December, 2012 | Dr. Forley
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Archive for December, 2012


Monday, December 31st, 2012

Successful wound healing occurs when the outcome of an injury or surgical procedure is a minimally apparent scar. Many variables can affect the final result of wound healing, including the size and depth of the wound, the blood supply to the area, the thickness and color of your skin, and tension on the repair. There are three principal phases in the wound healing process: inflammation, transitional repair, and maturation.


Inflammation Phase

The healing process begins immediately following tissue injury when blood vessels begin to narrow and clot, releasing various chemical substances into the wound. The extent of wound inflammation that is produced can be affected by the length of time that passes until the wound is repaired.

Transitional Repair Phase

During the transitional repair phase the density of cells in the tissue around the wound increase, beginning several days after the injury and lasting for several weeks. New skin cells and blood vessels begin to form to maximize the tissue replacement. These new blood vessels will supply the rebuilding cells with oxygen and nutrients to sustain the growth of the new cells and support the production of collagen, which acts as the framework for wound repair.

Maturation Phase

Scar maturation begins within 6-12 weeks and is the final phase of wound healing. This phase produces an improved scar contour as the collagen remodels from type III to type I. Less redness of the scar results from reduced cellular activity and a decrease in the number of blood vessels.

There are two different types of unfavorable scars that can appear after a surgical procedure. A hypertrophic scar is a thick, disfiguring scar that is usually raised above the skin surface. It can be caused by prolonged inflammation of the wound due to infection or excessive tension on the wound repair. This type of thickened scar will often improve over time. A keloid scar is an outcome of healing that results from a genetic predisposition to forming a thickened mass of scar tissue extending beyond the borders of the original wound. It generally does not regress and frequently resists attempts at treatment.

Our next blog will discuss techniques for managing surgical scars to get the most favorable result.

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Friday, December 21st, 2012

Skin texture, fine lines, and brown spots can be improved with the use of chemical peels. They accelerate the exfoliation of the superficial layers of photodamaged skin and stimulate new skin cell formation to yield a more youthful and even tone and texture. Brown spots or discoloration, known as hyperpigmentation, can be diminished. The depth of the peel indicated for an individual patient is dictated by the type of skin problem that is being addressed. Deeper peels also have a longer peeling phase that should be considered when planning a procedure.

SkinMedica® Illuminize, Vitalize, and Rejuvenize Peels are performed individually or in a series of 3-4 treatment sessions depending on the needs of the patient.



This is the most superficial of the SkinMedica® peels and targets the outermost skin cells. Alpha-hydroxy acids (mandelic acid and malic acid) in combination with phytic acid, salicylic acid, and resorcinol are used to achieve skin rejuvenation with minimal irritation. The mild exfoliation it produces typically results in little visible peeling. It is gentle in its effect and is ideal for very sensitive skin types.


Vitalize Peel is medium in depth and appropriate for all skin types. It can improve fine lines and wrinkles as well as brown spots and contains a blend of alpha and beta hydroxy acids and resorcinol with a final layering of retinoic acid. Peeling usually lasts about 2-3 days and the treatment may be repeated at 3 week intervals.


Rejuvenize Peel uses a formulation of lactic acid and salicylic acid for a more aggressive exfoliation of the skin. The skin will start to peel after 24-48 hours and will continue for 3-4 days. The peel is well tolerated and can improve  fine lines and skin texture, melasma and brown spots, and superficial acne scars.

Chemical peels are often combined with an at home skin care regimen that will enhance and prolong the results obtained after the peel. It is important to apply moisturizers to the skin following a peel to counteract the dryness that results from the procedure. In addition, the regular use of sunscreen is critical to protect the skin while it remains sensitive following a peel and also to prevent further damage from UV exposure. Daily use of skin lightening agents, such as Lumixyl, will enhance the treatment of skin discoloration with a peel. Dr. Forley will fully evaluate your skin during your initial consultation to determine a treatment plan that will be most effective for your individual needs.

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