Acne red marks,
if you were only trying to get rid of them
you've been mistaken
Director Wi Young-jin, Beauty's Doctor | Beauty Stone Clinic, Hongdae
Please check this first before reading
Q. Do acne red marks
get worse if you just leave them alone?
A. No. Red marks are a sign that the skin is
recovering on its own. If you don't understand this principle,
you'll end up doing care that backfires.
Q. Are red marks and brown marks the same?
A. They are different. The cause and the approach are
completely different skin reactions.
Key points of this article
Red marks are a sign that the skin is recovering
![[위영진 칼럼] 여드름 빨간자국, 레이저보다 장벽 관리가 먼저인 이유](https://framerusercontent.com/images/0Zb7XWxm4sm61GXopowVyirwyo0.jpg)
What are acne red marks?
After inflammation
erythema (Post-Inflammatory Erythema, PIE) is
a condition in which, after acne inflammation subsides, the skin surface below
the dilated blood vessels remain and make it look red.
Many people confuse it with brown marks (PIH, hyperpigmentation),
but
PIH is melanin pigment buildup, and
PIE is a remaining vascular response, so
the treatment direction is completely different.
Red marks,
'recovering'
what does that mean?
Honestly, when I first
told this to people, most of them
"But still, shouldn't we get rid of it?"라고
ask me back.
That's a natural reaction. Because it's red and noticeable,
it feels like something is wrong.
But here's what's important.
When skin is damaged, it tries to repair itself.
In that process, it deliberately widens some blood vessels.
To quickly send oxygen, nutrients, and immune cells
to the damaged area.
Red marks are the trace of those widened blood vessels.
In other words, it's a sign that the skin is still being repaired.
The tricky part is that this raises the question,
"So should I just leave it alone?"라는
question. Half right and half wrong.
It's true that it's recovering, but whether you create an environment
that lets that recovery finish properly or
interfere with it makes a clear difference in the result.
UV rays, physical irritation, and applying the wrong ingredients
interrupt this recovery process.
Then the blood vessels stay dilated, and
the red marks eventually become fixed in place.
On the other hand, if you support recovery well, red marks will
mostly fade naturally over time.
However, in some cases it takes too long, or
self-care alone has its limits.
One thing many people misunderstand is that, for red marks,
some people exfoliate or do strong peels.
They think,
"If it's on top of the stratum corneum,
peeling it off should make it go away."
But PIE is a vascular response in the dermis
below the epidermis.
It won't be solved by peeling off dead skin.
Rather, because the skin barrier becomes weaker,
the recovery often slows down even more.
Director Wi Young-jin's Key Summary
Red marks are the result of the skin repairing damage
by dilating blood vessels.
In other words, it's not broken; it's being repaired.
If you understand this, the question changes from
"how do I get rid of it?" to "how do I help it recover?"
That difference creates the result.
Red marks,
depending on what state they're in,
the approach changes
It differs from case to case, but
I usually divide it up like this.
How recently did it appear, or has it been a long time?
Is it a broad area or a localized one?
How much of the skin barrier is still left?
Those are the three things.
Category | Red marks (PIE) | Brown marks (PIH) |
Cause | Vasodilation (post-inflammatory vascular response) | Melanin pigmentation |
Color | Red to pink | Brown to yellow-brown |
When pressed with glass | Color fades (blood vessels) | No color change (pigment) |
Natural recovery | Often possible within months | Tends to take longer |
Treatment approach | Vascular laser, soothing care | Brightening ingredients, toning laser |
If it's been less than 3 months since it appeared, UV protection and
barrier care alone can
lead to substantial natural recovery.
But that's not entirely a good thing.
While you're waiting, if acne keeps coming back and
you keep irritating the skin,
the vessels can become fixed, and even after 6 months or a year,
some cases still remain.
For those cases, we use a vascular-targeting laser, and
devices like Vbeam or Excel V
selectively shrink the dilated blood vessels themselves.
Some people say they saw no effect after 10 treatments elsewhere,
but after 2 or 3 sessions with us,
it clearly faded, and
in most cases that was because they kept repeating the same toning laser
without distinguishing whether it was PIH or PIE.
Frequently Asked Questions
Q1. If I apply niacinamide or
vitamin C to red marks, does it help?
Niacinamide helps strengthen the skin barrier and has
anti-inflammatory effects, so
it helps create an environment for recovery.
Vitamin C is more effective for PIH than for PIE.
If it's red marks, gentle moisturizing and UV protection come
before ingredient-focused care.
Q2. If I get laser treatment,
how many sessions until it goes away? What about the cost?
To be honest, it depends on the case.
In general, many people see a meaningful change after 2 to 4 sessions, and
rather than trying to erase it completely,
it's more realistic to aim for a natural fading
over time.
Q3. When you have red marks,
is there anything besides basic skincare you should avoid?
One thing I definitely need to tell you is to avoid scrubs,
physical exfoliation, and gommage.
PIE is a vascular response below the epidermis, so rubbing the
dead skin away won't solve it, and
it only weakens the barrier even more.
And UV rays are the biggest enemy.
They keep blood vessels dilated longer and
delay recovery.
Bringing sunscreen before going out
is more effective than any expensive serum.
This was Wi Young-jin.
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