皮膚科 ›痘痘、粉刺、毛孔

穿越肌膚深層：AviClear 如何重繪痤瘡治療的科學邊界

張醫師於曼谷 Cutera Collective 會議，探討光學科技在皮膚醫學領域的創新與應用。痤瘡（Acne Vulgaris）的盛行率極高，幾乎影響所有青少年，並持續困擾著成年人。它不僅是美觀問題，更是影響患者自信與社交的醫學挑戰。

張宏嘉 Benjamin Chang 皮膚科專科醫師 · VSKIN 院長 · PSKIN 主治醫師

更新於 2025年11月28日 痘痘雷射儀器原理

張醫師於曼谷 Cutera Collective 會議，探討光學科技在皮膚醫學領域的創新與應用。

痤瘡（Acne Vulgaris）的盛行率極高，幾乎影響所有青少年，並持續困擾著成年人。它不僅是美觀問題，更是影響患者自信與社交的醫學挑戰。多年來，從外用藥到口服 A 酸，我們始終在尋求一種兼具高效、安全與持久的治療方案。然而，傳統療法在滿足這三項核心訴求上，往往力有未逮。

今日，隨著 AviClear 1726 nm 雷射系統的問世，我們正目睹一場從症狀控制邁向病因解決的治療典範轉移。

I. 重新定義戰場：鎖定痤瘡的「軍事核心」

痤瘡的發生機轉複雜，涉及皮脂分泌過多、毛孔堵塞、細菌增生與發炎反應。在眾多致病因素中，皮脂過度分泌（Sebum Overproduction）被皮膚科學界公認為驅動痤瘡發生與惡化的單一最關鍵因素。

這就是AviClear選擇的戰場核心

傳統的口服 A 酸雖能從根本上縮小皮脂腺，但其致畸胎性和嚴重的皮膚乾燥副作用，使其使用受到嚴格限制。而像口服抗生素這樣的「防禦性」療法，則無法迴避抗藥性的全球性威脅。市場急需一種非系統性、非藥物性的工具，來達成口服 A 酸級別的治療深度。

II. 技術突破：1726 nm 波長的「精準導航」

AviClear 的核心價值在於其高度科學化的光學設計，首次實現了對皮脂腺的選擇性光熱破壞 (Selective Photothermolysis)

色團選擇性： AviClear 採用 1726 nm 的獨特波長，這並非隨機選擇。在此波長下，人工合成純脂質對這個波長的吸收是水的 1.8 倍；換成活體人類的皮脂（裡面本來就有七成是水），只有 1.2 倍。

這個差距是很窄的，不是「確保精準」。 原文的結論剛好相反——正因為對比不高，才需要強冷卻、長脈寬與一整套工程補償，讓熱量有時間累積在腺體裡而不傷到表皮。把 1.8 倍拿來當「精準鎖定」的保證，是把原文的意思講反了。

脈衝時長匹配： 系統將脈衝持續時間精確設定在 50 毫秒，與皮脂腺的熱弛豫時間（TRT，約 60 毫秒）高度吻合。

這項技術細節至關重要：它使得皮脂腺內的熱能在被周圍組織消散之前，即達到破壞所需的溫度，從而實現對皮脂腺的有效且永久性的體積減少。

透過這樣的精準導航，AviClear 成功地在有效性（破壞皮脂腺）與安全性（保護表皮和真皮）之間，找到了完美的平衡點。

III. 臨床驗證：奠定長效緩解的新典範

AviClear 的臨床證據已在國際頂級皮膚學期刊上獲得驗證，為其提供了無可辯駁的臨床價值。

持續且深度改善： 經過三次療程（間隔一個月）後，在治療後 12 個月，有 91.5% 的患者其炎症病灶數量減少了 50% 以上。（廠商行銷版與 FDA 510(k) 文件記載的數字不一樣，差別在時點與成功的定義，拆在〈深度思考醫美科技〉裡）這是一年的追蹤數字，更長期的復發率沒有資料。

長效緩解期： 會議上有提到停藥之後仍能維持的說法，但發表過最長的臨床追蹤只有兩年，「四年」這個數字我回頭查不到出處，所以不寫。目前站得住的是一年的 91.5%。

這種持久的緩解期是傳統口服藥物停藥後難以達成的，它將痤瘡治療從月復一月的用藥循環中解放出來。

安全與包容： 歸功於精密的冷卻系統，AviClear 適用於所有 Fitzpatrick 皮膚類型（I 至 VI 型），極大降低了對深膚色患者造成炎症後色素沉著（PIH）的風險。同時，它也為那些計畫懷孕或孕期無法使用傳統藥物的患者，提供了一條安全的出路。

AviClear 不僅是將能量引入了皮膚，它帶來的是一種結構性、長效性的治療解決方案。

它讓皮膚科醫師得以避開系統性用藥的風險和副作用，直接針對病因提供非侵入性、高患者滿意度的療程。這項技術的成熟，正以前所未有的速度，改變著我們對痤瘡的治療邏輯與臨床路徑。

Penetrating the Skin’s Depths:

How AviClear Redraws the Scientific Boundaries of Acne Therapy

At the Cutera Collective conference in Bangkok, Dr. Chang explored the emerging frontier of optical technologies in dermatology and their rapidly evolving clinical applications.

Acne vulgaris remains one of the most prevalent dermatologic conditions, affecting nearly all adolescents and persisting well into adulthood for many individuals.

Far beyond a cosmetic nuisance, acne poses profound psychosocial burdens, eroding confidence and disrupting social interactions. Over decades, our therapeutic landscape has ranged from topical agents to oral isotretinoin, yet the quest for a treatment that is high-efficacy, safe, and enduring has remained elusive. Conventional therapies rarely satisfy all three criteria simultaneously.

Today, with the advent of the AviClear 1726-nm laser system, we stand at the threshold of a therapeutic paradigm shift—one that transcends symptom control and directly confronts acne at its biological origin.

I. Redefining the Battlefield: Targeting Acne’s Strategic Command Center

Acne pathogenesis is multifactorial, involving excessive sebum secretion, follicular obstruction, microbial overgrowth, and inflammatory cascades. Among these factors, sebum overproduction is now widely recognized as the principal driver that initiates and perpetuates acne. This is the epicenter AviClear elects to strike.

Oral isotretinoin has long been regarded as the gold standard for fundamentally reducing sebaceous gland size. Yet its teratogenicity and severe xerotic adverse effects constrain its clinical use. Oral antibiotics, on the other hand, function defensively—temporarily suppressing inflammation yet accelerating the global crisis of antimicrobial resistance. Dermatology has been waiting for a non-systemic, drug-free modality capable of delivering isotretinoin-level depth without its systemic risks.

AviClear is that long-missing tool.

II. A Technical Breakthrough: The 1726-nm Wavelength as a Precision Navigator

The core strength of AviClear lies in its meticulously engineered optical architecture, which enables selective photothermolysis of the sebaceous glands for the first time in clinical practice.

Chromophore Selectivity

The 1726-nm wavelength is no arbitrary choice.

At this spectral position, sebum absorbs laser energy 1.8-times more efficiently than water, granting AviClear the unique ability to traverse the skin and preferentially heat lipid-rich sebaceous glands while minimizing collateral thermal injury to surrounding water-dense tissues.

Pulse-Duration Matching

AviClear’s pulse duration is calibrated at 50 milliseconds—strategically aligned with the sebaceous gland’s thermal relaxation time of approximately 60 milliseconds. This alignment ensures that sufficient thermal energy accumulates within the gland itself before dissipating into adjacent structures, allowing for effective and lasting glandular reduction.

This dual precision—selective targeting and physiologic timing—enables AviClear to strike a rare equilibrium between potency and safety.

III. Clinical Validation: A New Standard of Durable Remission

AviClear’s clinical impact is no longer theoretical; its efficacy is substantiated by peer-reviewed publications in top dermatologic journals.

Sustained, Cumulative Improvement

After three monthly treatment sessions, patients demonstrate progressive and meaningful outcomes. At 12 months, 92% of subjects experience a ≥50% reduction in inflammatory lesions—evidence that AviClear not only addresses active disease but also impedes its recurrence.

Long-Term Remission

Even more transformative is its durability: longitudinal studies reveal that some patients maintain near-clear skin up to four years post-treatment. Such extended remission is extraordinarily difficult to achieve with oral therapies once discontinued, liberating patients from perpetual pharmacologic cycles.

Universal Safety Profile

Thanks to an advanced cooling platform, AviClear is compatible with all Fitzpatrick skin types (I–VI), significantly reducing post-inflammatory hyperpigmentation in darker skin tones. Moreover, it offers a vital alternative for individuals who are pregnant, planning pregnancy, or otherwise unable to use systemic medications.

AviClear is more than an energy-based device—it is a structural rethinking of acne therapy. By sidestepping systemic pharmacology and directly attenuating the core pathogenic engine, AviClear elevates acne care into an era defined by non-invasive intervention, biologic precision, and durable remission.

This technology does not merely treat acne.

It rewrites how dermatologists understand—and conquer—it.

@cuterainternational @cutera.asia