Article: Removing Red Acne Scars
Removing Red Acne Scars
Acne marks can be frustrating, even after the actual breakout has healed. However, not all acne marks are the same! Understanding whether you have red or brown marks is crucial for choosing the right treatment for red acne marks.
Red acne marks vs brown acne marks
Red acne marks are the residual pink or reddish marks left behind after an acne breakout. Red acne marks are also known as post-inflammatory erythema (PIE) whereas brown acne marks are referred to as post-inflammatory hyperpigmentation (PIH).
Even though they both occur after an acne breakout, they have very distinct pathophysiology.
Quick comparison chart
| Feature | Red Marks (PIE) | Brown Marks (PIH) |
|---|---|---|
| Color | Pink/Red/Purple | Brown/Tan/Dark |
| Cause | Damaged blood vessels | Excess melanin |
| Blanching Test | Fades when pressed | Stays same color |
| Best Treatment | Laser therapy, silica | Vitamin C, AHAs, sunscreen |
| Sun Sensitivity | Moderate | Very high |
| Healing Time | 6 months or up to 2 years | 6-12+ months |
Red acne marks or post-inflammatory erythema (PIE)
Post-inflammatory erythema (PIE) occurs when the skin is injured, irritated or inflamed.
Red acne marks are more common in people with pale and olive skin tones. When left untreated red acne marks can trigger melanin producing cells called melanocytes to make more melanin, creating brown marks. This process is accelerated by UV exposure.
Red acne marks can take 6 months to fade on their own; and up to 2 years if the acne lesion was larger and deeper (means more damage).
Red acne marks treatment
Clinical trials show that red acne marks respond best to vascular lasers such as V-Beam, and targeted topical agents that reduce redness or support the wound healing stage.
For V-Beam lasers, 2–5 sessions spaced 2 weeks apart yielded good results, targeting the hemoglobin in the blood vessels and reducing redness.
For topical therapy, studies show topical treatments such as silica can also help accelerate the wound healing process, improve collagen and elastin production and help manage the skin's response to damage. Topical over the counter red acne marks treatment with silica include Red Scar Therapy Gel. Other ingredients like azelaic acid can also help reduce the inflammatory process.
Melanin reducing ingredients such as glycolic acid peels, retinol, Vitamin C and Niacinamide do not work on red acne marks at first. They will only work once there is excess melanin present because their main function is melanin-reducing, not wound healing or anti-inflammatory.
Brown acne marks or Post-inflammatory hyperpigmentation
In contrast, brown acne marks, also known as post-inflammatory hyperpigmentation occur due excess melanin production.
Brown acne marks are most common in people with olive to darker skin tones and they respond well to traditional skin discolouration treatments such as Retinol, dermabrasion and chemical peels.
Conclusion
Understanding the difference between red acne marks and brown acne marks is the first step towards clearer skin. Red acne marks (PIE) respond best to wound healing ingredients and vascular lasers, and brown acne marks require brightening agents and strict sun protection.
References:
- Jean-Pierre, P et al (2024). "Emerging lasers and light-based therapies in the management of acne: a review". J Lasers Medical Science. 2024 Sep 28;39(1):245. doi: 10.1007/s10103-024-04196-8
- Quignard, X et al (2017). "Silica nanoparticles as sources of silicic acid favouring wound healing in vitro." Colloids and Surfaces. 1 July 2017, Vol 155, Pages 530-537
- Acne Support: Skin discolouration (2024). British Association of Dermatologists.
- Ludman, P (2023). Acne Scars. American Academy of Dermatology Association.
- Pie, S et al (2015). "Light-based therapy in acne treatment." J Indian Dermatology Online. 2015 May-Jun;6(3):145–157. doi: 10.4103/2229-5178.156379
