PicoSure Skin Rejuvenation blotchy red around cheeks after treatment, is this due to the healing process?

Hello and thank you for your question.  PicoSure is a phenomenal treatment for skin rejuvenation. Your reaction is  totally normal and simply means that your body is responding appropriately to the treatment. The bumps are superficial and are localized areas of new collagen and elastin generation, this is awesome.  I know you might feel uncomfortable, but the bumps are underneath and will go away in 1-2 weeks. Itciness is due to the skin drying out a bit, so I recommend hydrating your skin all the time with moisturizer of your choice and reapply as often as needed. This reaction tells me that you had an appropriate treatment done by an expert.  Hope this helps. Best, Dr.Avaliani

if it's just a week, I would wait longer for recovery. I wonder however if you had roseacea prior to treatment. If that was the case, I would still expect the roseacea to be present.

Picosure treatment targets the melanin (pigmentation) on the skin.  With that being said, the area around the pigment can show some inflammation and erythema which is temporary and expected and will resolve quickly.  The area of erythema (redness) will be most pronounced beside the areas of pigmentation.  The skin can feel tingly and itchy as it heals, so you are correct, this is a normal response.  Make sure to sun protect post treatment with sunscreen.
Best of luck.