21/08/2025
病人祛疤案例分享 Scar Removal Treatment
二氧化碳激光（CO₂ Laser）是一項常見且有效的技術，廣泛應用於疤痕修復。透過高能量光束，激光可瞬間汽化表皮層中的水分子，精確地剝離異常增生的組織。同時，能刺激真皮層中的成纖維細胞活化，促進膠原蛋白有序再生，進而改善疤痕的外觀與質地，使皮膚更為平整柔滑。
可治療的疤痕類型包括：
- 萎縮性疤痕（如痘疤、凹陷性創傷痕跡）
- 增生性疤痕及疤痕疙瘩
- 手術縫線疤痕及燒傷後疤痕
疤痕的產生來自皮膚受創後的異常修復反應。當傷口深入至真皮層，身體會透過膠原蛋白等細胞外基質的增生來填補損傷。然而，若膠原蛋白的合成與分解失衡，便可能導致纖維排列紊亂或過度堆積，使疤痕在結構與色澤上與正常皮膚顯著不同，表現為隆起、凹陷或色素改變。
疤痕的臨床發展通常可分為三個階段：
🧪 第一階段：發炎期
若傷口反覆感染或持續處於炎症狀態，會提高膠原過度增生的風險，進而增加疤痕形成機率。
💥 第二階段：增生期
此時纖維母細胞開始活化並大量分泌膠原蛋白，以重建受損組織，導致疤痕呈現隆起狀態。
🔧 第三階段：重塑期
在癒合過程中，膠原蛋白會逐漸重排與修飾：
若膠原過度增生，可能形成凸起的增生性疤痕；
若膠原生成不足，則形成萎縮性疤痕，如痘坑。 特別是面積較大的傷口，更容易因膠原排列失序而導致凹凸不平的疤痕組織。
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Carbon dioxide laser (CO₂ Laser) is a widely used and effective technique for scar revision. By emitting high-energy laser beams, it rapidly vaporizes water molecules in the epidermis, allowing for the precise removal of abnormal tissue overgrowth. At the same time, it stimulates fibroblasts in the dermis to promote the orderly regeneration of collagen, which helps improve the appearance and texture of scars, resulting in smoother skin.
Types of Scars That Can Be Treated:
- Atrophic scars (e.g. acne scars, sunken wounds)
- Hypertrophic scars and keloids
- Surgical suture scars and post-burn scars
Mechanism and Stages of Scar Formation
Scars form due to an abnormal healing process after skin injury. When damage reaches the dermis layer, the body attempts to repair the wound by proliferating extracellular matrix components such as collagen. However, if collagen synthesis and degradation become imbalanced, either through excessive growth or disorganized alignment, scar tissue can differ markedly from normal skin in structure and appearance, manifesting as raised, sunken, or discolored patches.
Clinically, scar formation is generally divided into three stages:
🧪 Stage 1: Inflammatory Phase
Frequent infections or persistent inflammation of a wound can significantly increase the risk of excessive scar formation.
💥 Stage 2: Proliferative Phase
Activated fibroblasts produce large amounts of collagen to fill damaged tissue, often resulting in raised scars.
🔧 Stage 3: Remodeling Phase
During healing, collagen fibers undergo reorganization:
Excessive collagen deposition may lead to hypertrophic scars;
Insufficient collagen synthesis can result in atrophic scars, like acne pits. Large wounds are particularly susceptible to uneven collagen alignment, often forming irregular, bumpy scar tissue.
