Reader question: “Whenever I break out, it always leaves behind a red mark after it clears up. Why does this happen and how can I get rid of it?” —Cady Griffin Facial redness can happen for many reasons, but if you’re turning red in the wake of acne, you’re suffering from something called post-inflammatory erythema, often referred to as PIE. And it’s usually just as aggravating and stubborn to treat as the original acne itself. Unfortunately, PIE doesn’t discriminate by location—it can impact the face and anywhere else that acne occurs, including the neck, chest, and back. As for the “why” of it all, it’s important to know that not all acne is created equal. In fact, there are many different types of acne that have different symptoms and aftereffects. “Acne is either comedonal, the term used for whiteheads and blackheads, or inflammatory, the term used for pimples, pustules, cysts and all red acne lesions,” says Loretta Ciraldo MD, FAAD, a board-certified dermatologist in Miami, Fla. and founder of Dr. Loretta skincare. The latter is what is causing the redness you see after a breakout. “The reddened skin in inflammatory acne is the result of blood moving into the skin of an acne lesion,” says Dr. Ciraldo. “It is mostly white blood cells that are responding to trapped dead skin cells, bacteria, debris, and excess oils in the acne lesions as if they were foreign matter, and the blood moves into the area to start a healing process.” In other words, that redness is proof of your skin regenerating. However, this redness is often worsened by acne treatments, and in some cases, product irritation might be the true culprit. “Overworking skin with acne products is often a major contributing factor to pimple redness,” says Dr. Ciraldo. “Certain ingredients, including benzoyl peroxide, retinoids, glycolic acid, and other AHAs, can all dry out the skin and promote redness. Products with these actives should not be applied onto skin that is already red, dry, or peeling.” If you aren’t sure if your redness is natural or the aftermath of product irritation, she recommends dialing down the frequency of application, or trying a lower concentration to see if redness improves. And whatever you do, don’t pick or pop your pimples, which will significantly increase the risk of PIE and trigger more inflammation. It could even take a turn for the worse and lead to post-inflammatory hyperpigmentation (PIH), the brown or dark spots that result from skin trauma. If you struggle with the picking urge (those with excoriation disorder will understand), try slapping on a pimple patch. Once you’ve ruled out picking and product irritation from the equation, there are some ways to make the redness less visible.
