Red acne scars; post inflammatory erythema, PIE

PIE or post-inflammatory erythema refers to red marks from acne. This type of acne scarring can respond to vascular lasers. Our nurses at Cutis can provide cost-effective, & effective solutions to markedly improve red acne scars in as little as two treatments. This is a painless procedure with a super quick recovery time of fewer than 24 hours. 


  • Post-inflammatory Erythema or PIE results from inflammation secondary to acne
  • Sunscreen markedly reduces the occurrence of redness
  • Vascular lasers can effectively & efficiently reduce redness 
  • Preventing new acne spots is important for long-lasting results
  • For cases or red & brown marks, pico lasers can be beneficial

Red acne scars; post-inflammatory erythema, PIE at a glance

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Surgical scars treatment cutis dermatology brisbane 17 scaled

Vascular lasers for red marks & acne scars.




    SKin Pen microneedling treatment cutis dermatology brisbane

    Skin Pen Microneedling can improve acne scars. For red scars like these, vascular lasers are far more effective.




      Surgical scars treatment cutis dermatology brisbane 16 scaled

      Vascular lasers for red marks & acne scars known as PIE or post inflammatory hyperpigmentation.



        What is PIE and why does it occur?

        PIE, also known as post inflammatory erythema or macular erythema are flat red scars. It is due to inflammation secondary to conditions like acne, chicken pox, as well as trauma from peels and lasers. 

        Unlike PIH or hyperpigmentation that affects darker skin types, PIE can affect both light and dark skin patients. The natural course of PIE is to improve over a period of 2-12 months. Some cases may take 3 years or longer to fade.

        What is the best treatment for PIE?

        The biggest traction you will get is with early application of sunscreen, as this reduces or in most cases prevents PIE.


        Established red scars are targeted with a vascular laser. This laser targets haemoglobin within the blood vessels, in turn heating them up. This causes collapse of the small capillaries, hence improving PIE. If you have both red and brown scars, we may elect to use a pico laser. 

        Learn more  (link to Picoway laser in the laser section)


        Session number depends on the duration of scars, your skin type & how you respond to lasers. Most require between 2-4 sessions, spaced 2-4 weeks apart. If you have darker skin or resistant scars, you may require 4 or more treatments. 

        If you have atrophic scars, CO2 or RF microneedling is best, whilst if you also exhibit post inflammatory hyperpigmentation (brown marks), pico lasers are indicated.

        How do I know if this is the correct treatment for my scars?

        Book a FREE consultation with our nurses. They will assess & guide you according to your scar patterns & skin type. 

        More complex cases are seen by our dermatologists. A consultation fee applies if a dermatologist is involved in your management. 


        *T&C 适用。 

        Is laser treatment painful?

        No. The lasers we use have a built-in cooling system to reduce pain and side effects. Treatments take a few minutes to perform. 

        What is the recovery time following vascular lasers?

        We employ one of two settings, 



        1. Minimal downtime / no purpura (bruising settings): indicated for darker skin types & those who do not want bruising. Flipside? More sessions are required. 



        1. Purpuric or bruising settings. Downtime of bruising for 3-6 days. Indicated for lighter skin types. 


        Your dermatologist or our practice nurse will forewarn you of settings prior to your laser appointment. In general, the harder we go, the longer the downtime, the better the outcomes. 

        Do creams work?

        Yes and no. The best creams are topical anti-inflammatories. They require a prescription by a dermatologist. 

        You can try fluffy treatments like niacinamide 10% alternating with azelaic acid, as both have weak anti-inflammatory properties. Don’t forget sunscreen, as this makes the biggest difference. 

        What DIY or home treatments can I try to reduce PIE or red scars?

        Home remedies may give some marginal benefits. If you are inclined to treat PIE yourself, the following is a sensible (and safe) starting point; 


        AM: Sunscreen, followed by an antioxidant mix (Vitamin C, E) or niacinamide 


        PM: Retinoic acid (over retinol)




        Cutis Dermatology has the largest portfolio of lasers in the Southern Hemisphere. Our team has access to over 35 devices, including 5 CO2 lasers, 4 vascular & 2 picosecond lasers. This ensures we can best match your scar signature & skin type for maximum results & minimal side effects.

        Can microneedling help?

        Marginally. Microneedling is great as a procedure to aid in delivery of topicals into the skin. In the context of red scars, lasers do a much better job.

        How much do treatments cost?

        Vascular lasers are more affordable than you think. They start from $199 by our specialist nurses. This treatment is not covered under Medicare. Some overseas insurance companies will partially cover it. 

        What devices do we use to treat PIE?

        At Cutis we have many vascular lasers to treat PIE/red marks. This is the rank, in order of efficacy. 



        1. VBEAM Prima: big spot, 595 nm
        2. VBEAM Perfecta: medium spot 595 nm
        3. Derma V: 532 solid state lasers
        4. V BEAM 1064: Long pulse (deeper vessels)
        5. BBL Sciton
        6. Sciton 1064 Vascular

        What other treatments do we offer for acne scarring?

        Our dermatologists and nurses perform other scar revision techniques including, 


        Deep focal peels: TCA or Phenolic acid. This is known as CROSS or paint. 


        Laser resurfacing (full ablation): CO2 and erbium.


        Fractional lasers: MixTo, eCO2, CORE 2, Ultrapulse Deep Fx, Scar Fx, Fraxel, C & B


        Subcision: Nokor, blunt cannula, hypodermic, Taylor, dove-tails


        Surgical: Punch elevation, excision, grafting, dermal grafting, fat transfer, micropigment transfer

        Why is sunscreen so important?

        UV makes redness worse, hence the importance of sunscreen. Choose a cosmetically elegant stand-alone sunscreen. La Roche Posay and Invisible Zinc are good brands. Use as follows;


        AM: 2-3 ml application face, neck


        Noon: 2-3 mls Re-application

        What should you consider before undertaking PIE treatments?




        • Always control your acne. You will go infinitely faster & better with any scar revision treatment. This means absolute (or almost absolute control), it does not mean ‘much better than before.’ If in doubt, see a dermatologist. 



        • Sun protection is paramount. It does not mean you can’t go out in the sun, it means sun protection is important. SPF 50+ twice a day regardless of exposure. If a 50 ml bottle lasts longer than 3 weeks, you are not using enough sunscreen.



        • More than one treatment is needed. At minimum 2, if your PIE is bad, it could take 3-4 sessions. For deep red scars, it can take up to 6 or more sessions. 



        • Darker skin type: you may require more sessions compared to lighter skin. 



        Settings of laser matter. Lasers are just tools to get the job done. Laser parameters are crucial for best outcomes. Additionally, using the correct vascular laser brand is vital for good outcomes.