Response to Treatment: PIE responds well to vascular treatments like PDL or IPL, while PIH is best treated with topical melanin-inhibiting ingredients and exfoliation.
Topical Treatments
Skincare ingredients like niacinamide and azelaic acid can be effective treatments for post inflammatory erythema. Niacinamide is a potent anti-inflammatory that can reduce redness and improve skin barrier function. Azelaic acid not only soothes inflammation but also offers gentle exfoliation.
The three most important things for PIE are Sunscreen, Azelaic acid (I personally recommend the Cos De Baha brand), and Niacinamide. Keep your skin as hydrated/moisturized as possible, and use an occlusive (like Vaseline or Aquaphor) at the end of your PM routine.
Facile's Brighten serum is a great choice for anyone with youthful skin and hyperpigmentation concerns. It contains a brightening trifecta of tranexamic acid, azelaic acid, and niacinamide to fade acne scars while helping to prevent new breakouts.
Alpha Arbutin 2% + HA is a water-based serum specifically designed to target uneven skin tone and dark spots. It combines a high concentration of purified alpha arbutin, a well-known skin-brightening ingredient, with hyaluronic acid. Purified alpha-arbutin works to visibly even skin tone and improve skin radiance.
Minimalist Tranexamic 3% Serum is a powerful serum to effectively diminish the appearance of melasma, PIE, PIH and hyperpigmentation. With the power of 3% tranexamic acid and 1% hydroxyphenoxy propionic acid, this serum inhibits melanin transfer with great efficacy and prevents UVB damage.
Effective treatment for PIE often involves laser therapy, especially Pulsed Dye Laser (PDL), which targets blood vessels. Topical treatments such as niacinamide and azelaic acid can also help reduce redness.
Try topical retinoids
Tretinoin and its over-the-counter cousin, retinol, helps quell inflammation and increase cell turnover, which can reduce red marks. But be patient: retinoids can take weeks to months to make their full impact.
Scrubbing and overwashing irritates your skin. The more you irritate it, the more inflammation you cause and the higher risk of having post-inflammatory erythema, scars, or longer-lasting skin irritation.
Niacinamide: Niacinamide's anti-inflammatory properties make it an attractive treatment for skin conditions marked by inflammation, like acne.
One of the best ingredients to reduce PIH is resorcinol. Resorcinol is a type of alcohol that inhibits tyrosinase, an enzyme that is responsible for the skin's production of melanin. Therefore, applying resorcinol to the skin helps to lighten dark spots caused by this pigment.
Vitamin C is a powerful topical that is used to treat PIE. It has anti-inflammatory properties to help reduce redness and inflammation. Vitamin C promotes collagen synthesis, is a potent antioxidant and has skin-brightening properties due to its ability to inhibit melanin production.
Vitamin C is a potent antioxidant proven to help protect the skin against signs of aging—especially from UV exposure. ⁷ Its anti-inflammatory properties may help reduce redness associated with post-inflammatory erythema. Vitamin C is a popular ingredient in skin-brightening creams and serums.
Areas of hyperpigmentation might also fade on their own without treatment. To help speed up the process, there are several different types of topical medication that can reduce PIH skin spots: Skin lighteners such as hydroquinone and azelaic acid to help reduce melanin production.
Best Azelaic Acid Product Overall: SkinCeuticals Phyto A+ Brightening Treatment, $110. Best Face Mask: Drunk Elephant Bouncy Brightfacial Brightening Mask, $69. Best for Dark Spots: Glytone Enhance Brightening Complex, $82. Best Spot Treatment: PCA Skin Pigment Gel HQ Free, $90.
Some of these ingredients to look for in post-inflammatory erythema treatment products include: ➔ Vitamin C: Vitamin C is a potent antioxidant that can help reduce inflammation and heal your skin. ➔ Niacinamide: Niacinamide is another ingredient that is effective in treating PIE.
Niacinamide is generally considered more effective for hyperpigmentation as it inhibits melanin production. Glycolic acid works by increasing cell turnover to reveal newer skin. Using both can provide a powerful approach.
Topical therapy is the recommended first-line treatment, with the gold standard being hydroquinone, which can be used alone or in combination with other agents.