Ӏϡਔ኏Ѝ‫ڼ‬ᒚᓚొ౟೹
ę 8 ּέ៉གྷរ ę
เᚹϲ ၐࡿӀ Ղ̀ࢆ ߸Ԉඡ
‫هࡔطܜ‬ᗁੰ ϩቲࡊ
Facial Freckles Treated by Intense Pulsed Light
— The Experience of 8 Cases in Taiwan —
Yau- Li Huang
Yuan-Li Liao
Shih-Hung Lee
Hong-Shang Hong
Freckles or ephelides are cutaneous pigmented lesions that have familial inheritance, increase
degree of pigmentation by sun-exposure, and frequently seen on face and other sun-exposure areas.
Freckles (ephelides) have been reported to respond completely and quickly to the Q-switched 532nm
Nd:YAG, alexandrite or ruby lasers. The skin types of Asian patients are above type III, and mostly
are type IV or V. The most important consideration for laser therapy on Asian skin is post-therapy
hypo-pigmentation or post-inflammatory hyper-pigmentation. We try to treat facial freckles of Asian
patients with intense pulsed light and with the following parameters: cut -off filters of 550 -590nm,
fluences of 25-35 J / cm2 , single pulse, and pulse width of 4.0 msec. The response results are evaluated by dermatologist, patients themselves, color photography, ultraviolet detect camera and ultraviolet
photography. The results reveal: in clinical evaluation, about 75% patients had "excellent" or "good"
results. About 87.5% patients had "Extremely" or "very" satisfied in patient-self evaluation. In conclusion, facial freckles of Asian skin treated with intense pulsed light is a quick, safe, satisfied, and
effective method with little side effects. (Dermatol Sinica 21 : 58-67, 2003)
Key words: Intense pulsed light, Freckles, Asian skin, Skin type, Post - therapy hypo - pigmentation,
Post-inflammatory hyper-pigmentation
౟೹Ăߏ˘჌ᓚ˯૱֍۞Ғ৵೹Ăѣछ୉᏷็ّĂᗞҒົᐌ͟ខ҃ΐࢦĂͷр൴д͟
Ѝᘉខ۞ొҜĄӀϡ Q ฟᙯ‫ ܜگ‬532nm ۞⊺ฮЧ࿩डă඘ჴϜ࿩डăٕࡓᚗϮ࿩ड̏གྷਕ
ԆБă҃ͷԣిг‫ڼ‬ᒚ౟೹Ąֲ߷ˠ۞ϩቲᙷ‫ݭ‬кΗߏௐˬ‫˯ͽݭ‬Ăͽௐαặ‫ࠎݭ‬౵
кĄ࿩डᙯ‫ڼ۞ࢬ͞˘఺ٺ‬ᒚ౵̂۞҂ณĂಶߏఙ‫ޢ‬Ғ৵۞ត̼Ăӈఙ‫ޢ‬Ғ৵৿εăٕ‫ۆ‬
া‫ޢ‬Ғ৵Ք඾۞ன෪Ąԧࣇဘྏͽ‫ ܜگ‬550 Ҍ 590nm ۞࿅ᕭጡĂਕณ૜‫ ޘ‬25 Ҍ 35 J / cm2 Ă
ಏ˘ਔ኏Ăਔ኏ᆵ 4.0 msec ۞ਔ኏Ѝ‫ڼ‬ᒚֲ߷ˠᓚ˯۞౟೹ć֭ӀϡᓜԖϩቲࡊᗁरăঽˠ
ҋ֗႕ຍ‫ޘ‬ă૾Ғ໰ͯăโϨ໰ͯă‫׶‬඘γЍઍീ࠹፟ᄃ໰ͯĂֽෞҤਔ኏Ѝ‫ڼ‬ᒚ౟೹۞
From the Department of Dermatology, Chang Gung Memorial Hospital
Accepted for publication: July, 22, 2002
Reprint requests: Yau-Li Huang, M.D., Department of Dermatology, Chang Gung Memorial Hospital, 199,Tun-Hwa North Road,
Taipei, Taiwan. TEL: 02-27135211 ext. 3397 FAX: 02-27191623
58
เᚹϲ
ᓜԖड़‫ڍ‬Ąඕ‫ڍ‬ពϯĂᓜԖ۞ෞҤѣ 75 % ۞ঽˠ྿‫מ " ז‬෸ " ‫ " ׶‬։р " ۞Լච඀‫ޘ‬ć҃ঽˠ
ҋ֗۞ෞҤĂঽˠ႕ຍ඀‫ޘ‬д‫ޝ‬႕ຍͽ˯ࡗҫ 87.5 %ĄඕኢߏĂਔ኏Ѝ̙εࠎ˘჌ԣిăщ
Бăઘүϡ͌ă႕ຍ‫˫੼ޘ‬ѣड़۞͞ёĂϡֽ‫ڼ‬ᒚֲ߷ˠᓚ˯౟೹Ą( ̚රϩᄫ 21 : 58 - 67,
2003 )
ᒚܑϩҒ৵ঽիॡĂΞ྿‫ ז‬8 % 7Ąώࡊд
݈ ֏
౟೹ ( Freckles or ephelides )Ăߏ˘჌ᓚ
Ӏϡ Q ฟᙯ‫ ܜگ‬532nm ۞⊺ฮЧ࿩ड̈́ Q
˯૱֍۞Ғ৵೹Ă̂̈ࡗ 1 ~ 2 mm Ӕ୺ነ
ฟᙯࡓᚗϮ࿩ड‫ڼ‬ᒚ౟೹۞གྷរ˯Ăᄃ઼
ҒĂᗞҒົᐌ͟ខ҃ΐࢦĂͷр൴д͟Ѝ
γ۞ಡӘᙷҬ 6, 8Ăӈֹֹϡ۞ਕณ૜‫࠹ޘ‬
ᘉខొҜĄϩቲҒ୺ăࡓጀăᖡீ۞୉ཏ
၆ྵ‫ڼ‬ᒚ‫۞΁׎‬โ೹ࠎҲĂ̪൒ົѣܑϩ
ྵࠎр൴Ąѣछ୉᏷็ّĂវߖҒវពّ
۞๋च ( ௡ᖐࢳᕯăᕇ‫ې‬΍ҕ̈́඘೹ )Ăͷ
᏷็ ( autosomal dominant inheritance ) ߏΞ
ূ൭۞‫⊺ڶې‬ฮЧ࿩ड˫ྵࡓᚗϮ࿩डࠎ
ਕ۞᏷็ሀё Ą‫׎‬௡ᖐঽநጯ۞ត̼ߏܑ
ᆖच ( ঽˠົࢋՐϡԊొ౫ዕᘽ )Ąͽ˯ˬ
ϩโҒ৵۞ᆧΐ ( melanosis )Ă҃‫ܧ‬โҒ৵
჌ Q ฟᙯҒ৵࿩डր௚‫׎‬Ѝᕇ̂̈ ( spot
௟ࡪ۞ᆧΐ ( melanocytosis ) 2Ą఼૱дᇆᜩ
size ) ఼૱ྵ̈ ( ᄃਔ኏Ѝ۞ filter ͧྵ )Ă҃
࡚टγ៍۞ଐ‫̖˭̝ڶ‬ᅮࢋ᎕ໂ‫ڼ‬ᒚĄ็
т‫ڍ‬౟೹۞ᇴϫкă̶Ҷቑಛ̂Ă‫ڼ‬ᒚ˯
௚۞͞ёΒ߁‫ۏ‬நّ̼̈́ጯّೱቲăᄏ೹
૱૱ົਈॡ෱˧ĄЯࠎ˯ࢗ Q ฟᙯҒ৵࿩
ჼă̈́࿰ّ֨۞֨ខඈඈĄ‫ܕ‬ѐֽĂϤ‫ٺ‬
डր௚۞˘ֱ‫ڼ‬ᒚ˯۞ઘүϡ‫׶‬યᗟĂԧ
࿩डᗁጯ۞ซՎĂӀϡ Q ฟᙯ (Q - switched)
ࣇဘྏӀϡਔ኏Ѝֽ‫ڼ‬ᒚֲ߷ˠᓚ˯۞౟
‫ ܜ گ‬5 3 2 n m ۞ ⊺ ฮ Ч ࿩ ड ( N d : YA G
೹Ą
1
laser )ă඘ჴϜ࿩ड ( Alexandrite laser )ăٕ
ਔ኏Ѝ ( intense pulsed lightĂIPL ) ߏ˘
ࡓᚗϮ࿩ड ( ruby laser ) ̏གྷਕԆБͷԣి
߱‫ૻ۞ܜگ‬ЍĂ‫ܜگ‬ቑಛརд 500 - 1200nm
г‫ڼ‬ᒚ౟೹ 3, 4, 5Ą൒҃Ăͽ˯఺˘ֱ Q ฟᙯ
̝มĂͷ֭‫ܧ‬ಏ˘‫۞ܜگ‬࿩डЍćᔵ൒ι
Ғ৵࿩डր௚ϡ‫ڼٺ‬ᒚҘ͞ˠ۞ᇃཌྷ۞โ
ѣ˘ֱኑᗔ۞ણᇴ ( тĂਔ኏ᆵăਔ኏ม‫ؼ‬
೹ ( Β߁ܑϩٕߏৌϩᆸ۞โҒ৵ঽիĂּ
Ᏽॡมăਕณ૜‫ޘ‬ăЍᕇ̂̈ඈඈ ) ᅮࢋአ
тខ঱ă౟೹ă͉ϣͩϓ೹ă‫ܦו‬ă‫׶‬โ
༼Ăҭߏ‫׎‬үϡࣧநᄃ࿩ड࠹ҬĄιΞͽ
൮ඈඈ )ĂӮ̏གྷѣҒ৵Ҳ˭ ( ͍‫ ߏ׎‬Q ฟ
ᑕϡдੵͨ 9ăҕგঽի۞‫ڼ‬ᒚ 10, 11ăਔ኏Ѝ
ᙯࡓᚗϮ‫׶‬඘ჴϜ࿩ड )ă௡ᖐࢳᕯ ( ͍‫׎‬
аߋఙ ( photorejuvenation ) 12, 13ă‫ֱ˘׶‬โҒ
ߏ Q ฟᙯ⊺ฮЧ࿩ड )ăᇶॡّܑϩ෇ᒺă
৵ঽի۞‫ڼ‬ᒚ 14, 15 ඈඈк͞ࢬ۞়ঽĄ൒҃
ᇶॡّቲኳԼតă‫׶‬ᕇ‫ې‬΍ҕ̈́඘঱ඈઘ
౟೹͞ࢬ۞‫ڼ‬ᒚ˵ѣಡӘ࿅ 15Ą
үϡ۞ಡӘ 6Ą၆‫ٺ‬ቲҒྵஎ۞ֲ߷ˠЯࠎ
‫ڼ‬ᒚ౟೹఺˘჌ܑϩ۞โҒ৵೹Ă‫׎‬
ܑϩѣྵ૜۞ melaninĂٙͽ‫ڼ‬ᒚ‫۞ޢ‬Ғ৵
ᇾ۞‫ۏ‬ăٕჍࠎҒૄኳ ( chromophore ) ߏโ
6
Ҳ˭۞ଐ‫ځྵົڶ‬ព Ą൴‫ޢۆ‬Ғ৵Ք඾۞
Ғ৵̈វ ( melanosome ) ٕߏโҒ৵
ઘүϡ۞ּͧдቲҒஎ۞ˠ჌˵ྵ੼Ă͍
( melanin )Ąࢋ྿‫ז‬։р۞ᏴፄّЍሤ̶ྋ
‫ߏ׎‬ϡ Q ฟᙯ‫ ܜگ‬532nm ۞⊺ฮЧ࿩ड‫ڼ‬
( selective photothermolysis ) ᇾ۞โҒ৵̈
59
Ӏϡਔ኏Ѝ‫ڼ‬ᒚᓚొ౟೹
វĂᏴϡ‫׎‬౵ट‫ٽ‬ӛќ۞‫ܜگ‬ቑಛߏ 351 Ҍ
1064nm 16, 17, 18, 19Ą҃ਔ኏ᆵ۞Ᏼፄߏֶፂโ
Ғ৵̈វ۞ሤቤྋॡม ( thermal relaxation
time, TRT ) ࡗ 250 Ҍ 1000 nsecĂٙͽਔ኏ᆵ
ᑕྍࢋ̈‫ ٺ‬1000 nsec ̖ਕ௢᎕྿‫ז‬ٙᅮሤ
ณͽၨ໑ᇾ۞‫ۏ‬Ă̙҃৔ᗼ‫׹‬ಛ௡ᖐ 20ĄQ
ฟᙯ۞‫ ܜگ‬532nm ⊺ฮЧ࿩डă඘ჴϜ࿩
डăٕࡓᚗϮ࿩ड ( Q - switched ruby laser )
̏གྷਕԆБͷԣిг‫ڼ‬ᒚ౟೹Ă҃ Q ฟᙯ
ր௚ٙ፬൴۞෹ൺਔ኏ ( ୮຋ѼቑಛĂ
nanosecond range ) ˵Ξͽдઘүϡໂ̈۞
ଐ‫˭̝ڶ‬৔ᗼܑ୺‫׶‬எᆸ۞โҒ৵ঽիĄ
൒҃Ăԧࣇ೩΍Ӏϡᆵ‫ܜگ‬ᙉր۞ਔ኏
ЍĂֽԣి˫ѣड़۞‫ڼ‬ᒚֲ߷ˠᓚొ۞౟
೹Ą
അགྷ៍၅‫ז‬Ӏϡ‫ ܜگ‬515nm ࿅ᕭጡ
( filter ) ۞ਔ኏Ѝ‫ڼ‬ᒚ୺ᆸโҒ৵ঽի۞ј
Fig. 1
A Intense pulsed light equipment ( Photoderm, ESC
medical systems Ltd., Yokneam, Israel).
B Keep the filter parallel to the skin to avoid uneven
treatment.
C Ultraviolet detect camera and standard film. The
photography was taken on a fix - staged table with
standard film with and without the use of the UV
filter.
Α९ּ 20Ăͽ̈́Ӏϡ‫ ܜگ‬590nm ۞࿅ᕭጡă
ਕณ૜‫ ޘ‬34 J / cm 2 ۞ਔ኏Ѝ‫ڼ‬ᒚᙷҬঽի
۞ѣड़ಡӘ 15Ă‫׶‬Ӏϡ‫ ܜگ‬550nm ٕ 570nm
۞࿅ᕭጡăਕณ૜‫ ޘ‬28 ‫ ז‬32 J / cm 2ă‫ؼ‬Ᏽ
ॡม 20.0 / 40.0 msec ۞ਔ኏Ѝઇаߋఙ҃โ
Ғ৵ঽիព඾Լච۞͛ᚥ 12, 13Ă҃ͷ‫׎‬ઘү
ϡӮໂ͌Ąٙͽώ͛۞ϫ۞ߏӀϡᓜԖᗁ
रăঽˠҋ֗႕ຍ‫ޘ‬ă૾Ғ໰ͯăโϨ໰
ͯă‫׶‬඘γЍઍീ࠹፟ᄃ໰ͯ ( Ultraviolet
detect camera and UV photography ) т
ࡁտĂѐ᛬ 26 Ҍ 60 ໐ ( πӮ 38.4 ໐ )Ăϩቲ
ᙷ‫ ( ݭ‬skin phototypes, Fitzpatrick scale ) ࠎௐ
ˬăௐα‫ ( ݭ‬ௐˬ‫ݭ‬Ĉ2 ҜĂௐα‫ݭ‬Ĉ6 Ҝ )
ତ‫צ‬ਔ኏Ѝ۞‫ڼ‬ᒚĄБొ۞ঽଈੵ˞˘ਠ
֨ខϡ‫̝ݡ‬γĂд˘ѐ̰֭൑ֹϡੜ೹۞
γϡᘽ‫ۏ‬ăٕߏତ‫΁׎צ‬࿩ड۞‫ڼ‬ᒚĄπ
Ӯତ‫ צ‬1.75 Ѩ ( ˘ѨĈ3 ҜĂ˟ѨĈ4 ҜĂ
ˬѨĈ1 Ҝ ) ۞ਔ኏Ѝ‫ڼ‬ᒚĂՏѨม࿣ 4
ฉĂВ៍၅̱࣎͡Ą
( Fig.1C )ĂֽෞҤਔ኏Ѝ‫ڼ‬ᒚ౟೹۞ᓜԖड़
‫ڍ‬Ą‫̚׎‬඘γЍઍീ໰࠹፟‫׍‬ѣ˘࣎পҾ
۞඘γЍ࿅ᕭጡ ( UV filter )ĂΞͽֹโҒ৵
۞ঽիΐૻពညĂֹԧࣇΞͽՀट‫ٽ‬ăՀ
‫៍މ‬ăᇾ໤̼гͧྵෞҤᓜԖ۞ड़‫ ڍ‬21Ą
Մफ़ᄃ͞‫ڱ‬
Śঽ ଈ
ˣҜᓜԖ෧ᕝࠎ౟೹۞ّ̃ঽଈৼˢ
Ś ‫ڼ‬ᒚᆇጡ
ਔ኏Ѝ፟ጡ ( ESC Sharplan medical systems Ltd., Yokneam, Israel ) т ( Fig. 1A ),Ξͽ
யϠᆵ‫ܜگ‬ቑಛ 500 Ҍ 1200nmă‫ܧ‬ТՎ̼
( noncoherent ) ۞ЍĄ҃఺˘ֱЍົ఼࿅প
Ҿనࢍ۞࿅ᕭጡ ( filters )Ăপ‫۞ܜگؠ‬Ѝົ
జᕭଫĂ౺˭ѩ‫˯ͽܜگ‬Ҍ 1200nm ۞Ѝజ
60
เᚹϲ
፬൴΍ֽĄপ‫۞ܜگؠ‬࿅ᕭጡΒ߁Ĉ515ă
( graying )ăٕតஎ ( darkening )Ă‫ڼܑ΃݋‬
550ă570ă590ă615ă645ă695ă715ăٕ
ᒚ·̶ٕඕՁ‫ڼ‬ᒚ۞޽ᇾ ( end point )Ąٙ
755nmĄѣ̙̂̈Тଣᐝ ( probes ) ΞֻՀ
ѣঽଈఙ݈ࢋ߾ᓚĂҭ̙υ๮ܑϩ౫ዕ
ೱĄҽ጖ቱ ( chilled gel ) ಶߏ෹ࢰ‫گ‬ֹٙ
጗Ąፆүॡมࡗ 10 ̶ᛗĄఙ‫̙ޢ‬υฟϲ˾
ϡă൑Ғ۞֤˘჌Ą
‫ͤڇ‬൭ᘽٕγϡԩϠ৵ĂΪᅮᑡ˘ֱܲᒅ
‫֨׶‬ខ ( SPF ̂‫ ٺ‬15 ) ۞֯ᔶĄٙѣ۞ঽˠ
ӮజӘۢͷ‫ٮ‬໰ࡔᐂĄ
Ś ‫ڼ‬ᒚ໤‫݋‬
ԧࣇ۞‫ڼ‬ᒚ໤‫ॲߏ݋‬ፂͽ‫۞ـ‬ಡӘ 12. 13,
15, 20
ĂᏴፄ‫ ܜگ‬550 Ҍ 590nm ( ͽ 570nm ࠎ
Ś ෞҤ͞ё
͹ ) ۞࿅ᕭጡĂਕณ૜‫ ޘ‬25 Ҍ 35 J / cm Ă
ঽˠՏ࿣ 2 ฉа෧ෞҤ֭঻˭ఙ݈‫׶‬ఙ
ಏ˘ਔ኏Ăਔ኏ᆵ 4.0 msec ۞ਔ኏ЍĄ఺
‫૾ޢ‬ҒăโϨă඘γЍ໰ͯ ( UV photo )Ă
࣎ቑಛ۞‫ ܜگ‬550 Ҍ 590nm ၆‫۞୺ܑٺ‬โҒ
В੠ᖸ 12 ฉĂˬ࣎͡‫ޢ‬Տ͡аֽኑ෧ĂВ
৵ѣྵр۞Լචड़‫ڍ‬ĄЍᕇ̂̈‫ॲ݋‬ፂঽ
៍၅ 6 ࣎͡ĄՏѨ໰࠹ࡔᐂĂӮϡ࠹Т۞ຳ
ˠঽի۞̂̈‫̶׶‬ҶҜཉֽᏴፄĂѣˬ჌
ٗăЍ໚ă࠹፟ ( ˘ਠ࠹፟‫׶‬඘γЍઍീ࠹
̂ ̈ Ξ ֻ Ᏼ ፄ Ĉ 8mm X 8mmĂ 8mm X
፟ĂUV detect camera, Faraghan Studio,
15mmĂ8mm X 35mmĄҽ጖ቱдՏ˘Ѩᑝ
Philadelphia, PA ) ( Fig. 1C )ă‫۞ؠ׽׶‬෼ᗓ
൴݈ࢋ๮д࿅ᕭጡ˯Ą࿅ᕭጡᄃϩቲ࿣඾
̝˭ซҖĄдֹϡ඘γЍઍീ࠹፟‫ٮ‬໰
ҽ጖ቱͽࡗ 2mm ࠹ତᛈĂᔖҺۡତତᛈౄ
ॡĂߏϡᇾ໤۞‫ ( ͯغ‬standard film, 400
ј፵լĄ࿅ᕭጡᄃϩቲܑࢬܲ޺ͪπࢬ˵
ASA Tri - X film )ăд‫ؠ׽‬෼ᗓ۞ॸߛ˯‫ٮ‬
‫ࢋࢦޝ‬Ăтѩ˘ֽϩቲତ‫۞צ‬ਕณ̖ਕπ
ᛷֹϡ඘γЍ࿅ᕭጡٕߏ՟ѣֹϡ࿅ᕭጡ
ӮĂт ( Fig. 1B )Ą༊ϩቲӔனࡓཚ ( erythe-
۞໰ͯĄѣֹϡ඘γЍ࿅ᕭጡ۞໰ͯĂߏ
ma around lesions )ăҒ৵঱ӔனѷҒត̼
โҒ৵ঽիពညΐૻ۞໰ͯ ( UV photo )ć
2
Fig. 2
A and C, regular and UV photographs of patient 6 were taken before IPL intervention.
B and D, Facial freckles improve a lot after IPL treatment at 4th week and show more apparent improvement
on UV photo. Parameters of IPL: filter: 570nm, fluence: 26 J / cm2, pulse duration: 4.0 msec, single pulse.
61
Ӏϡਔ኏Ѝ‫ڼ‬ᒚᓚొ౟೹
҃՟ѣֹϡ࿅ᕭጡ۞໰ͯĂಶтТ˘ਠ۞
( ᅅă̚ăࢦ )Ąଈ۰۞ତ‫צ‬඀‫ޘ‬Ă̶Ξତ
โϨ໰ͯ ( regular photo ) ( Fig. 2 )Ą
‫ ( צ‬acceptable ) ‫̙׶‬Ξତ‫ ( צ‬non - acceptable )
ᗁरෞҤ͞ࢬĂϤ‫׌‬ҜᗁरॲፂᓜԖ
ܑன‫׶‬໰ֽͯෞҤซՎ඀‫ޘ‬Ѻ̶ͧĄ૟ঽ
‫׌‬৺Ąଈ۰дఙ‫ޢ‬ෞҤഇมĂੵ˞֨ខ‫ݡ‬
̝γĂ̙Ξϡ‫΁׎‬Ꮛ೹ய‫ݡ‬Ą
ˠ۞ͅᑕᕩᙷ‫מٺ‬෸ड़‫ ( ڍ‬Excellent result
ę ӈԼච඀‫ ٺ̂ޘ‬75 % )Ă։рड़‫ ( ڍ‬Good
ඕ ‫ڍ‬
result ę ӈԼච඀‫ ٺ̂ޘ‬50 % ҃̈‫ٺ‬
ඕ‫ڍ‬т ( Table I and II )Ăдௐ˟ฉॡѣ
75 % )Ă೼఼ड़‫ ( ڍ‬Fair result ę ӈԼච඀‫ޘ‬
6 Ҝঽˠ ( 75 % ) ྿‫מז‬෸ड़‫ڍ‬Ă2 Ҝঽˠ
̂‫ ٺ‬25 % ҃̈‫ ٺ‬50 % )Ă‫̙׶‬։ड़‫ ( ڍ‬Poor
( 25 % ) ྿‫ז‬։рड़‫ڍ‬Ąдௐαฉॡѣ 2 Ҝঽ
result ę ӈԼච඀‫ ٺ̈ޘ‬25 % ) ඈα৺Ą
ˠ ( 25 % ) ྿‫מז‬෸ड़‫ڍ‬Ă4 Ҝঽˠ ( 50 % )
ঽˠҋ֗۞ຏ‫צ‬ෞҤߏӀϡય‫͞۞ס‬
྿‫ז‬։рड़‫ڍ‬Ă2 Ҝঽˠ ( 25 % ) ྿‫ז‬೼఼ड़
ёĂ඀‫ͽ݋ࢬ͞ޘ‬ໂ႕ຍ ( Extremely satis-
‫ڍ‬Ąдௐˣฉॡѣ 3 Ҝঽˠ ( 37.5 % ) ྿‫מז‬
fied )Ă ‫ ޝ‬႕ ຍ ( very satisfied )Ă ႕ ຍ
෸ड़‫ڍ‬Ă3 Ҝঽˠ ( 37.5 % ) ྿‫ז‬։рड़‫ڍ‬Ă
( Satisfied )Ă຋႕ຍ ( Slightly satisfied )Ă‫׶‬
2 Ҝঽˠ ( 25 % ) ྿‫ז‬೼఼ड़‫ڍ‬Ąдௐ˩˟ฉ
̙႕ຍ ( Not satisfied ) ඈ̣৺̶ֽҾĂдௐ
ॡѣ 3 Ҝঽˠ ( 37.5 % ) ྿‫מז‬෸ड़‫ڍ‬Ă3 Ҝ
̱࣎͡ॡෞҤĄ‫ڼ‬ᒚ۞̙։ͅᑕෞҤ˵ߏ
ঽˠ ( 37.5 % ) ྿‫ז‬։рड़‫ڍ‬Ă2 Ҝঽˠ
Ӏϡય‫͞ס‬ёĂෞҤఙ̚‫׶‬ఙ‫ূ۞ޢ‬൭޺
( 25 % ) ྿‫ז‬೼఼ड़‫ڍ‬ĄдඕՁௐ˘Ѩ‫ڼ‬ᒚ
ᜈॡมăࡓ೹ăҒ৵ள૱ ( Ғ৵ᆧΐٕҒ৵
۞ௐ˩˟ฉĂԼච඀‫ ٺ̂ޘ‬50 % ͽ˯۞ҫ
࿅͌ )ă‫ڼ‬ᒚโຳഇ ( Down time ) ۞ѣ൑̈́
˞ 75 %ĄΪү˘Ѩਔ኏Ѝ۞ˬҜঽˠĂд
޺ᜈॡม‫ܜ‬ൺĄ֭ͷϤᗁरෞҤᚑࢦ඀‫ޘ‬
ௐ˟ฉĂԼච඀‫ ٺ̂ޘ‬50 % ͽ˯۞ҫ˞
Table I. Eight patients with facial freckles treated with IPL
case Age Skin No.
2nd
4th
6th
8th
10th
12th
6th
Patient Side
( Y ) / Type
of
week week week week week week month Self Effects
Sex
Tx
after Tx after Tx after Tx after Tx after Tx after Tx after Tx Evaluate
1. 26 / F
III
1
A
A
A
B
B
C
C
b
2. 29 / F IV
1
A
B
B
B
B
B
B
b
3. 45 / F IV
1
B
C
C
C
C
C
C
c
4. 52 / F IV
2
A
B#
A
A
A
A
A
b
5. 60 / F IV
2
A
B#
A
A
A
A
A
b
6. 32 / F IV
2
A
B#
A
A
A
A
A
a
7. 35 / F IV
2
B
A#
A
B
B
B
B
a Hypopigm
8. 28 / F
III
3
A
C
A
C*
A
B
B
F, female. M, male.
A: Excellent, 76-100%. B: Good, 51-75%. C: Fair, 26-50%. D: Poor, 0-25%
a : Extremely satisfied. b: Very satisfied. c: Satisfied. d: Slightly satisfied. e: Not satisfied.
# : Evaluating before the second treatment, which was performed at the 4th week.
* : Evaluating before the third treatment, which was performed at the 8th week.
b
-entation
-
62
เᚹϲ
100 %Ą‫˞ז‬ௐαฉᔵ൒Լච඀‫ ٺ̂ޘ‬50 %
ͽ˯۞̪ҫ˞ 100 %Ăҭߏ྿‫מז‬෸ड़‫۞ڍ‬
Ѻ̶ͧ̏གྷϤ 66.7 % ࢫ‫ ז‬33.3 %ĄௐˣฉԼ
ච඀‫ ٺ̂ޘ‬50 % ͽ˯۞ࢫ‫ ˞ז‬66.7 %Ă҃
ௐ˩˟ฉԼච඀‫ ٺ̂ޘ‬50 % ͽ˯۞‫ࢫ݋‬Ҍ
33.3 %ĄΩ˘௡дௐαฉତ‫צ‬ௐ˟Ѩਔ኏Ѝ
‫ڼ‬ᒚ۞ঽˠĂдௐ˟ฉĂԼච඀‫ٺ̂ޘ‬
50 % ͽ˯۞ĂᄃΪү˘Ѩ۞௡ͧྵ˵ҫ˞
100 %Ą‫˞ז‬ௐαฉĂࢋүௐ˟Ѩਔ኏Ѝ̝
݈Ăᔵ൒Լච඀‫ ٺ̂ޘ‬50 % ͽ˯۞̪ҫ˞
100 %Ăҭߏ྿‫מז‬෸ड़‫۞ڍ‬Ѻ̶ͧ˵ߏϤ
75 % ࢫ‫ ז‬25 %ĄдઇԆௐ˟Ѩ‫ޢ‬αฉĂ˵
ಶߏ៍၅۞ௐˣฉĂԼච඀‫ ٺ̂ޘ‬50 % ۞
̪ߏ 100 %Ă‫ ̚׎‬3 Ҝঽˠ ( 75 % ) ྿‫מז‬෸
ड़‫ڍ‬Ă1 Ҝঽˠ ( 25 % ) ྿‫ז‬։рड़‫ڍ‬Ą҃఺
ᇹ۞Լචଐ‫៍ז޺ܲۡ˘ڶ‬၅ഇ۞ௐ 6 ࣎
͡ĄᓁវֽᄲĂᓜԖ۞៍၅ᄃෞҤΞͽ൴
ன‫ז‬Ă‫ڼ‬ᒚ‫׌‬ฉॡ۞ᓜԖͅᑕ౵рĂӈ " ‫מ‬
෸ " ‫ " ׶‬։р " Լච඀‫ ( ޘ‬Լච඀‫ ٺ̂ޘ‬50 %
ͽ˯ )Ăд‫ڼ‬ᒚ˘Ѩ‫˟׶‬Ѩ۞‫׌‬௡Ӯࠎ
Fig. 3
Clinical evaluation by dermatologists at the 6th
month. X-axis is the clinical results: A: Excellent,
76-100%. B: Good, 51-75%. C: Fair, 26-50%. D:
0 - 25 %.Y- axis is the percentage of the patient in
each clinical result condition. " Treat twice " group
had better clinical results than " treat once " group.
About 75 % patients reach the clinical results of
" excellent " and " good " results ( A + B ). About
100% patients treated by twice IPL reach the clinical results of "excellent" and "good" results.
100 % ( 8 / 8 )ćαฉٕ̂ࡗ˘࣎͡ॡĂᓜԖ
۞Լච඀‫ޘ‬តमĂѩॡࡶГү˘Ѩਔ኏Ѝ
ྃૻĂ‫מ " ݋‬෸ " ‫ " ׶‬։р " Լච඀‫ ( ޘ‬඀‫ޘ‬
ঽˠҋ֗۞ຏ‫צ‬ෞҤ۞ඕ‫ڍ‬дௐ 6 ࣎͡
྿‫ ז‬100 % ( 4 / 4 )Ă҃ჯ޺Լචड़‫ڍ‬Ξ྿‫ז‬
ॡĂт ( Fig. 4 )Ăໂ႕ຍ ( Extremely satis-
6 ࣎͡ĄᓜԖ۞ෞҤдௐ 6 ࣎͡ॡĂѣ 75 %
fied ) ۞ҫ 25 %Ă‫ޝ‬႕ຍ ( very satisfied ) ۞ҫ
ͽ˯۞ঽˠ྿‫מ " ז‬෸ " ‫ " ׶‬։р " Լච඀‫ޘ‬
62.5 %Ă႕ຍ ( Satisfied ) ۞ҫ12.5 %ĄΪү
( Fig. 3 )Ą
˘Ѩਔ኏Ѝ۞௡Ăໂ႕ຍ ( Extremely satis-
Table II. The percentage of patients in different response levels at different week of evaluation.
2nd week
4th week
6th week
8th week
10th week
12th week
and
6th month
No. of Tx
1
2
A
66.7% 75%
B
33.3% 25%
C
0
0
D
0
0
total 1
2 total 1
2 total 1
2 total 1
2 total 1
2 total
75% 33.3% 25% 25% 33.3% 100% 75% 0 75% 37.5% 0 75% 50% 0 75% 37.5%
25% 66.7% 75% 50% 33.3% 0 12.5% 66.7% 25% 37.5% 66.7% 25% 37.5% 33.3% 25% 37.5%
0
0
0 25% 33.3% 0 12.5% 33.7% 0 25% 33.3% 0 12.5% 66.7% 0 25%
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
A: Excellent, 76-100%. B: Good, 51-75%. C: Fair, 26-50%. D: Poor, 0-25%
63
Ӏϡਔ኏Ѝ‫ڼ‬ᒚᓚొ౟೹
ܑϯᅅ຋ͷΞͽତ‫צ‬Ăূ൭޺ᜈࡗ 1 ͇Ąఙ
̚۞ࡓ೹ӮࠎᇶॡّĂᓜԖෞҤӮࠎᅅ຋
඀‫ޘ‬Ăࡗ 1 ͇ಶঐεĄҒ৵តளଐ‫ڶ‬Ăੵ˞
ௐ 7 Ҝঽˠдௐ˟ฉෞҤॡ൴ன‫ז‬Ғ৵Ҳ˭
۞ត̼Ă‫׎‬ዶঽଈ֭൑ѩ჌ត̼Ą҃‫׎‬Ғ
৵Ҳ˭۞ត̼˵дௐ̱ฉෞҤॡঐεĄ֭
൑ঽˠயϠࠫஶ۞ঽիĄᓚ˯۞ඕৄĂࡗ
2.8 ͇ಶБొ௲ར˞Ą
੅ ኢ
౟೹۞௡ᖐঽநត̼Ă͹ࢋ۞ಶߏܑ
Fig. 4
Patients self-evaluation at the 6th month. X-axis is
the satisfied results: a: Extremely satisfied. b: Very
satisfied. c: Satisfied. d: Slightly satisfied. e: Not
satisfied. Y-axis is the percentage of the patient in
each satisfied result condition. "Treat twice" group
had better satisfied results than "treat once" group.
About 100% patients treated by twice IPL reach the
level of " extremely satisfied " and " very satisfied "
results that assessed by patients themselves.
ϩ۞โҒ৵ᆧΐ 1, 2ĄࢋӀϡ࿩ड۞Ᏼፄّ
Ѝሤ̶ྋ۞ࣧநֽ৔ᗼܑϩ۞โҒ৵Ăಶ
ࢋ҂ᇋ‫ז‬โҒ৵ٕโҒ৵̈វ۞ӛќ‫ܜگ‬
Ѝᙉ ( 351 ~ 1064nm )ĂᏴፄዋ༊۞࿩ड፟
჌ăዋ༊۞‫۞ܜگ‬࿩डăྻϡዋ༊۞ਕณ
૜‫׶ޘ‬ਔ኏ᆵͽ྾‫׎‬ϫ۞ 16Ąॲፂͽ‫ࡁ۞ـ‬
տಡӘĂӀϡ Q ฟᙯ۞‫ ܜگ‬532nm ۞⊺ฮ
Ч ࿩ ड ( Nd : YAG laser )ă ඘ ჴ Ϝ ࿩ ड
( alexandrite laser )ăٕ Q ฟᙯࡓᚗϮ࿩ड
( ruby laser ) ̏གྷਕԆБͷԣిг‫ڼ‬ᒚ౟೹3,
Ą൒҃ĂЯࠎ a ͽ˯ˬ჌ Q ฟᙯҒ৵ّ
fied ) ۞ҫ 0 %Ă‫ޝ‬႕ຍ ( very satisfied ) ۞ҫ
4, 5
66.7 %Ă႕ຍ ( Satisfied ) ۞ҫ 33.3 %Ąү‫׌‬
࿩डր௚ϡֽ‫ڼ‬ᒚֲ߷ቲҒྵஎ۞ܑϩҒ
Ѩ۞௡Ăໂ႕ຍ ( Extremely satisfied ) ۞ҫ
৵ঽիĂٙயϠ۞ఙ‫ޢ‬Ғ৵۞ត̼Ăӈఙ
50 %Ă‫ޝ‬႕ຍ ( very satisfied ) ۞ҫ 50 %Ąᓁ
‫ޢ‬Ғ৵৿εăٕ‫ۆ‬া‫ޢ‬Ғ৵Ք඾۞፟ົྵ
វֽᄲĂঽˠ႕ຍ඀‫ޘ‬д‫ޝ‬႕ຍͽ˯ࡗҫ
੼ 6, 7ć b Q ฟᙯ‫ ܜگ‬532nm ۞⊺ฮЧ࿩ड
87.5 % ( 7 / 8 )Ăү‫׌‬Ѩਔ኏Ѝ۞႕ຍ‫ͧޘ‬Ϊ
̈́ Q ฟᙯࡓᚗϮ࿩ड‫ڼ‬ᒚܑϩҒ৵ঽիົ
ү˘Ѩ۞੼ĄΩγঽˠдௐ˟ฉॡĂೀͼ
ѣܑϩ۞๋च ( ௡ᖐࢳᕯăᕇ‫ې‬΍ҕ̈́඘
Ѻ̶̝Ѻ۞ໂ႕ຍĂҭߏдௐαฉॡĂ႕
঱ ) 6Ăͷূ൭۞‫⊺ڶې‬ฮЧ࿩ड˫ྵࡓᚗ
ຍ‫ޘ‬ѣ˭໣Ąࡶֶ໰‫ڼ‬ᒚ݈‫۞ޢ‬ซՎ඀‫ޘ‬
Ϯ࿩डࠎᆖच8ćc ͽ˯ˬ჌ Q ฟᙯҒ৵࿩
‫׶‬႕ຍ‫ྵֽͧޘ‬Ăֶ໰ Wilcoxon ᑭ‫ ( ؠ‬൑ϓ
डր௚‫׎‬Ѝᕇ̂̈ ( spot size ) ఼૱ྵ̈ ( ᄃ
ᇴͷᇹώᇴ̈‫ ٺ‬30 ۞ᑭ‫ؠ‬ĂᙷҬ੨၆ t ᑭ
ਔ኏Ѝ۞ filter ͧྵ )Ă҃т‫ڍ‬౟೹۞ᇴϫ
‫) ؠ‬Ăдௐ 6 ࣎͡ॡᗁरෞҤ͞ࢬ t = 2.546,
кă̶Ҷቑಛ̂Ă‫ڼ‬ᒚ˯૱૱ົਈॡ෱
p < 0.05ć҃ঽଈҋ֗ຏ‫ ̶ొצ‬t = 10.043,
˧ĄЯࠎ˯ࢗˬᕇ Q ฟᙯҒ৵࿩डր௚۞
p < 0.005ĂӮѣ௚ࢍ˯۞ຍཌྷĄ
˘ֱ‫ڼ‬ᒚ˯۞ઘүϡ‫׶‬યᗟĂԧࣇဘྏӀ
ঽˠ၆‫ٺ‬ఙ̚۞ূ൭۞ҋᛇͅᑕĂӮ
ϡਔ኏Ѝֽ‫ڼ‬ᒚֲ߷ˠᓚ˯۞౟೹Ąਔ኏
64
เᚹϲ
Ѝ( intense pulsed light ) ۞үϡࣧநᄃ࿩ड
Weiss ඈˠ៍၅‫ז‬Ӏϡਔ኏ᆵ 2 - 4 msec
࠹ҬĂιΞͽᑕϡдੵͨ ăҕგঽի۞‫ڼ‬
۞ਔ኏Ѝ‫ڼ‬ᒚ୺ᆸโҒ৵ঽի ( poikiloder-
ᒚ
12,
ma of Civatte ) 20ĂΩγ Moreno Arias ඈˠӀ
ă‫ֱ˘׶‬โҒ৵ঽի۞‫ڼ‬ᒚ 14, 15 ඈඈк͞
ϡਔ኏ᆵ 3.8 msec Ҍ 5 msec ̝ม۞ਔ኏Ѝ
ࢬ۞়ঽĂ҃౟೹͞ࢬ۞‫ڼ‬ᒚ˵ѣజಡӘ
‫ڼ‬ᒚ୺ᆸโҒ৵௟ࡪᆧϠঽի 15Ą఺࣎ቑಛ
࿅ 15Ą
۞ਔ኏ᆵࣣрࠧ‫ ٺ‬epidermis TRT ( 3 -10
9
13
10, 11
ăਔ኏Ѝаߋఙ ( photorejuvenation )
Weiss ඈˠ៍၅‫ז‬Ӏϡ‫ ܜگ‬515nm ࿅ᕭ
msec ) ̝̰Ăܑϯሤਕх঻ܑϩ̝̰Ă‫إ‬Ϗ
ጡ ( filter )ăਕณ૜‫ ޘ‬20 - 24 J / cm2Ăͽಏ˘
ᕖ೸Ҍܑϩ̝γ ( ҃౟೹ࠎܑϩ̰۞โҒ৵
ٕᗕਔ኏ᆵ 2 - 4 msec ۞ਔ኏Ѝ‫ڼ‬ᒚ୺ᆸโ
ঽի ) 15ĄԧࣇᏴϡ۞ parametersĂಶߏॲፂ
Ғ৵ঽի ( poikiloderma of Civatte ) ۞јΑ
఺˘ֱಡӘ‫៍׶‬၅ĂᏴፄᙷҬ۞࿅ᕭጡ‫گ‬
९ּ ĄΩγ Moreno Arias ඈˠӀϡ‫ܜگ‬
‫ܜ‬ăਔ኏ᆵăਕณ૜‫ޘ‬Ăӈֹдਔ኏ᆵ۞
590nm ۞࿅ᕭጡăਕณ૜‫ ޘ‬34 J / cm2ăͽᗕ
Ᏼፄ˯࿁ࡦ˞ selective photothermolysis ۞
ਔ኏ᆵ 3.8 msec Ҍ 5 msecă‫ؼ‬Ᏽॡม20
நኢ ( ӈਔ኏ᆵ̂‫ ٺ‬melanosome ۞ TRT )Ă
msec ۞ਔ኏ЍĂ੫၆୺ᆸโҒ৵௟ࡪᆧϠ
ҭߏඕ‫ڍ‬ᄃ‫઼΁׎‬γ۞ಡӘᙷҬĂ֭൑ౄ
ঽիĂม࿣αฉ‫ڼ‬ᒚ˟Ѩ۞ಡӘĄ‫̚׎‬ѣ
јᚑࢦ۞ઘүϡĄ
20
ˬҜঽଈߏ౟೹۞ঽଈĂ‫ڼ׎‬ᒚඕ‫ڍ‬Ӯ྿
ΩγॲፂᓜԖ۞៍၅‫׶‬ಡӘ۞ඕ‫ڍ‬Ă
‫ ז‬76 % Ҍ 100 % ۞୻ੵத ( clearance ) Ąਔ
ԧࣇ൴ன‫ڼז‬ᒚ‫׌‬ฉॡ۞ᓜԖͅᑕ౵рĂ
኏ЍϡֽүЍаߋఙ ( photorejuvenation )Ă
ӈ " ‫מ‬෸ " ‫ " ׶‬։р " Լච඀‫ ( ޘ‬Լච඀‫̂ޘ‬
‫ܕ‬ѐֽѣ̙͌͛ᚥಡӘ࿅
Ą‫˘̚׎‬ቔ೩
‫ ٺ‬50 % ͽ˯ )Ăд‫ڼ‬ᒚ˘Ѩ‫˟׶‬Ѩ۞‫׌‬௡Ӯ
‫ז‬ĂӀϡ‫ ܜگ‬550nm ٕ 570nm ۞࿅ᕭጡă
ࠎ 100 % ( 8 / 8 )ćαฉٕ̂ࡗ˘࣎͡ॡĂᓜ
ਕ ณ ૜ ‫ ޘ‬28 ‫ ז‬32 J / cm ă ‫ ؼ‬Ᏽ ॡ ม
Ԗ۞Լච඀‫ޘ‬តमĂѩॡࡶГү˘Ѩਔ኏
20.0 / 40.0 msec ۞ਔ኏ЍĂ੫၆ֲ߷ˠ۞ϩ
ЍྃૻĂ‫מ " ݋‬෸ " ‫ " ׶‬։р " Լච඀‫ޘ‬྿‫ז‬
ቲઇЍаߋఙ҃โҒ৵ঽիព඾Լච۞ඕ
100 % ( 4 / 4 )Ă҃ჯ޺Լචड़‫ڍ‬Ξ྿‫̱࣎ז‬
‫ ڍ‬12Ą‫׎‬ඕ‫ڍ‬ពϯĂд 97 Ҝତ‫ڼצ‬ᒚ۞ঽ
͡ĄҬͼд‫׌‬ฉνΠঽˠಶ྿‫ޝז‬р۞ड़
ଈĂᓜԖᄃঽˠҋ֗۞ෞҤѣ 90 % ͽ˯۞ "
‫ ( ڍ‬Table II )Ăҭߏдఙ‫ޢ‬αฉٕࡗ˘࣎͡
‫מ‬෸ " ‫ " ׶‬։р " Լචड़‫ڍ‬Ąॲፂ఺˘ֱಡ
۞ॡ࣏ѣೇ൴‫׶‬ᅅ຋۞ГโҒ৵̼ٕͅโ
ӘĂԧࣇనࢍ۞ࡁտߏ੫၆ֲ߷ˠ۞ϩ
( repigmentation ) ۞ன෪ĂҭߏགྷϤௐ˟Ѩ
ቲĂϩቲᙷ‫ݭ‬ௐˬҌ̣‫۞ݭ‬ঽˠĂϡਔ኏
۞ਔ኏Ѝ‫ڼ‬ᒚĂ‫׎‬Լචड़‫׶ڍ‬႕ຍ‫ޘ‬Ӯ೩
Ѝֽ‫ڼ‬ᒚ‫׎‬ᓚ˯۞౟೹ঽիĄԧࣇᏴፄ‫گ‬
੼֭Ξͽჯ޺̱࣎͡νΠĄ‫׌‬Ѩਔ኏Ѝ‫ڼ‬
‫ ܜ‬550 Ҍ 590nm ۞࿅ᕭጡĂਕณ૜‫ ޘ‬25 Ҍ
ᒚ۞ड़‫˘ྵڍ‬Ѩ‫ڼ‬ᒚ۞ड़‫ڍ‬рĂ҃ͷჯ޺
35 J / cm Ăಏ˘ਔ኏Ăਔ኏ᆵ 4.0 msec ۞ਔ
۞ॡม˵ྵ˳ ( Fig. 3 & 4 )Ąலౣ౟೹ߏ˘
኏Ѝֽ‫ڼ‬ᒚĄॲፂԧࣇ۞ඕ‫ڍ‬ĂᓜԖ۞ෞ
჌छ୉᏷็ّăᄃ͟Ѝᘉខѣᙯ۞ϩቲ
Ҥѣ 75 % ͽ˯۞ঽˠ྿‫מ " ז‬෸ " ‫ " ׶‬։р "
ঽĂఙ‫֨۞ޢ‬ខନ߉ેҖ۞ᚑॾᄃӎĂᄃ
Լච඀‫ ( ޘ‬Fig. 3 )ć҃ঽˠҋ֗۞ෞҤĂঽ
ೇ൴۞ԣၙ‫׶‬ᚑࢦ඀‫ޘ‬ѣ૜̷࠹ᙯĄ
15
12, 13
2
2
ˠ႕ຍ඀‫ޘ‬д‫ޝ‬႕ຍͽ˯ࡗҫ 87.5 %Ą఺
ᇹ۞ඕ‫઼׶ڍ‬γ۞ಡӘ‫ޝ‬ତ‫ܕ‬Ą
65
Ӏϡਔ኏Ѝ‫ڼ‬ᒚֲ߷ˠโҒ৵೹۞Ω
˘࣎૱֍۞યᗟĂಶߏఙ‫ޢ‬Ғ৵۞ត̼Ă
Ӏϡਔ኏Ѝ‫ڼ‬ᒚᓚొ౟೹
ӈఙ‫ޢ‬Ғ৵৿ε ( post - therapy hypo-pigmen-
35 J / cm2 Ăಏ˘ਔ኏Ăਔ኏ᆵ 4.0 msec ۞ਔ
tation )ăٕ‫ۆ‬া‫ޢ‬Ғ৵Ք඾ ( post - inflamma-
኏Ѝֽ‫ڼ‬ᒚĂߊщБ˫ѣड़ĄЯࠎఙ݈̙
tory hyperpigmentation ) ۞ன෪ Ą˘ਠ࿩ड
ᅮࢋܑࢬ౫ዕăఙ‫ޭޢ‬ೇԣăઘүϡ͌ă
۞‫ڼ‬ᒚĂ‫ۆ‬া‫ޢ‬Ғ৵Ք඾౵૱൴Ϡдϩቲ
ड़‫ڍ‬΍ன۞ѝă˫ѣྵ̂۞Ѝᕇ̂̈ ( spot
ௐˬٕα‫ ( ݭ‬skin phototypes III or IV ) ͽ
size ) ‫׶‬ΞՀೱ̙Т̂̈۞࿅ᕭጡଣᐝĂٙ
˯ă̈́ខ๋۞ঽˠ Ąॲፂԧࣇ۞ࡁտĂҒ
ͽΞͽྵԣăྵѣड़த۞‫ڼ‬ᒚ̂ቑಛ۞౟
৵តளଐ‫ڶ‬Ăੵ˞ௐˣҜঽˠдௐ˟ฉෞ
೹Ą҃Тᇹቑಛ۞ਕณ૜‫ޘ‬ăТᇹ‫۞ܜگ‬
Ҥॡ൴ன‫ז‬Ғ৵Ҳ˭۞ត̼Ă‫׎‬ዶঽଈ֭
࿅ᕭጡă‫׶‬ତ‫ܕ‬ቑಛ۞ਔ኏ᆵ˵Ξͽ༊ү
൑ѩ჌ត̼Ą҃‫׎‬Ғ৵Ҳ˭۞ត̼˵дௐ
Ѝаߋఙֽ‫ڼ‬ᒚćд‫ڼ‬ᒚ౟೹۞ТॡĂ˵
̱ฉෞҤॡঐεĄ‫͛۞΁׎‬ᚥಡӘ˵ព
Ξͽ྿‫ז‬Լච௟৳ă຋௟ҕგᕖૺăϩቲ
ϯĂдϡਔ኏ЍүЍаߋఙ۞ 97 Ҝֲ߷ঽ
π໣‫ޘ‬ă͉ͨ͋̂ඈаߋ۞ड़‫ ڍ‬12, 13Ąٙͽ
ˠ۞ಡӘ‫׶‬Ҙ঱Ͱ۞ 3 Ҝϡਔ኏Ѝ‫ڼ‬ᒚ౟೹
ඕኢߏĂਔ኏Ѝ̙εࠎ˘჌ԣిăщБă
۞ঽˠ̚Ă֭൑៍၅‫ז‬Ғ৵តள۞ઘүϡ
13,
ઘүϡ͌ă႕ຍ‫˫੼ޘ‬ѣड़۞͞ёĂϡֽ
ĄΩγఙ̚ূ൭ăఙ‫ޢ‬ᇶॡّࡓ೹ăఙ‫ޢ‬
‫ڼ‬ᒚֲ߷ˠᓚ˯౟೹Ą҃ᄃ‫΁׎‬Νੵโ೹
ຏߖă‫ࠫ׶‬ஶĂдԧࣇ۞࣎९̚˵֭՟ѣ
۞࿩डͧྵĂ‫غז‬૖ᐹ૖КĂ̪ᅮࢋซ˘
൴னĄ҃ঽˠତ‫ڼצ‬ᒚ‫ޢ‬ĂඕৄҌԆБ௲
Վ۞ᓜԖᐌ፟၆໰௡۞၁រֽᙋ‫ځ‬Ą
22
25
15
རࡗ 2 Ҍ 3 ͇Ăఙ‫ޭ۞ޢ‬ೇͧྵԣĄᔵ൒֭
՟ѣͧྵ۞ࡁտ͛ᚥಡӘĂಶᓜԖ۞៍
၅Ă఺ͧ˘ਠ࿩ड‫ڼ‬ᒚโҒ৵೹۞ઘүϡ
͌ădown time ྵൺăޭೇԣăͷঽଈତ‫צ‬
‫ָޘ‬Ą˘ਠ࿩डᄃਔ኏Ѝ۞मҾĂ͹ࢋ۞
ಶߏ‫۞ܜگ‬ԛёĂಏ˘‫ܜگ‬ᄃᆵ‫ܜگ‬ᙉր
( broad spectrum )Ą҃โҒ৵̈វٕโҒ৵
၆‫ٺ‬ಏ˘‫˘ ( ܜگ‬ਠ࿩ड ) ٕᆵ‫ܜگ‬ᙉր
( ਔ኏Ѝ ) ۞ӛќ඀‫ߏޘ‬ӎ̙ТĂౄјᏴፄ
ّЍሤ̶ྋड़ᑕ۞̙Т˵̙ቁ‫ؠ‬Ă͛ᚥ˯
˵՟ѣ఺͞ࢬ۞ଣ੅ćҭಶԧࣇ۞ࡁտ‫׶‬
ᓜԖ៍၅҃֏ĂԧࣇဘྏΝଯീĂҬͼਔ
኏Ѝѣྵр۞โҒ৵ਕณӛќĂ҃ͷᏴፄ
ّЍሤ̶ྋड़ᑕྵрĂٙͽౄј౟೹ঐε
ԣădown time ൺăޭೇԣăͷઘүϡྵ
͌Ąቁ‫۞ؠ‬፟ᖼᄃநኢૄᖂ̪‫ޞ‬ซ˘Վ۞
ࡁտĄ
ፋវֽᄲĂਔ኏Ѝϡֽ‫ڼ‬ᒚֲ߷ˠĂ
ϩቲᙷ‫ݭ‬ௐˬăαặ‫۞ݭ‬౟೹ĂᏴፄ‫گ‬
‫ ܜ‬550 Ҍ 590nm ۞࿅ᕭጡĂਕณ૜‫ ޘ‬25 Ҍ
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