Can Retinoids Improve PIE?
Post-inflammatory erythema, or PIE, shows up as red or pink marks left on the skin after acne heals. These marks come from damaged tiny blood vessels under the skin from inflammation. Many people deal with PIE after breakouts, and it can linger for months. Retinoids, which come from vitamin A, offer a way to help fade these marks.
Retinoids work by speeding up cell turnover. This means they push old skin cells off the surface faster and bring new ones up. For PIE, this process helps even out the skin tone over time. Doctors often suggest topical retinoids like adapalene at 0.1 to 0.3 percent or tretinoin at 0.025 to 0.1 percent. Use them at night as part of a long-term plan to keep acne away and reduce new red marks.[4]
Start slow to avoid irritation, which retinoids can cause at first. Dryness, peeling, or redness might happen, especially on sensitive skin. Pair retinoids with niacinamide to calm things down. Niacinamide cuts inflammation and strengthens the skin barrier, making retinoids easier to handle. It boosts ceramide production to lock in moisture and soothes redness from retinoid use.[1]
One smart trick is the retinol sandwich method. Put moisturizer on first, then retinoid, then more moisturizer. This buffers the skin and keeps retinoid benefits while cutting irritation. Studies show adding a simple moisturizer to retinoid routines lessens dryness and peeling without losing effectiveness.[3]
Retinoids also help prevent future PIE by clearing acne that causes it. They promote collagen and smooth texture, which supports overall healing. For best results, use sunscreen daily since retinoids make skin more sun-sensitive. Combine with gentle cleaners and avoid harsh scrubs.
People with active eczema or rosacea should check with a doctor first. Retinoids might sting on broken skin. Those with oily skin often tolerate them well with light moisturizers.[3]
Sources
https://sachiskin.com/blogs/skin-education/how-to-safely-use-niacinamide-and-retinol-for-best-results
https://artofskincare.com/blogs/learn/how-to-treat-post-inflammatory-hyperpigmentation-at-home
https://www.westlakedermatology.com/trends/retinol-sandwhich-method/
https://www.droracle.ai/articles/592293/what-are-the-treatment-options-for-acne-post-inflammatory-erythema
https://www.serenityrejuvenationcenter.com/services/post-inflammatory-hyperpigmentation-pih-treatment-in-seattle/
https://pubmed.ncbi.nlm.nih.gov/41351204/?fc=None&ff=20251220022630&v=2.18.0.post22+67771e2
