Can red marks left by acne be treated?
Flat red marks remaining after a spot has settled are known as post-inflammatory erythema and are different from true scars. They represent dilated blood vessels within healing skin, and most fade over three to six months without any treatment. Where they persist beyond that, vascular laser treats them effectively. The distinction that matters is whether the surface of the skin is level.
The simplest test is to press gently upon the mark with a fingertip or a glass slide. Post-inflammatory erythema (redness) blanches (fades), since the colour arises from blood vessels and pressure empties them, whereas a scar does not change. The second test is contour. A scar has depth and casts a shadow under directional light, whereas post-inflammatory erythema is flat and represents a problem of colour rather than of structure.
Most red marks resolve without treatment although this can take many months. Where redness persists for a year or more, the small vessels formed during healing have not regressed. Redness persisting beyond six to twelve months is unlikely to resolve much further without treatment.
Vascular laser is the treatment of choice, targeting the haemoglobin within the dilated vessels, and several sessions are usually required. Downtime is minimal compared with resurfacing, with some redness and occasionally bruising for a few days. Sun protection and treating any active acne is essential.
Generally I would advise waiting six months before treating new red marks, since most resolve spontaneously and treating early means paying for something that time would have accomplished. Where the marks are brown rather than red this is post-inflammatory hyperpigmentation, which behaves differently and is treated differently.
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