIE shows up as red or pink spots left behind after inflammation. Unlike PIH, which is pigment based, PIE is caused by damaged or dilated blood vessels just under the skin.
- Who gets it: More common in fairer skin types, though anyone can develop it.
- Common causes: Acne, aggressive extractions, or any trauma that leads to broken capillaries.
How Do You Tell the Difference Between PIH and PIE?
- PIH = brown/black/gray pigmentation (melanin related)
- PIE = red/pink discoloration (blood vessel related)
- Some clients have both at the same time which requires a customized, layered treatment plan.
What are the Treatment Options for PIH and PIE?
At The Injectables Lounge, we focus on anatomy led, physician guided skin treatments that address both pigment and vascular concerns. Here are the most effective ways we treat PIH and PIE:
Fractional CO Laser
- How it works: The fractional CO2 laser delivers precise beams of light that create controlled micro injuries in the skin, triggering collagen production, and resurfacing damaged tissue.
- For PIH: Breaks up excess melanin, lightens dark spots, and evens out skin tone.
- For PIE: Can help reduce redness indirectly by improving overall skin health, though it is primarily pigment and texture focused.
- Best for: Clients with stubborn hyperpigmentation, acne scars, or significant texture conners who want dramatic results
Morpheus8 (Mircroneedling with Radiofrequency)
- How it works: Uses tiny microneedles combined with radiofrequency energy to heat deep layers of the skin, stimulating collagen, elastin, and cellular renewal.
- For PIH: Promotes faster turnover of pigmented cells, improving tone, and reducing discoloration.
- For PIE: Helps strengthen the skin barrier and improve healing, which reduces lingering redness over time.
- Best for: Clients looking for an advanced, minimally invasive option that targets both tone and texture with less downtime than CO2.
Procell Microchanneling
- How it works: Creates microchannels in the skin that stimulate collagen production and deliver powerful growth factor serums to accelerate healing and repair.
- For PIH: Speeds up cell turnover and infusion of active serums to fade dark spots more quickly.
- For PIE: Supports skin healing and barrier repair, which can calm redness, though it is not a direct vascular treatment.
- Best for: Clients who want a gentler, lower downtime solution or ongoing maintenance between more intensive treatments.
Medical Grade Skincare
- How it works: Professional products with clinically proven actives like vitamin C, retinoids, niacinamide, and SPF provide daily protection and correction.
- For PIH: Brightening agents fade dark spots and prevent new pigmentation.
- For PIE: Anti inflammatory and soothing ingredients calm redness and support vascular healing.
- Best for: Every client- especially when paired with in clinic treatments and maximize and maintain results.
Why DIY Won’t Cut It
Over the counter creams and home remedies may fade pigment slightly, but they rarely target the underlying causes of PIH or PIE. Without professional intervention, results are slow, inconsistent, and often frustrating. Treatments like fractional CO2 laser and Morpheus8 are designed to address skin at the source- safely and effectively.
Q&A: What People Ask Most About PIH & PIE
Q: How do I know if I have post inflammatory hyperpigmentation (PIH) or post inflammatory erythema (PIE)?
A: If your mark looks brown, black, or gray, it is likely PIH. If it looks red or pink, it is PIE. Some people have both.
Q: Can post inflammatory hyperpigmentation (PIH) and post inflammatory erythema (PIE) go away on their own?
A: They may fade naturally over months, but professional treatments like fractional CO2 laser, Morpheus8, or Procell Mircochanneling dramatically speed up results.
Q: Which treatment works fastest for PIH?
A: Fractional CO2 laser delivers the most dramatic results for stubborn hyperpigmentation, especially when paired with medical grade skin care.
Q: What is the best treatment option for PIH or PIE if I don’t want much downtime?
A: Procell Microchanneling and Morpheus8 are lower downtime options that still deliver noticeable improvements in tone and redness.
Q: Can skincare alone fix PIH or PIE?
A: Skincare helps prevent and support correction, but in office treatments provide the deeper, faster changes most clients want.
