![](https://1.bp.blogspot.com/-7nCZjyziMB8/XkPIgcxS4dI/AAAAAAAADZo/DJ07_h4NwxMEOMN78OQNGLdZyrnF1FThQCEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB.jpg)
痘疤治療與改善,對於皮膚科醫師來說,一直是項挑戰。因為要將被破壞、缺損、組織排列不正常的疤痕組織,使其恢復到「接近最初的樣貌」,是件不容易的事情。2019年痘疤雷射治療,UP雷射討論度之高,尤其對於嚴重痘疤族群,更被視為救星。與其吹捧這台雷射又多神奇、多威猛,不如先釐清在痘疤膚質的治療上,需要突破、改善的幾個關鍵。
痘疤(凹疤)的形成:凹疤、疤痕及組織流失
![](https://1.bp.blogspot.com/-HVBuupJn0rg/XkPIhPjV31I/AAAAAAAADZs/gvN_YWbFHuoyqv7kPPrQ0n66P4BRtWqfgCEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB3.jpg)
痘疤分成許多型態(色素型、增生型、萎縮型),較難處理的是嚴重萎縮型疤,也就是凹疤。原因在肌膚的修復過程中,產生纖維化(組織排列不正常的疤痕組織)與體積流失,而造成向下萎縮的凹陷。
凹疤大致可粗分為三大類:「冰鑿型」「車廂型」及「滾動型」。滾動型表面有廣口型的凹洞,凹洞較淺、開口較大,疤痕組織僅存在於真皮層淺層,過去的光電雷射對於此類型治療效果佳;車廂型及冰鑿型深度較深,過去雷射較無法明顯改善此類型痘疤。
而除了痘疤本身,位於其下的疤痕組織也會是處理重點。疤痕是皮膚損傷後取代正常皮膚的纖維組織,它是生物身體皮膚和其他組織的創面修復過程中的結果。正常皮膚組織中,膠原蛋白的排列是與皮膚表面平行,因此表面平滑。但傷口在癒合的過程,新生的膠原蛋白會過量增生且排列凌亂,這些疤痕組織雖然是位於看不見的底層,會使得觸感上與正常皮膚不同,就是「摸起來硬硬、粗粗的」膚質;更重要的是若忽略了疤痕組織,就算再怎麼以雷射刺激膠原蛋白新生,仍會有向下拉扯的力量,使凹疤無法回彈。因為疤痕組織把周圍的皮膚緊緊扣住,因此治療效果不佳。
另一個重要的關鍵,就是過去治療較少考慮到組織萎縮、流失的問題。這也是為什麼嚴重痘疤族群的輪廓線條,會覺得不若一般膚質緊實。因此治療時應當考慮分層處理的,補足皮下組織的不足;最後則是整體膚質的優化、改善,提升質感。
![](https://1.bp.blogspot.com/-oMAfcI5F4rw/XkPIhvWepfI/AAAAAAAADZ4/3kJzOOIUiY0Nu-7cd37_fOw7VDEkeYLRACEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB6.jpg)
改善重點一 UP雷射 改善痘疤本身以及疤痕組織
![](https://1.bp.blogspot.com/-lQOXlM-broU/XkPIhYqOOrI/AAAAAAAADaI/2cRV0McYruIxuqImnTpja1HVoscbU8lPQCEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB4.jpg)
過去痘疤雷射,會以磨掉表面皮膚、減少凹洞的高低差,達到凹洞變淺目的,同時雷射熱能刺激皮膚新生膠原蛋白為主。但是對於看不見的疤痕組織、嚴重痘疤(深度較深)沒有幫助。
![](https://1.bp.blogspot.com/-cDxTlpTzUD0/XkPIiMc0NbI/AAAAAAAADaM/C4YByrKfkj8vBEJtZO92WFqOWfJaMoWSACEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB7.jpg)
UP雷射的UltraPulse極速脈衝科技,可以讓能量更快速、更精準(不傷及周邊組織)的深入皮下近4mm深度,鬆解疤痕組織,同時刺激膠原蛋白增生 。而其10600nm波長,研究顯示刺激膠原蛋白長達三個月,長出正常的組織取代疤痕組織,同時凹疤回彈、變淺,達到大幅度改善的目的。
改善重點二 舒顏萃補充缺損的體積
![](https://1.bp.blogspot.com/-HZUIquiEKc0/XkPIgCraI1I/AAAAAAAADaA/mWUuJUKBOA8233rFXNt3t20OnRzlxDeCgCEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB2.jpg)
流失的皮下組織,可以透過 3D聚左旋乳酸(又稱舒顏萃/Sculptra/液態拉皮)的治療過後,改善缺損流失的體積,視覺上更顯豐盈、年輕,線條更緊實、滑順。且當體積重新長出,能夠使痘疤的最低緣向上升高,減少與正常皮膚間的高低落差。
改善重點三 膚質細緻及粗大的毛孔
![](https://1.bp.blogspot.com/-m-nwgH8CeFI/XkPIhmSOLsI/AAAAAAAADaI/c2OxeFJ8-Y0WXMPlnwMms835oILodoCyQCEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB5.jpg)
最後,痘疤膚質整體來說粗糙、毛孔粗大、暗沈、膚色不勻,視覺上較花,觸覺上觸感不佳、粗糙。而755蜂巢皮秒雷射除了可以針對黑色素清除,蜂巢透鏡更在沒有傷口的情況下,重啟修復機制,刺激淺層膠原蛋白增生,改善毛孔、細紋及整體質感。
![](https://1.bp.blogspot.com/-HPvT0pTgycY/XkPIgD1FC2I/AAAAAAAADaE/xf6STByq1_gpv2t51zh-SF_c7kZ4eaRXACEwYBhgL/s1600/UP%25E9%259B%25B7%25E5%25B0%2584%25E6%2595%2588%25E6%259E%259CUltraPulse%25E7%2597%2598%25E7%2596%25A4%25E5%2587%25B9%25E7%2596%25A4%25E7%2597%2598%25E7%2596%25A4%25E6%25B7%25A1%25E5%258C%2596%25E5%2587%25B9%25E7%2596%25A4%25E4%25BF%25AE%25E5%25BE%25A9%25E5%2587%25B9%25E6%25B4%259E%25E6%25B2%25BB%25E7%2599%2582%25E8%25B2%25BB%25E6%2596%25B0%25E7%25AB%25B9%25E7%259A%25AE%25E8%2586%259A%25E7%25A7%2591%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E7%259A%25AE%25E8%2586%259A%25E5%25B0%2588%25E7%25A7%2591%25E8%25A8%25BA%25E6%2589%2580%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB%25E6%2596%25B0%25E7%25AB%25B9%25E6%258E%25A8%25E8%2596%25A6%25E9%2586%25AB%25E5%25B8%25AB1.jpg)
如此整體的規劃,全面改善痘疤膚質的關鍵問題,會比單單以傳統飛梭雷射進步的明顯,術後才能接近期待。