分段式二氧化碳激光（Fractional CO2 Laser）的微光束直徑比皮秒激光小，只有100-200微米，激光化細幼光束平均散點擊發，令激光進入皮膚底層。 表皮層與真皮層的水分吸收激光能量後，讓皮膚及疤痕組織加熱，並刺激皮膚組織及膠原蛋白再生與重組，達至煥膚效能。因此，Fractional CO2 Laser對刺激膠原蛋白重組與新生，如嫩膚、緊膚、改善凹凸洞、暗瘡印、去皺、收毛孔等 效果都比皮秒激光更顯著。
Fractional CO2 Laser 分段式二氧化碳激光 VS Fraxel 激光??
不少人聽說 Fractional CO2 Laser 對凹凸洞效果好，但亦有不少人推薦 Fraxel，究竟有甚麼分別?
Fractional CO2 Laser 是一種激光，而Einxel Plus/ Scarlet RF 等微針射頻是 Radio frequency (RF)，兩者都是以能量加熱皮膚以刺激皮膚膠原蛋白再生。
Fractional CO2 Laser 對以上三種凹疤都有改善，特別是對滾動型和車廂型效果十分顯著，能有效刺激皮膚組織及膠原蛋白再生與重組；由於Fractional CO2 Laser 只能到達淺層真皮層，只能對中度深度的冰錐型都有良好改善效果，對於一些較深的冰錐型，由於已達深層真皮層，單靠Fractional CO2 Laser不能打至冰錐型凹疤的根部。因此臨床上醫生一般會建議混合治療，例如先用三氯醋酸（TCA）作化學煥膚破壞整條冰錐，再使用Fractional CO2 Laser治療，或是Einxel Plus/ Scarlet RF 微針射頻 與Fractional CO2 Laser混合使用。
Fractional Carbon Dioxide Laser in Treatment of Acne Scars Andrej Petrov and Vesna Pljakovska
介紹:
The study was carried out in Acibadem Sistina Clinical Hospital, Skopje at the Department of Dermatovenerology. The study included patients with residual acne scars of a different type.
Exclusionary criteria in the study were the use of oral retinoids in period of 6 months prior to the laser treatment; the use of anticoagulation therapy; age under 17; and the presence of systemic diseases in the patient.
A questionnaire was prepared to collect the data needed for the objectives of the study. Every patient gave consent to participate in the study after being informed about the nature of the treatment and the research.
The treatment was carried out by different protocols depending on the type of lesion and its depth. Patients were treated with eCO2 beams of 120 and 300 nm. It used static method directly on the lesion, while the periphery was treated with dynamic module. It used different pulse energy, power, density and number of passes in a single session, and a different number of sessions depending on the clinical features of the patient.
To determine the efficacy and safety of the treatment three methods were used: a questionnaire for subjective evaluation of adverse effects by the therapy (pain, redness, and pigmentation), scale of satisfaction by the treatment and comparison of digital photographs before and after the treatment.
方法:
The average age of patients in our study for men and women collectively was 28.2 years – the average age for men was 28.33, and for women 26.26. The average total duration of acne was 4 years in men and 9 years in women.
More severe clinical forms of acne conglobata and nodular cystic acne appeared in men. Comedogenic and papular acne in our material were proportionately presented in 50% of cases, while the other half were the more severe clinical forms of acne – pustular inflammatory acne and nodulocystic acne that leave residual lesions in the form of second, third and fourth grade of scars.
Average age of acne appearance was 15.5 years. They started earlier in women than in men. Average duration of scars was 12 years.
過往史:
Firstly, Anderson and Parrish described fractional photothermolysis in 1983 in the journal Science.
Secondly, the FDA approved the application of fractional carbon dioxide laser in the treatment of acne blemishes in 2007.
Thirdly, numerous studies on the impact of fractional laser on acne scars indicate great success of the treatment.
Moreover, most patients who participated in the studies noticed improvement of their face condition and loss of blemishes.
Relevant studies indicate that ablative CO2 lasers are ideal for treating grade 3 scars caused by acne.
發現:
The more time has passed since the appearance of a certain scar, the more severe and refractory it becomes for therapy in the treatment of scars.
We can conclude that the selection of patients and their response to the therapy in this study coincide with worldwide experiences and the findings of numerous research studies.
In conclusion, the results of this study show that fractional laser treatment in these patients is fast and practical. Depending on the scar condition it could be made 6 treatments, and even if the scar is not completely disappeared after the treatment, it significantly improves the look. In 35% of cases there is a complete reduction of scarring, and in 40% a significant reduction of scars with more than 50%.
The time period between two treatments is one month. Dotted and atrophic scars showed the best response to treatment with CO2 laser. Fractional photothermolysis using fractional eCO2 laser is effective and safe method for treating acne scars. The experiences of our work confirm the world experiences that the best result with this method is achieved in dotted ice pick or V-shaped acne scars.
