PIE is often confused with other skin conditions, such as Post-Inflammatory Hyperpigmentation (PIH) and active acne. The primary factor determining whether someone develops PIE or PIH is the way their skin responds to the inflammatory process.

Vascular Response: PIE is characterised by red or pink marks, which indicate an increase in blood flow to the area. When the skin is injured or inflamed, the body's natural response includes the dilation of blood vessels in the affected area. This increased blood flow can lead to redness and is what distinguishes PIE.

PIH involves Melanin PIE does not: In contrast, PIH is characterised by dark brown or discoloured marks. This discolouration is due to an overproduction of melanin, the pigment responsible for the colour of our skin, hair, and eyes. When the skin experiences inflammation or injury, it triggers the release of melanin, leading to the dark spots associated with PIH.

Skin Type and Genetics: The tendency to develop PIE or PIH can also be influenced by a person's skin type and genetics. Individuals with fair or lighter skin are more prone to developing PIE, whereas those with darker skin are more likely to develop PIH due to the increased melanin production. Genetics play a role in determining how the skin responds to inflammation and trauma.

Treatment and Sun Protection: The way these conditions evolve can also be influenced by how pie acne treatment and the level of sun protection used. Sun exposure can worsen both conditions, but it can be particularly detrimental to PIE, making it more prominent. Effective sun protection, like the daily use of sunscreen, can help prevent and manage both conditions.

Inflammatory Severity: The severity of the inflammation or injury can also influence whether someone develops PIE or PIH. More intense inflammation is often associated with a greater likelihood of developing PIE, whereas milder inflammation may result in PIH.

Post-Inflammatory Erythema is Temporary: It's essential to note that PIE is typically temporary and may fade over time, while PIH can persist for a more extended period. PIE marks can take months to years to resolve but often improve gradually as the skin's natural healing processes work to reduce the redness.