A Complete Guide to the 4 Stages of Wound Healing
3 min read
The OneSkin Team
February 16,2022
SKIN CARE
A Complete Guide to the 4 Stages of Wound Healing
3 min read
The OneSkin Team
February 16,2022
SKIN CARE
Our skin doesn’t just serve as a key part of our outward appearance. It is a functional organ tasked with protecting our bodies from external aggressors and armed with the amazing ability to regenerate itself when damaged.The body’s mechanism for repairing damaged tissue is an organized and dynamic process achieved through four main steps that are initiated by our largest organ - skin. This blog will discuss the four main stages of wound healing, along with signs of proper wound healing. [1]
Our skin doesn’t just serve as a key part of our outward appearance. It is a functional organ tasked with protecting our bodies from external aggressors and armed with the amazing ability to regenerate itself when damaged.The body’s mechanism for repairing damaged tissue is an organized and dynamic process achieved through four main steps that are initiated by our largest organ - skin. This blog will discuss the four main stages of wound healing, along with signs of proper wound healing. [1]
01
What triggers wound healing?
The body’s wound healing process starts as soon as an injury occurs. Blood cells called platelets are the first responders at the wound site. These platelets release chemicals into the bloodstream called cytokines to alert the body’s wound healing stages to start. White blood cells called neutrophils are also present immediately at the wound site to prevent infection from foreign bodies that can enter the body through the wound bed. [2] The first stage of wound healing, hemostasis, begins immediately at the onset of an injury. [1]
01
What triggers wound healing?
The body’s wound healing process starts as soon as an injury occurs. Blood cells called platelets are the first responders at the wound site. These platelets release chemicals into the bloodstream called cytokines to alert the body’s wound healing stages to start. White blood cells called neutrophils are also present immediately at the wound site to prevent infection from foreign bodies that can enter the body through the wound bed. [2] The first stage of wound healing, hemostasis, begins immediately at the onset of an injury. [1]
02
What are the main stages of skin wound healing?
- Hemostasis: The goal of hemostasis is to occlude the wound to prevent infection and further damage happening to the body. This is where the emergency repair system, blood clotting, takes place. Blood clotting creates a temporary barrier to stop bleeding and protect the body from foreign particles entering at the site of injury. [3]
- Inflammation: The goal of this phase is to clear foreign bodies and bacteria from the wound in order for the body to be able to start the regrowth of tissue. [3] The inflammatory phase is commonly exhibited by swelling, pain, heat, and redness. [1]
- Proliferation: During proliferation, the wound is filled in with new tissue. The edges of the wound shrink during this stage as the new tissue closes across the wound bed. The new tissue, called granulation tissue, is light pink or red in color, uneven in texture, and does not bleed easily. [3]
- Maturation: In the last phase of wound repair, the collagen fibers from earlier stages are restructured to have a more smooth texture, greater tensile strength, and flexibility. Maturation can last anywhere from 21 days to 2 years, depending on the placement and severity of a wound. [3]
02
What are the main stages of skin wound healing?
- Hemostasis: The goal of hemostasis is to occlude the wound to prevent infection and further damage happening to the body. This is where the emergency repair system, blood clotting, takes place. Blood clotting creates a temporary barrier to stop bleeding and protect the body from foreign particles entering at the site of injury. [3]
- Inflammation: The goal of this phase is to clear foreign bodies and bacteria from the wound in order for the body to be able to start the regrowth of tissue. [3] The inflammatory phase is commonly exhibited by swelling, pain, heat, and redness. [1]
- Proliferation: During proliferation, the wound is filled in with new tissue. The edges of the wound shrink during this stage as the new tissue closes across the wound bed. The new tissue, called granulation tissue, is light pink or red in color, uneven in texture, and does not bleed easily. [3]
- Maturation: In the last phase of wound repair, the collagen fibers from earlier stages are restructured to have a more smooth texture, greater tensile strength, and flexibility. Maturation can last anywhere from 21 days to 2 years, depending on the placement and severity of a wound. [3]
04
What happens at each stage of the wound healing process?
- Hemostasis: Blood clotting occurs when platelets come into contact with collagen to form clots. These clots are attached together with the help of the enzyme thrombin to create a mesh that covers the wound and secures the clot in place. [3]
- Inflammation: Inflammation allows repair cells to move freely across the wounds to heal the skin. Inflammation is caused by the white blood cells, growth factors, and enzymes that are brought to the wound during this stage to remove any debris and germs in order for the body to progress to the next stage of wound repair. [1]
- Proliferation: The new tissue that grows in the wound during proliferation is composed of collagen and extracellular matrix. New blood vessels are created in the forming tissue to allow for oxygen supply to return to the area. [1] At the end of proliferation, epithelial cells resurface the wound. [3]
- Maturation: During maturation, the reparative cells from earlier wound healing stages are removed by apoptosis, or programmed cell death. Water is reabsorbed allowing for collagen fibers to cross-link together. Even with the stronger cross-linked fibers, the tensile strength of the connective tissue during maturation is only about 80% of what it was before the area incurred an injury. [1]
04
What happens at each stage of the wound healing process?
- Hemostasis: Blood clotting occurs when platelets come into contact with collagen to form clots. These clots are attached together with the help of the enzyme thrombin to create a mesh that covers the wound and secures the clot in place. [3]
- Inflammation: Inflammation allows repair cells to move freely across the wounds to heal the skin. Inflammation is caused by the white blood cells, growth factors, and enzymes that are brought to the wound during this stage to remove any debris and germs in order for the body to progress to the next stage of wound repair. [1]
- Proliferation: The new tissue that grows in the wound during proliferation is composed of collagen and extracellular matrix. New blood vessels are created in the forming tissue to allow for oxygen supply to return to the area. [1] At the end of proliferation, epithelial cells resurface the wound. [3]
- Maturation: During maturation, the reparative cells from earlier wound healing stages are removed by apoptosis, or programmed cell death. Water is reabsorbed allowing for collagen fibers to cross-link together. Even with the stronger cross-linked fibers, the tensile strength of the connective tissue during maturation is only about 80% of what it was before the area incurred an injury. [1]
05
How long does each stage of wound healing last?
- Wounds typically take between 4-6 weeks to fully heal. [4]
- Hemostasis begins immediately and finishes when the bleeding has stopped. [5]
- Inflammation lasts between 4-6 days and begins when hemostasis has finished. [3]
- Proliferation lasts from between 4 and 24 days. There is no set beginning and ending times to proliferation as it occurs simultaneously with the other phases. [3]
- Maturation occurs around 3 weeks into the healing process and can last as long as 12 months.[4]
05
How long does each stage of wound healing last?
- Wounds typically take between 4-6 weeks to fully heal. [4]
- Hemostasis begins immediately and finishes when the bleeding has stopped. [5]
- Inflammation lasts between 4-6 days and begins when hemostasis has finished. [3]
- Proliferation lasts from between 4 and 24 days. There is no set beginning and ending times to proliferation as it occurs simultaneously with the other phases. [3]
- Maturation occurs around 3 weeks into the healing process and can last as long as 12 months.[4]
06
What color should a healing wound be?
Inflammation is often paired with a red color and swelling in the area. [1] The new tissue created during the proliferation phase is first a deep red color as new blood vessels are created. Later in proliferation, the tissue often appears light pink or red in color. [3] Therefore, it is perfectly normal to have a healing wound appear red and pink, especially in the beginning stages of the healing process.
06
What color should a healing wound be?
Inflammation is often paired with a red color and swelling in the area. [1] The new tissue created during the proliferation phase is first a deep red color as new blood vessels are created. Later in proliferation, the tissue often appears light pink or red in color. [3] Therefore, it is perfectly normal to have a healing wound appear red and pink, especially in the beginning stages of the healing process.
07
How do you know if a skin wound is healing well?
If the newly forming tissue that appears during the proliferation phase of healing appears pink or light red, the wound is likely healing well and free from infection. However, if this new tissue is coming in dark, it could be a sign of infection or a lack of blood supply to the area, which will likely cause slow wound healing. Also, wounds that progress quickly through the stages of healing are likely healing well. [1]Signs of infection in a wound include pus, fever, increased redness and swelling, and warmth radiating from the wound. This can occur if bacteria managed to enter the wound and the white blood cells introduced during inflammation weren’t able to remove the infection. This can be avoided by cleaning the wound site soon after it appears, keeping the wound dressed with clean gauze, and changing the dressing regularly. [6]
07
How do you know if a skin wound is healing well?
If the newly forming tissue that appears during the proliferation phase of healing appears pink or light red, the wound is likely healing well and free from infection. However, if this new tissue is coming in dark, it could be a sign of infection or a lack of blood supply to the area, which will likely cause slow wound healing. Also, wounds that progress quickly through the stages of healing are likely healing well. [1]Signs of infection in a wound include pus, fever, increased redness and swelling, and warmth radiating from the wound. This can occur if bacteria managed to enter the wound and the white blood cells introduced during inflammation weren’t able to remove the infection. This can be avoided by cleaning the wound site soon after it appears, keeping the wound dressed with clean gauze, and changing the dressing regularly. [6]
08
Tips for Helping a Wound Heal
In order to allow a fresh wound to heal correctly, it is important that the wound stays clean and undisturbed during the healing process. [6] If you suffer a superficial wound that is small enough to treat at home, follow these steps to allow for a quick recovery, and always consult a physician if you’re in doubt of what to do:
- Start with clean, dry hands before touching the wound. If there is bleeding, apply pressure to the wound with a clean bandage or gauze, and elevate the wounded area. [7]
- Wash the wound immediately with clean water to remove any debris from the area. Clean around the area with warm soapy water to disinfect.
- Hydrogen peroxide is not recommended for use on open wounds because it can irritate the skin and may contribute to delayed wound healing. [6]
- Cover the wound bed with a clean gauze or bandage to prevent the wound site from coming into contact with dirt and bacteria. Change the dressing daily, when it becomes wet or dirty. [7]
- Consistently apply topical skin care products that will help support the wound healing process while combating scar formation.
- Take note of which foods to avoid during wound healing as diet plays a significant role in healing skin from the inside out.
08
Tips for Helping a Wound Heal
In order to allow a fresh wound to heal correctly, it is important that the wound stays clean and undisturbed during the healing process. [6] If you suffer a superficial wound that is small enough to treat at home, follow these steps to allow for a quick recovery, and always consult a physician if you’re in doubt of what to do:
- Start with clean, dry hands before touching the wound. If there is bleeding, apply pressure to the wound with a clean bandage or gauze, and elevate the wounded area. [7]
- Wash the wound immediately with clean water to remove any debris from the area. Clean around the area with warm soapy water to disinfect.
- Hydrogen peroxide is not recommended for use on open wounds because it can irritate the skin and may contribute to delayed wound healing. [6]
- Cover the wound bed with a clean gauze or bandage to prevent the wound site from coming into contact with dirt and bacteria. Change the dressing daily, when it becomes wet or dirty. [7]
- Consistently apply topical skin care products that will help support the wound healing process while combating scar formation.
- Take note of which foods to avoid during wound healing as diet plays a significant role in healing skin from the inside out.
Key Takeaways:
- The four stages that wounds progress through while healing are hemostasis, inflammation, proliferation, and maturation
- Wounds typically take between 4 and 6 weeks to heal, but can take longer if the wound becomes infected or is disturbed
- It is normal for wounds to have a pink or reddish appearance during the healing process
- Keep wounds clean and dry to allow for quick healing of damaged tissue and to prevent infection
Key Takeaways:
- The four stages that wounds progress through while healing are hemostasis, inflammation, proliferation, and maturation
- Wounds typically take between 4 and 6 weeks to heal, but can take longer if the wound becomes infected or is disturbed
- It is normal for wounds to have a pink or reddish appearance during the healing process
- Keep wounds clean and dry to allow for quick healing of damaged tissue and to prevent infection
References
- https://pubmed.ncbi.nlm.nih.gov/29676998/
- https://www.niehs.nih.gov/health/topics/science/biomarkers/index.cfm
- https://medlineplus.gov/genetics/understanding/basics/gene/
- https://medlineplus.gov/genetics/understanding/howgeneswork/epigenome/
- https://askabiologist.asu.edu/explore/when-body-attacked
- http://www.shieldhealthcare.com/community/popular/2015/12/18/how-wounds-heal-the-4-main-phases-of-wound-healing/
- https://www.ncbi.nlm.nih.gov/books/NBK470443/
- https://www.healthline.com/health/skin/stages-of-wound-healing#stages-of-wound-healing
- https://www.medicalnewstoday.com/articles/325040#prevention-and-treatment https://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
References
- https://pubmed.ncbi.nlm.nih.gov/29676998/
- https://www.niehs.nih.gov/health/topics/science/biomarkers/index.cfm
- https://medlineplus.gov/genetics/understanding/basics/gene/
- https://medlineplus.gov/genetics/understanding/howgeneswork/epigenome/
- https://askabiologist.asu.edu/explore/when-body-attacked
- http://www.shieldhealthcare.com/community/popular/2015/12/18/how-wounds-heal-the-4-main-phases-of-wound-healing/
- https://www.ncbi.nlm.nih.gov/books/NBK470443/
- https://www.healthline.com/health/skin/stages-of-wound-healing#stages-of-wound-healing
- https://www.medicalnewstoday.com/articles/325040#prevention-and-treatment https://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
Reviewed by Alessandra Zonari, PhD, Chief Scientific Officer (CSO) and Co-Founder of OneSkin
Alessandra earned her Master’s degree in stem cell biology, and her PhD in skin regeneration and tissue engineering at the Federal University of Minas Gerais in Brazil in collaboration with the 3B’s Research Group in Portugal. Alessandra did a second post-doctoral at the University of Coimbra in Portugal. She is a co-inventor of three patents and has published 20 peer-reviewed papers in scientific journals.
Reviewed by Alessandra Zonari, PhD, Chief Scientific Officer (CSO) and Co-Founder of OneSkin
Alessandra earned her Master’s degree in stem cell biology, and her PhD in skin regeneration and tissue engineering at the Federal University of Minas Gerais in Brazil in collaboration with the 3B’s Research Group in Portugal. Alessandra did a second post-doctoral at the University of Coimbra in Portugal. She is a co-inventor of three patents and has published 20 peer-reviewed papers in scientific journals.
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Decoding the Connections Between Intrinsic & Extri...
Causes of Skin Itching: Understanding the Reasons ...
How to Protect Your Skin from UVA and UVB Rays
Morning vs. Night Exfoliation: Determining the Bes...
How to Tell if Acne is Hormonal or Bacterial?
How to Know if Your Skin Barrier is Damaged
Tips for Managing Hormonal Breakouts
Understanding Hormonal Acne and Its Triggers
How to Repair & Restore Your Skin Barrier
How To Get Rid of Crepey Skin: 7 Solutions
When to Apply Sunscreen: Before or After Moisturiz...
How Alcohol Impacts Your Skin’s Health
The Effects of Alcohol on Your Skin's Aging Proces...
OS-01 FACE: Clinically Validated to Support Your S...
Can Alcohol Cause Breakouts?
The Proof is in the Peptide: 12-Week Clinical Stud...
Why Is My Neck Aging So Fast?
6 Factors That Contribute to Slow Skin Healing
6 Tips and Tricks for a Youthful Neck
Addressing the Need for Indoor Sun Protection
The Science of Sunburns: How to Treat and Prevent ...
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OS-01 F...
Can Air Quality Affect Skin? Exploring the Impact ...
Understanding the Relationship Between Sleep and U...
Exploring the Effects of Quality Sleep on Your Ski...
How to Improve Gut Microbiome
Exploring Caloric Restriction and Its Effects on A...
What’s the Connection Between Quality Sleep and Lo...
Unlocking the Skin Benefits of Intermittent Fastin...
Why Exercise is a Game-Changer for Longevity
The Microbiome Diet and Its Effects on Skin
Cold Exposure: Hype or Longevity Boosting?
Eat Better, Live Longer: Top Foods for Longevity
How to Protect Your Skin from Everyday Environment...
How Does Sunscreen Work? How Long Does it Last?
Pressing the Pause Button on Aging Skin: OS-01 BOD...
What Causes Dark Circles Under and Around Your Eye...
How to Brighten Eyes and Under-Eyes
Lip Balm Ingredients: What to Look for and What to...
Exploring Blue Zones: How Can We Optimize Our Heal...
Nurturing Your Lips: How to Keep Them Moisturized ...
Uncovering the 9 Causes of Dry Lips: Why Do Lips G...
How to Travel with Skin Care Products
Why is my Skin Peeling on My Face?
The Importance of Sunscreen: Why Should You Wear I...
Lip Sunscreen: Do Lips Need SPF Protection?
The Science of Gratitude
Removing Sunscreen: Tips for Clean and Healthy Ski...
Skin Explained: Is Skin An Organ?
UV Light and Skin: Effects and Protection Strategi...
Understanding The Epidermis: Functions, Compositio...
Diving into Dermis: Functions and Significance
Unlocking the Science of Wrinkles: Causes, Formati...
PREP enhances the effects of OS-01 FACE, and the p...
Why Skin Barrier is Important
Ingredient Spotlight: Bentonite Uses, Benefits, & ...
Hypodermis: Exploring Its Vital Functions
The EU is Limiting Retinol in Skincare: Here’s Eve...
Why You Should Use OS-01 FACE & OS-01 SHIELD Toget...
Ceramides For Skin: Everything You Need to Know ne...
Age Gracefully: How to Manage Neck Wrinkles and Ac...
Discover Why Our New SPF Outperforms the Rest
How to Preserve Your Feet: 5 Strategies for Wrinkl...
Hands and Dermal Elasticity: Understanding and Man...
The Lip Lineage: Exploring the Why Behind Wrinkled...
How to Address Stomach Wrinkles For Smoother Skin
A Scientific Approach to Addressing Wrinkly Skin o...
What is Skin Cycling? Understanding, Embracing, an...
How to Skin Cycle: A Guide to Optimize Your Skin C...
Do You Know What Clinical Claims Really Mean?
What is Tinted Sunscreen?
2 Types of Wrinkles and Tips for Treating Them
Understanding Marionette Lines: Causes and Prevent...
How to Help Your Skin Act Younger
The Science of Sunscreen: Understanding the Optima...
Better Elasticity, More Firmness: Discover OS-01 E...
Symptoms and Causes of Melasma on Face
How to Prevent Skin Aging Before It Starts
A Comprehensive Guide to Understanding the Differe...
How to Strengthen Your Skin: A Guide to Thicker, H...
An In-Depth Look at Glycerin: What is it and What ...
Exploring the Benefits of Glycerin for Skin Health
Exploring the Difference Between Hydrating and Moi...
3 Natural Ways to Keep Your Skin Hydrated and Glow...
How To Create A Hydrating Skin Care Routine For Dr...
Senotherapeutics, Senolytics, and Senomorphics -- ...
Cleansing 101: How to Wash Your Face the Right Way...
Scientific Breakthrough: OneSkin’s scientists show...
Dry Skin 101: How To Identify This Skin Type
How OS-01 Can Help Your Collagen Levels As You Age...
Developing a Skin Care Routine for Normal Skin: 4 ...
What is Normal Skin & Do I Have This Skin Type?
A Step-by-Step Guide to Creating the Perfect Skin ...
Understanding Oily Skin: Causes & Characteristics
7 Keys to Understanding Menopause and Skin Changes
Is This The Root Cause of Aging?
UV Damage Increases Cellular Senescence. Here's Ho...
Our Research Has Been Published in npj Aging
How To Reduce Hyperpigmentation by Targeting Cellu...
4 Steps to Crafting the Perfect Skin Care Routine ...
A Comprehensive Guide to Understanding and Managin...
An In-Depth Look At The Benefits Of Moringa Oil Fo...
How to Tighten the Skin Under Your Eyes
7 Causes For Crepey Skin Under Eyes
101 Guide To Restoring Dry Skin Around The Eyes
How is OS-01 EYE different from OS-01 FACE?
How to Remove Lingering Dead Skin Cells On the Fac...
Safe Beauty, Validated: Why OneSkin trusts SkinSAF...
Hallmarks of Aging
What is Sensitive Skin?
How OS-01 Works on Mature Skin
Is Fragrance Bad for Your Skin?
Target Cellular Senescence with the Highest Concen...
Can a Plant-Based Diet Really Increase Your Health...
Eye Skin Ages Faster: Here’s How OS-01 Can Help
Gut Health and Skin: How Are They Connected?
The Science Behind Why The Skin Around the Eyes Ag...
How OS-01 EYE Supports the Ultra-Thin Skin Around ...
How Do You Know When to Stop Using Retinol?
How To Heal Skin From Picking Your Face Too Much
Collagen And Elastin: What Role Do They Play In Sk...
Why We Want Skin To Be More, Not Less
More Than Skin Deep: How Physical Touch Predicts L...
What is Skin Inflammation? What Causes it?
How to Reverse (or Prevent) Aging Skin
Yes, You Need Sunscreen During Winter
Can You Use Hyaluronic Acid with Retinol?
Exploring the skin’s purpose in whole-body health
Stressed Skin: 4 Stress Effects on the Skin
What Does Hyaluronic Acid Do For Your Skin?
Good Genes vs. Good Habits: Which Impacts Your Lon...
What Are The Causes Of Dry, Flaky Skin On Your Fac...
What is the Best Skin Care Regimen for Aging Skin?
7 Benefits of Jojoba Oil
What happens to skin as a person ages?
What are the Benefits of Sulforaphane?
8 Benefits of Andiroba Oil For Skin
Invasive vs. Non-Invasive Skincare: The pros and c...
Allantoin For Skin: A Comprehensive Guide
This is the Data to Look For When Choosing Skin Ca...
Why cellular senescence is more than just one of t...
A Simplified Guide To The Different Skin Texture T...
How OS-01 Works With Different Skin Types
How To Smooth Skin Texture On The Face: 4 Expert T...
Skin Microbiome: What It Is, Why it’s Important, A...
What Foods Cause Acne and Which Fight Against It?
The 101 Guide To Understanding Acne-Prone Skin
The Top 4 Prickly Pear Benefits for Skin
What Is Exfoliation & Is It A Necessary Measure Fo...
OneSkin Notable Mention: Dave Asprey's The Human U...
Clean Beauty: What “clean” really means and why “s...
Retinol 101: Debunking Retinol as the Gold Standar...
Menopause & Skin: What you need to know
Take an Inside Look into Our Cutting-Edge R&D Plat...
101 Guide On The Benefits Of Cleansing Your Face
Cleanser Vs. Face Wash: Which Should I Reach For?
Five Common Skin Problems Experienced in Perimenop...
Get to Know OneSkin’s Topical Supplements:
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The Top 3 Benefits of Peptides for Skin
How to Use Peptides In Your Skincare Regimen to Op...
Peptides vs Retinol: Is One Better For Increasing ...
What Is Causing the Uneven Skin Tone On Your Body?
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Three Ways To Extend Your Skinspan Starting With Y...
What Are Free Radicals and How Do They Impact Skin...
The Top 6 Best Antioxidants For Skin Health and Lo...
How OneSkin Developed the OS-01 Peptide
How chronic stress makes you age faster
What is Epidermal Thickness & Why Does it Matter?
Cell Turnover & Why It Slows As We Age
OneSkin Notable Mention: OneSkin Featured In Tony ...
101 Guide To Skin Tightening + 7 Noninvasive Metho...
Tight Feeling Skin: 3 Reasons Why
3 Skin Tightening Ingredients To Help Boost Skin H...
How to Reduce Skin Inflammation & Redness
Niacinamide Vs Retinol: How Do They Compare?
How to Incorporate OneSkin’s OS-01 Topical Supplem...
Why Is Nutrient Absorption Key To Better Skin Heal...
OneSkin Notable Mention: LifeSpan Episode 6 | The ...
The Top 10 Best Foods for Skin Repair
Are There Dangers of Retinol Cream Use?
What is Skin Elasticity & How Can You Improve It?
A Complete Guide to the 4 Stages of Wound Healing
4 Foods To Avoid During Wound Healing & Why
Celebrating Black History Month: A Discussion With...
What is the Function of Skin as a Protective Barri...
Representation of the Black Community in Skin Care...
Our Story: Learn more about the history of OneSkin...
What Is Senescence & Its Relationship To Aging?
Winter Skincare - How To Prevent Dry Skin this Sea...
Special Announcement: OneSkin to Donate 1% of Sale...
Biological Age: What is Biological Age, Why Does i...
What your skincare routine is missing (Hint. It’s ...
What is a peptide?
Peptides: the first piece of th...
Peptides: the first piece of th...
Health Is The New Wealth
The Correlation Between Sleep and Skin: Why It Mat...
How Relationships, Community, & Social Interaction...
Calorie Restriction And Intermittent Fasting: Eati...
Healthspan: A New Way To Think About Aging