Post-Inflammatory Pigmentation: Acne Marks and Discoloration Caused By Pimples

What Is Post-Inflammatory Pigmentation?

Post-Inflammatory Pigmentation is the fancy term for skin discoloration caused by inflammation. Unlike acne scars, pigmentation usually resolves on its own and is highly treatable. If you read my post on the seven different types of acne, you know that there are four types of inflamed acne and any one of these can lead to discolored marks that last for weeks, months, and even years after the acne itself is long gone. You can even cause a non-inflamed acne lesion like a blackhead or whitehead to become inflamed by picking at it which is why leaving your hands off your face is so important. The most common type of discoloration causes the skin to turn darker or HYPER-pigment although, in rare cases, your skin might HYPO-pigment or turn lighter. There are three types of post-inflammatory pigmentation or discolored marks that can occur from inflamed acne or picking: Postinflammatory erythema which are pink or red marks, postinflammatory hyperpigmentation which are brown marks, and postinflammatory hypopigmentation which are white marks.

How To Prevent Pigmentation

The most effective and sustainable way to prevent pigmentation is to clear the acne itself. If your acne is still active though, there are two keys to preventing pigmentation:

  1. Reducing Inflammation: this is key because it is the inflammation rather than the acne itself that causes the pigmentation in the first place. The two main tools we use to reduce inflammation with our program are icing and using an effective and non-comedogenic benzoyl peroxide product like our Clearing Treatment.

  2. Avoiding abrasion and pressure: pressure and abrasion inflicted on the skin can send signals to our bodies that we are injured which can then set off the inflammatory response that leads to pigmentation. The best way to avoid this is to avoid picking or even resting against your hands or anything else that might put pressure on areas of your face or body that are broken out. Also, avoid any form of mechanical exfoliation (scrubs, exfoliating brushes, loofahs, microdermabrasion) which can tear and damage the skin.

How To Treat Pigmentation

Treating pigmentation should only be done once your skin is completely clear. If your skin is still broken out, you will likely be wasting your time and money treating the existing pigmentation because you will likely just have more pigmentation come up from future breakouts. The methods used to treat pigmentation also typically speed up the cell turnover process which can accelerate the rate of acne movement and trigger an inflammatory response that actually induces more pigmentation. Once your skin is completely clear, the most effective way to get rid of pigmentation is a combination of mild chemical peels and a daily product plan that helps purge the pigmented cells out of the skin. Our serums contain mandelic acid and lactic acid which are two of the most gentle and effective exfoliants for clearing acne and our acne facials include peels that contain a cocktail of ingredients meant to target acne and speed up the lifting and lightening of all three types of pigmentation.

How Long Does Pigmentation Treatment Take and What To Expect

Pigmentation usually takes longer than acne itself to clear out of the skin. With our program, most people see acne clear within 6-8 treatments over 3-4 months but it can take 3-4 times as long for the pigmentation to lift depending on how aggressive your product plan is and what type of peels your skin can tolerate.

The Seven Different Types of Acne

When most people think of acne, they think of giant, red bumps but acne actually comes in all different shapes and sizes.  Acne also ranges from mild to severe, it can be occasional or constant, and it can last for a month or a decade. Regardless of how noticeable it is, how often you breakout, or how long it lasts, it all counts! I have experienced every type of acne at various points in my life and I can assure you that having non-inflamed acne sucks just as much as inflamed acne does.

The two main categories of acne

There are two main categories of acne: inflamed and non-inflamed and there are seven different subtypes within those two categories. As you can see from the pictures, these two types of acne look very different and could easily be mistaken for completely different conditions altogether. Inflamed acne is the type of acne that most people identify as “acne” because inflamed lesions are bigger, redder, and can be pus filled and sore. Non-inflamed acne looks like little tiny bumps or seeds underneath the skin and people often describe it as “bumpiness” or “texture” that might only be visible under certain angles and lighting. A lot of people with NI acne don’t even realize they have acne and I have even had clients whose Dermatologists misdiagnosed their non-inflamed acne for allergies! Dermatologists are special….Anyways, non-inflamed acne is basically the baby stage of acne and when it gets bigger, it can become the more grown-up inflamed acne. The most common acne type is combination because most people have some of each type although you might have more of one type than the other and your acne type will likely shift at different points in your acne journey.


The seven types of acne

Here are the seven types of acne and each one falls within the inflamed or non-inflamed category. The three types of non-inflamed lesions are microcomedones, blackheads (aka open comedones), and whiteheads (aka closed comedones). The four types of inflamed lesions are papules, pustules, cysts, and nodules. Different types of acne should be handled differently which is why the AES method was designed to handle every type of acne with the appropriate types of care.

5 Pimple Remedies When Traveling

If you follow me on Snapchat, you saw the red pimple that was trying to wriggle it's way onto my face one day before my trip (and if you didn't, you are in luck because you can see them all on the AES Youtube Channel. I wasn't surprised, pimples have a way of coming right when you want them least. Lucky for me and you, there are a few steps you can take to calm those unwanted pimples so you can get on and enjoy your trip:

1. Ice: What do you do when you sprain your ankle and it gets all big and swollen?  You ice it to help bring the inflammation down.  Well the same inflammatory process is happening when you get those big inflamed pimples and applying direct ice for 2-5 minutes after cleansing morning and night will do the same.  I always bring my silicone popsicle molds with me because apparently, people aren't as obsessed with ice as we are in the U.S.  If you don't have one, you can find them for cheap on Amazon. As soon as I get to the hotel, I fill that thing up, put a towel bib under my chin, and put the ice part directly on my face if I even think I feel a pimple coming.

2. Spot treat: The BP Cream is usually a part of the evening regimen but when you have an inflamed zit, an extra application in the morning can help calm symptoms of inflammation like redness and swelling.  Apply a thin layer after your serum in the morning and let it sit for as long as possible before applying your moisturizer to avoid decreasing the effectiveness of the benzoyl peroxide. You can see the red bump that was forming on my upper lip in the first video snap the day before my trip.  It hadn't quite formed a pimple yet but I just knew it was coming (as us people with acne always do!) because it started feeling itchy and sore, classic signs of inflammation.  I iced it multiple times that day, did an extra application of BP Cream in the morning, and you can in the video on the way to the airport that the redness and swelling had already gone down by the next day.

3. Be consistent with your regimen: Sticking to your regimen after you've spent all day sightseeing or drinking or partying or whatever it is that you fancy doing when you travel is rough.  The cleansing, then the icing, then the Aqua Gel, then the drying before the BP Cream, I know I know. BUT just because you have taken a vacation doesn't mean your retention hyperkeratosis has and the serum keep those dead skin cells from accumulating in the follicle and causing future pimples.  So if you really really really can't deal with doing your entire regimen one night, at least slap on the serum before bed to keep those comedones from forming.  If it's too late and you can already feel something forming but still can't find the motivation to do your whole regimen, apply the serum to help move that seed up and the BP cream too to keep it from blowing up and becoming inflamed.

4. Don't touch it: If this post was called, "How to make a zit bigger and more noticeable", picking/touching/helping/whatever other terms you may use to excuse yourself would be at the top of the list.  Please believe me when I say that a few days of pimple is better than a few days of picked nastiness so leave it alone and let the products do their thing.  If you are a compulsive picker and your hands can't help but roam onto your face, follow the three foot rule (or the 1 meter rule if you are not American) and stay at least three feet away from the mirror at all times. Don't worry, it's still close enough that you will see if your lipstick is on your forehead.

5. Practice acceptance: After you have taken what steps you can to help the pimple heal, accept it, remind yourself that that nobody notices your acne as much as you do (literally, repeat it to yourself throughout the day like a mantra), and try to enjoy yourself.  Seriously, this is the most important step on this list and also the hardest but we can't heal the physical effects of acne without healing the psychological ones too.  And if it feels impossible to stop obsessing about your acne today, that is okay too. Focusing on the good things is a practice so don't beat yourself up if you can't help but well, beat yourself up. As I tell my clients, just do your best and be as kind to yourself as you would be to your favorite person :)

Coach Kimmy's Clear Skin Travel Essentials

Traveling is the second most common time for my clients to fall off of the clear skin wagon.  Even my graduates who have been clear for years tend to come back with a few more zits post-vacay than they left with.  Regardless of what stage you are at in the clearing process, here is a list of travel essentials that I prepared for this trip to prevent breaking out:

Pillowcases and face towel (a body towel too if you are prone to body-acne): When hotels use dryer sheets, fabric softener, and detergents containing fragrance or other cloggy ingredients, just sleeping on their pillows and using their towels can lead to new breakouts.  I actually forgot to put my face towel in my luggage so if life happens (as it will sometimes), improvise!  (You can see how I improvised in the picture above that I Snapchatted from earlier today). And if you haven't yet cut out the dryer sheets and switched over to a non-cloggy detergent, choose an AES approved product from our Acne Safe Household Products Pinterest board, do a load of laundry before you leave, and try not to forget like I did ;)

Popsicle molds: If icing is still a part of your regimen, pack a silicone popsicle mold because you will be doing your regimen twice a day even on vacation, right?!  Heck, it's not a bad idea to pack that sucker even if you are clear or you don't usually get inflamed pimples like me because you never know when an inflamed pimple will emerge and they tend to pop up when you least expect it (more on that situation in the next post).

Coffee creamer: If you don't have a full blown coffee addiction like I do, feel free to skip this one.  If you are a fellow Coffeeholics Anonymous member and you don't like your coffee black, do like I do and pack a bottle (or two or three...) of dairy/soy free creamer because most places do not offer dairy and soy free milk options. If you are going to Italy, they definitely don't have acne-safe options, TRUST.

Acne-Safe Snacks: Bring your own AES approved snack (free of dairy, peanuts, and soy).  I like nuts and granola bars but make sure to check that the bars you are getting don't contain soy protein because a lot of them do.

Toiletries: Unless you want to risk breaking out around your hairline and mouth while vacationing, bring your own hair products and toothpaste. If pimples around the mouth and forehead is the look you are going for then by all means, use the random toothpaste that your travel partner brought with them. And no, if doesn't matter that you are only traveling for a few days, it only takes ONE usage to breakout from a cloggy product.  If you forget any of your toiletries, take a screenshot of our list of comedogenic ingredients and scout a non-cloggy ingredient at a nearby store (a lot of countries have ingredient lists in English).