Laser | Dr. Forley
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Posts Tagged ‘Laser’


Saturday, March 31st, 2018

As the aging process progresses, facial veins may appear more visible. The area around the eye, known as the periorbital region, is a frequent site for visible veins. These can become quite prominent and detract from the aesthetics of the eye. They are difficult to conceal and are a frequent complaint of patients concerned about their appearance. Fortunately, a safe and effective treatment option exists with the Ellipse Nordlys Nd:YAG laser. This device uses a specific wavelength of light that is absorbed by the red blood cells found within veins. The resulting heat that occurs results in the eventual elimination of blood flow through the veins due to the collapse of the vessel walls. The veins will disappear when blood doesn’t flow through them. The deeper veins remain untouched so there is no functional effect when treating the superficial veins. Minimal discomfort is associated with this rapidly performed treatment. One or more laser sessions may be required depending on the extent of the problem.

45 year old female 4 months following laser treatment of periorbital vein

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Sunday, August 20th, 2017

The Ellipse Nordlys is a state of the art device with multiple light and laser based treatment options for effectively managing various conditions. Superficial veins around the eye and temporal region are a frequent complaint that can be very visible and difficult to conceal due to the thin skin in this region. Treatment with the Nordlys Nd:YAG laser can reduce or eliminate the veins by using a specific wavelength of light to deliver energy that is absorbed by the red blood cells contained within these vessels. The energy is converted to heat which is transmitted to the inside surface of the vein. This results in eventual collapse and sealing of the veins so no further blood flow occurs. The lack of blood flow is what makes the veins gradually disappear. There are plenty of deeper veins in this area so eliminating the superficial ones that are visible is not a problem. There is minimal discomfort and the treatment only takes a few minutes. Frequently one treatment is sufficient but additional treatments may be indicated depending on the response of the veins.

38 year old female 8 months after Nd:YAG laser treatment of veins

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Sunday, December 25th, 2016

The Nd:YAG laser applicator on the multi-platform Nordlys system is very effective in treating vascular skin conditions that appear as red spots on the face. These clusters of small dilated blood vessels are called spider angiomas and respond to the wavelength of light energy that is delivered by the Nd:YAG laser. The energy is selectively absorbed by the red blood cells of the angioma and causes the inside wall of the vessels that are targeted to heat up and collapse. This prevents any further blood flow and the redness disappears. The treatment is very rapid with minimal discomfort and may require 1-3 sessions about 6 weeks apart with no downtime.

39 year old female 3 weeks after 2 Nordlys Nd:YAG laser treatments of the red spider angioma of her forehead

39 year old female 3 weeks after completing 2 Nordlys Nd:YAG laser treatments of the red spider angioma of her forehead

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Wednesday, June 29th, 2016

You can add a type of benign nodular vascular growth, known as a venous lake, to the many negative effects of sun exposure. It is commonly found in areas of the body that are often unprotected such as the vermillion or red part of the lip. It appears as a dark blue or purple collection of dilated, blood filled channels. It is compressible and tends to be very slow growing. It can mimic melanoma or basal cell carcinoma and must be distinguished from these malignant conditions prior to treatment.

74 year old female following 2 treatments of lower lip venous lake with Nordlys Nd:YAG laser

74 year old female following 2 treatments of lower lip venous lake with Nordlys Nd:YAG laser

The Nordlys Nd:YAG laser delivers energy at a wavelength that is selectively absorbed by the blood cells in the vascular channels of the venous lake. This causes a heating of the channel lining and collapse of the vessel wall that ultimately results in shutting down blood flow. Without blood flow, the venous lake will disappear. Treatment of the venous lake is quick, often requiring only 1 or 2 pulses of laser energy with minimal discomfort. In most cases, one or two treatment sessions at 6-8 week intervals is sufficient.

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Monday, August 20th, 2012

A troublesome problem that accompanies the onset of wrinkles and skin laxity with aging is the development of age spots. They are primarily caused by years of exposure to ultraviolet (UV) light from the sun and are typically brown, black, or gray in color. They commonly appear on the face, chest, shoulders, upper back, arms, and hands. The pigment in the upper layer of skin (epidermis) that gives your skin its normal color is called melanin. The tan that is created from exposure to the UV rays of the sun is the result of accelerated melanin production. This is the skin’s defense mechanism to protect the deeper layers of skin from damage. On areas of the skin that have years of frequent and prolonged sun exposure, age spots appear when melanin becomes “clumped” or is produced in particularly high concentrations and is known as hyperpigmentation.


Although anyone can develop age spots, you may be more likely to develop the condition if you have light-colored or fair skin, have a history of frequent or intense sun exposure, or have a genetic predisposition to extra production of melanin.

When to be Concerned

Although you may not like the way age spots look, they are usually harmless and don’t require medical care. You should see your doctor if the following changes occur to make sure a skin cancer, such as melanoma, is not present:

  • Dark pigmentation
  • A rapid increase in size
  • An irregular border
  • An unusual combination of colors
  • Itching, redness, tenderness, or bleeding

A Treatment Strategy for Age Spots

The cosmetic treatment of age spots requires a multifaceted approach to be successful.  Dr Forley utilizes a program of topical lightening products, the Fraxel® DUAL 1550/1927 laser, and sunscreens to achieve a beneficial outcome for his patients.

Topical Lightening Products

Prescription bleaching creams containing hydroquinone, often in combination with Retin-A and a mild steroid, may gradually fade age spots over several months. However, a significant number of patients will develop irritation and increased sun sensitivity from the use of hydroquinone on their skin.

Lumixyl™ Topical Brightening Crème is a lightening cream that utilizes naturally occurring peptides to decrease the availability of tyrosinase, the skin enzyme that is required for the production of melanin. Hyperpigmentation and age spots will improve over a period of 2-3 months of daily use and can be combined with Retin-A to enhance the result. Lumixyl™ does not cause the skin irritation or sun sensitivity that can result from the use of hydroquinone based lightening products.


Elure™ is a new lightening cream for treating age spots. The active ingredient is Melanozyme™, which is based on the naturally occurring enzyme lignin peroxidase, and helps to reduce melanin in the skin. It can be used in combination with Lumixyl™ to yield improved results in resistent age spots.

68 year old female before treatment

68 year old female before treatment

68 year old female 7 months following Fraxel®

7 months following Fraxel® DUAL 1550/1927 laser series of 4 treatments and Lumixyl™ Topical Brightening Crème



Dr Forley uses the Fraxel® DUAL 1550/1927 laser to treat age spots with limited downtime. The two wavelengths of energy are delivered in microscopic treatment zones, which do not affect the surface layer and enable rapid healing. Redness and swelling of 2-4 days duration with flaking and exfoliation occurring during the first week can be expected. Treatments with the Fraxel® DUAL laser typically require 3-5 sessions at monthly intervals. Age spots fade gradually over several weeks or months following each treatment. Dr. Forley uses Lumixyl™ as a pre-treatment for 4 weeks prior to the start of the Fraxel® DUAL laser series and between each laser treatment to maximize the lightening of age spots.


Sun Protection

Any effort at treating age spots will be counteracted by exposure to the UV rays of the sun. It is imperative to utilize sun protection if you want to benefit from the age spot treatments discussed. Dr. Forley recommends physical sunscreens, such as EltaMD®, because of their long lasting, broad spectrum UVA and UVB protection.

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Wednesday, July 25th, 2012

The redness and dryness associated with laser skin treatments can be reduced with the use of skin care products that are specifically formulated for this purpose. Dr. Forley will help you select the products that will work best for your individual needs:

Epidermal Repair: (SkinCeuticals)Epidermal Repair: (SkinCeuticals)

This post-treatment hydrating product also contains a pure concentrated form of two highly effective, proven healing ingredients. Beta Glucan and Centella Asiatica provide a protective barrier layer and help accelerate the biological processes involved in skin healing while reducing redness and soothing irritation.

TNS Ceramide Treatment Cream: (SkinMedica)TNS Ceramide Treatment Cream: (SkinMedica)

The dry skin that frequently occurs following a laser treatment be soothed and hydrated with this rich treatment cream. It contains NouriCel-MD, human growth factors and other naturally occurring elements that are crucial to the regeneration of healthy skin. It can also be used for treating dry skin as a complement to TNS Essential Serum in your daily skin care regimen.

Redness Neutralizer: (SkinCeuticals)Redness Neutralizer: (SkinCeuticals)

This pharmaceutical grade formulation prevents and controls the inflammation cascade that produces redness. It calms the irritation that may occur immediately following your laser treatment, and helps relieve post-procedure flushing.

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Monday, April 30th, 2012

An area of the body that often is overlooked in our anti-aging efforts is the hand. Recent attention has been directed to creating a more youthful appearing hand to match the facial rejuvenation treatments more commonly performed. The aging process in the hand is characterized not only by the changes in the appearance of the skin with wrinkling and brown spots but also by the increased visibility of the tendons and blue colored veins. This is the result of the loss of volume on the back of the hand and thinning of the skin. A key component in restoring a youthful appearing hand is the replacement of the volume that has diminished over the course of time. Here we will discuss a few treatment options that can help your hands to look younger: Radiesse®, Sculptra®Aesthetic, fat grafting, and Fraxel® re:store Dual laser.




After Radiesse®


Radiesse® is an injectable filler used to thicken the tissue on the back of the hand. It is FDA-approved and consists of calcium-based microspheres suspended in a water-based gel that will immediately restore volume to the hand when injected just below the deep layer of the skin. It also has a collagen stimulating effect that may prolong its usual one-year duration.



Sculptra®Aesthetic is an injectable material composed of poly-L-lactic acid that stimulates the production of collagen in the skin. A very natural appearing restoration of hand volume is produced by the gradual thickening of the skin that occurs over a three-month period. Generally, a series of 2-3 treatments at 6-week intervals are necessary to achieve the desired effect. The results from the treatment can last up to three years at which time maintenance treatments will be necessary.

Fat Grafting

A simple technique of injecting fat under the skin of an aging hand can achieve long-lasting rejuvenation. Your own fat is obtained using liposuction and then specially prepared prior to injecting it under the skin in fine tunnels. Survival of fat depends on it getting a good blood supply and may require several sessions to achieve the desired result. The physical presence of a thin layer of tissue will not only decrease the blue of the dorsal hand veins and the white of the extensor tendons but will also soften the shape of veins and tendons.

Fraxel® re:store Dual Laser

The new Fraxel® re:store Dual Laser can be used in addition to volume restoration to improve the surface texture of the skin and lighten brown spots. The new, more superficial Thulium fiber laser (1927 nm) wavelength can better address skin discoloration with minimal discomfort. In addition, the deep penetrating Erbium fiber laser (1550 nm) improves skin quality with collagen remodeling.

Microscopic treatment zones delivered by the Fraxel® re:store Dual laser produce “fractional” zones of heating with every zone surrounded by unaffected skin. This technology enables rapid initial healing with redness and swelling lasting for 2-4 days. There is no visible wound healing but some dryness and flaking will occur during the first week. The treatment regimen consists of 3-5 sessions at about 4 week intervals with beneficial changes continuing to occur for 2 to 3 months after each treatment.

During your consultation, Dr. Forley will discuss which treatment options would be best for you.


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Saturday, January 14th, 2012

What is a laser?
A laser is a wavelength source of high-energy light that is accurately focused and transmitted onto a very small area of the skin. The light travels in one direction, heating the skin selectively based on the wavelength and energy settings of the laser. In some cases, the skin is vaporized with an ablative laser when wrinkles are more severe. Current lasers such as the Fraxel re:store Dual and the Fraxel re:pair are precise and selective, allowing treatment of wrinkles, pores, brown spots, acne scars, and sun-damaged skin.


Ablative vs. Nonablative
There are two kinds of lasers: non-ablative and ablative. Non-ablative lasers, such as the Fraxel re:store Dual, work beneath the surface skin layer, using two wavelengths to deliver energy in “fractional” zones of heating with every microscopic treatment zone surrounded by unaffected skin. By maintaining the integrity of the surface layer of the skin, the downtime is kept to a minimum with this type of laser. Ablative lasers, such as the Fraxel re:pair, provide deeper dermal remodeling of more severely sun damaged skin by heating and vaporizing the treatment zones using fractional carbon dioxide (CO2). Both approaches stimulate collagen growth, improve skin tone, and decrease fine lines and skin discoloration. During your consultation, Dr. Forley will discuss which laser will work best for you.


Treatment and Healing Expectations
Topical numbing cream is applied for 1 hour prior to the treatment to decrease skin sensitivity. During the laser procedure, cold air is used on the skin, making any discomfort manageable but pain medication can also be used if desired. A sedation or “twilight” type of anesthesia may be indicated when an ablative laser is used. A full face treatment takes about 30 minutes.

Fraxel re:store Dual laser treatment produces a variable amount of redness and swelling over the first 3-4 days and dryness and flaking will occur throughout the first week. You are able to return to routine activities within 3-4 days but must use sun protection. Benefits are most evident with three to five treatments, spaced every 4-6 weeks.

Fraxel re:pair laser has a more involved recovery period and requires the area of treatment to be kept moist with gauze soaks and ointment for 5-7 days. The skin will be red and may be covered with a fine crust. Pinpoint areas of bleeding may also occur in the first 48 hours. The treated sites must be protected from sunlight after the procedure. In some cases, a pink surface color may remain for several weeks. You are able to return to routine activities and use make-up after 7-10 days although concealer may be necessary. Often, one treatment is all that is required to achieve the desired result.

Areas of Treatment

The Fraxel re:store Dual laser can treat wrinkles, acne scars, surgical scars, age spots/sunspots, melasma and actinic keratoses. The Fraxel re:pair laser is used for advanced sun damage and wrinkles, irregular texture, and age spots/sunspots. Laser treatment is not a substitute for a facelift nor can the procedure eliminate excessive skin or jowls. However, when combined with surgery, laser resurfacing can enhance the outcome of a facelift by improving skin quality.

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Tuesday, May 31st, 2011

With the recent introduction of  Ulthera®, the first energy-based device to be cleared by the FDA with a non-invasive “lift” indication, we are now able to offer a trio of non-surgical treatments that work to lift the skin and rebuild collagen that has been damaged with aging. Ulthera® joins the Fraxel® re:store Dual Laser and Sculptra®Aesthetic to provide an innovative platform of minimally invasive treatments to restore a more youthful appearance to your face. These three anti-aging treatments can be used in a combined non-surgical strategy that unlocks the potential of your own skin to produce a natural, more youthful appearance that is long-lasting.


The sound waves generated by the Ulthera® deviceresult in an innovative non-surgical treatment, Ultherapy®, that safely lifts and tones the skin without any downtime.  The sound waves produce a focused ultrasound energy that is delivered in a pattern that targets the deep layers of the face and neck with a series of thermal coagulation points. The  image on the viewing screen allows Dr. Forley to see precisely at what level the energy is being delivered. Because the sound waves pass directly below the surface of the skin, the deep support layer responsible for sagging is tightened without disrupting the skin. Contraction of the skin is immediately visible and treats the loss of elasticity and firmness that has occurred with aging.   The building of new collagen occurs gradually over the next two to three months as visible improvement progresses. Most patients require one treatment but a second session might be recommended for additional benefits when more severe skin sagging is present. Discomfort during the procedure is variable but there is no aftercare necessary and you may resume normal activities following your treatment. The combination of contraction of the tissues and new collagen formation can counter the effects of gravity on the skin and achieve significant lifting results that can persist for up to two years.

Fraxel®The Fraxel® re:store Dual Laser uses two wavelengths of laser energy to treat wrinkles and age spots in the skin. Both wavelengths work to improve collagen by stimulating the “collagen cascade” effect that results in the deposition of thickened, healthy collagen fibers to improve skin tone and firmness and to diminish pore size.  Brown spots are lightened and a more even skin complexion can be achieved. The face, neck, chest, and hands can be safely treated with this light energy-based technology in a series of four monthly treatments with short-term redness and swelling over 2-4 days. The duration of effect varies depending on the pre-existing quality of your skin with maintenance treatments recommended at 18-24 month intervals.

Sculptra®Aesthetic Sculptra®Aesthetic is composed of an injectable biocompatible material, poly-L-lactic acid, that creates a gradual and very natural appearing restoration of facial volume by stimulating the collagen producing cells of the skin. Youthful facial contours are achieved as the volume that has been lost or has shifted with aging is replaced by  skin that has been thickened by the newly formed collagen. Generally, a series of 2-3 treatments at 6-week intervals are necessary to achieve the desired effect. The results from the treatment can last up to 3 years at which time maintenance treatments will be necessary. Sculptra is quickly becoming the injectable of choice for patients looking for non-surgical facial rejuvenation. Dr. Forley and Philadelphia dermatologist, Dr. Ringpfeil report an increase of non-surgical procedures over the past few years.

A consultation with Dr. Forley will provide you with further insight into how this non-surgical trio of treatments can be used to address your concerns.  A sequence of treatment sessions that is customized for your specific needs will be discussed and the time frame necessary to achieve your goals will be determined.

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