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<span style="font-family:新細明體;color:gray;">問： 宋 醫師你好</span><span style="color:gray;" lang="EN-US">~</span><span style="font-family:新細明體;color:gray;">我是伊美的學員</span><span style="color:gray;" lang="EN-US">~</span><span style="font-family:新細明體;color:gray;">昨天聽你與護理長的課後</span><span style="color:gray;" lang="EN-US">~</span><span style="font-family:新細明體;color:gray;">有些小小疑問</span><span style="color:gray;" lang="EN-US">~</span><p></p> <p class="a" style="margin:0pt 0pt 8.55pt 24pt;text-indent:-24pt;"><!--[if !supportLists]--><span style="font-family:Wingdings;color:gray;" lang="EN-US"><span style="">l<span style="font-style:normal;font-variant:normal;font-weight:normal;font-size:7pt;line-height:normal;font-size-adjust:none;font-stretch:normal;"> </span></span></span><!--[endif]--><span style="font-family:新細明體;color:gray;">針對「以雷射退紅」</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">這句話</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">本人覺得相當不可思議</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">因為日前我接受八億柔膚雷射的</span><span style="color:gray;" lang="EN-US">DEMO...</span><span style="font-family:新細明體;color:gray;">臉簡直像被炸彈炸到般的紅（我是敏感性膚質）</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">為何貴診所的機器有如此神效？</span><span style="color:gray;" lang="EN-US"></span></p> <p class="a" style="margin:0pt 0pt 8.55pt 24pt;text-indent:-24pt;"><!--[if !supportLists]--><span style="font-family:Wingdings;color:gray;" lang="EN-US"><span style="">l<span style="font-style:normal;font-variant:normal;font-weight:normal;font-size:7pt;line-height:normal;font-size-adjust:none;font-stretch:normal;"> </span></span></span><!--[endif]--><span style="font-family:新細明體;color:gray;">一般觀念針對較深的斑會使用</span><span style="color:gray;" lang="EN-US">1064</span><span style="font-family:新細明體;color:gray;">？對較淺的斑我會建議客人打脈衝光</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">讓臉斑點處局部結痂後脫落</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">我看到貴診所都是採：柔性的換膚處理斑點問題</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">但一般複合式果酸、胜肽酸、杏仁酸對斑點的效果</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">我覺得</span><span style="color:gray;" lang="EN-US">SOSO</span><span style="font-family:新細明體;color:gray;">耶</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">究竟貴診所用的換膚</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">有何不同點呢？</span><span style="color:gray;" lang="EN-US"></span></p> <p class="a" style="margin:0pt 0pt 8.55pt 24pt;text-indent:-24pt;"><!--[if !supportLists]--><span style="font-family:Wingdings;color:gray;" lang="EN-US"><span style="">l<span style="font-style:normal;font-variant:normal;font-weight:normal;font-size:7pt;line-height:normal;font-size-adjust:none;font-stretch:normal;"> </span></span></span><!--[endif]--><span style="font-family:新細明體;color:gray;">我以前的老大（</span><span style="color:gray;" lang="EN-US">@@</span><span style="font-family:新細明體;color:gray;">醫師）都認為客人自己洗臉會比較乾淨</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">我個人也認為自己洗臉比較乾淨</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">但現在基於服務周到的立場</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">（目前在別間診所）</span><span style="color:gray;" lang="EN-US">…</span><span style="font-family:新細明體;color:gray;">還是會幫客人洗</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">不知 宋 醫師的看法？</span><span style="color:gray;" lang="EN-US"></span></p> <p class="a" style="margin:0pt 0pt 8.55pt 24pt;text-indent:-24pt;"><!--[if !supportLists]--><span style="font-family:Wingdings;color:gray;" lang="EN-US"><span style="">l<span style="font-style:normal;font-variant:normal;font-weight:normal;font-size:7pt;line-height:normal;font-size-adjust:none;font-stretch:normal;"> </span></span></span><!--[endif]--><span style="font-family:新細明體;color:gray;">你說清粉刺</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">先在毛孔上灌水</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">粉刺就會浮出</span><span style="color:gray;" lang="EN-US">~</span><span style="font-family:新細明體;color:gray;">這個原理我十分贊同</span><span style="color:gray;" lang="EN-US">~</span><span style="font-family:新細明體;color:gray;">所以清粉刺前要先幫客人導入或敷面膜嗎？打柔膚雷射後粉刺也會有浮出的現象</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">你覺得要清嗎？還是等他自己代謝？</span><span style="color:gray;" lang="EN-US"></span></p> <p class="a" style="margin:0pt 0pt 8.55pt 24pt;text-indent:-24pt;"><!--[if !supportLists]--><span style="font-family:Wingdings;color:gray;" lang="EN-US"><span style="">l<span style="font-style:normal;font-variant:normal;font-weight:normal;font-size:7pt;line-height:normal;font-size-adjust:none;font-stretch:normal;"> </span></span></span><!--[endif]--><span style="font-family:新細明體;color:gray;">你說貴診所沒有</span><span style="color:gray;" lang="EN-US">IV</span><span style="font-family:新細明體;color:gray;">和</span><span style="color:gray;" lang="EN-US">IM...</span><span style="font-family:新細明體;color:gray;">那為何貴診所的員工一定要是護理師或護士呢？美容師做的美容及服務不是比較好嗎？</span><span style="color:gray;" lang="EN-US"></span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;color:gray;">對不起問題有點怪</span><span style="color:gray;" lang="EN-US">~~^^</span><span style="font-family:新細明體;color:gray;">我是希望知道醫生的看法</span><span style="color:gray;" lang="EN-US">~</span><span style="font-family:新細明體;color:gray;">有助於將來我的轉職</span><span style="color:gray;" lang="EN-US">~</span><span style="font-family:新細明體;color:gray;">哈哈</span><span style="color:gray;" lang="EN-US">~</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;color:gray;">感謝回答喔</span><span style="color:gray;" lang="EN-US">^^</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;color:gray;">一間小診所的醫學美容師敬上</span><span style="color:gray;" lang="EN-US"></span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">答：「<span style="color:gray;">為何貴診所的機器有如此神效？</span>」</span><span lang="EN-US">=></span><span style="font-family:新細明體;">這與「機器」無關，<span style="color:fuchsia;">與「治療手法」有關</span>。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">您的問題可以分成二個方向討論：</span></p> <p class="a" style="margin:0pt 0pt 8.55pt 24pt;text-indent:-24pt;"><!--[if !supportLists]--><span style="font-family:Wingdings;" lang="EN-US"><span style="">l<span style="font-style:normal;font-variant:normal;font-weight:normal;font-size:7pt;line-height:normal;font-size-adjust:none;font-stretch:normal;"> </span></span></span><!--[endif]--><span style="font-family:新細明體;color:fuchsia;">也許您的肌膚根本就不適合「立即」執行雷射治療</span><span lang="EN-US">—</span><span style="font-family:新細明體;">這就是我課堂上說的「<span style="color:fuchsia;">治療前應該先評估</span>」。</span></p> <p class="a" style="margin:0pt 0pt 8.55pt 24pt;text-indent:-24pt;"><!--[if !supportLists]--><span style="font-family:Wingdings;" lang="EN-US"><span style="">l<span style="font-style:normal;font-variant:normal;font-weight:normal;font-size:7pt;line-height:normal;font-size-adjust:none;font-stretch:normal;"> </span></span></span><!--[endif]--><span style="font-family:新細明體;color:fuchsia;">該操作人員的技巧不好</span><span lang="EN-US">—</span><span style="font-family:新細明體;">這個部份，請恕我「不再吹噓」了</span><span lang="EN-US">…</span><span style="font-family:新細明體;">詳情請自行參照關鍵字「</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/searchblog?p=%E9%9B%B7%E5%B0%84+%E8%A4%AA%E7%B4%85&my=1"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">雷射褪紅</span></span></a></span><span style="font-family:新細明體;">」。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">「<span style="color:gray;">一般觀念針對較深的斑會使用</span></span><span style="color:gray;" lang="EN-US">1064</span><span style="font-family:新細明體;color:gray;">？對較淺的斑我會建議客人打脈衝光</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">讓臉斑點處局部結痂後脫落</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;">」</span><span lang="EN-US">=></span><span style="font-family:新細明體;">您的「<span style="color:gray;">一般觀念</span>」不知道依據是什麼？極緻對於</span><span lang="EN-US">1064</span><span style="font-family:新細明體;">奈米的經驗是「<span style="color:fuchsia;">相對</span>深部，但有相當去角質作用；如果過度使用可能導致脫色斑出現」。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">至於脈衝光的部分，我們放棄脈衝光已經三年多了（</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/article?mid=1802"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">「</span></span><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">悲壯</span></span><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">」的脈衝光</span></span><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">：</span></span><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">極緻皮膚科選擇讓它走入歷史</span></span>...</a></span><span style="font-family:新細明體;">）</span><span lang="EN-US">…</span><span style="font-family:新細明體;">這是為了<span style="color:fuchsia;">治療安全</span>與<span style="color:fuchsia;">可控性</span>的問題。也許其它脈衝光高手會有不同意見，但是<span style="color:fuchsia;">對我來說</span>，使用</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/searchblog?p=%E9%9D%9A%E9%A1%8F%E5%85%89&my=1"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">靚顏光</span></span></a></span><span style="font-family:新細明體;">（淨膚雷射的特殊手法）比脈衝光安全又有效。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">「<span style="color:gray;">我看到貴診所都是採：柔性的換膚處理斑點問題</span></span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">但一般複合式果酸胜肽酸杏仁酸對斑點的效果</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">我覺得</span><span style="color:gray;" lang="EN-US">SOSO</span><span style="font-family:新細明體;color:gray;">耶</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">究竟貴診所用的換膚</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">有何不同點呢？</span><span style="font-family:新細明體;">」</span><span lang="EN-US">=></span><span style="font-family:新細明體;color:fuchsia;">您可能誤會了</span><span lang="EN-US">…</span><span style="font-family:新細明體;">極緻的</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/searchblog?p=%E9%9D%9A%E9%A1%8F%E5%85%89&my=1"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">靚顏光</span></span></a></span><span style="font-family:新細明體;">是非常有名的治療，我們<span style="color:fuchsia;">並不僅僅</span>使用柔性換膚處理斑點。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">對於斑點，極緻的態度是「<span style="color:fuchsia;">先詳細評估</span>，再決定使用</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/searchblog?p=%E9%9D%9A%E9%A1%8F%E5%85%89&my=1"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">靚顏光</span></span></a></span><span style="font-family:新細明體;">、微飛梭、煥膚、微晶</span><span lang="EN-US">/</span><span style="font-family:新細明體;">鑽石磨皮...或者只建議瑞昇療程」。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;color:fuchsia;">我們的治療方式非常多元</span><span lang="EN-US">—</span><span style="font-family:新細明體;">這是醫療的本質</span><span lang="EN-US">—</span><span style="font-family:新細明體;">但是前提都是「<span style="color:fuchsia;">先詳細評估</span>」。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">「<span style="color:gray;">我以前的老大</span></span><span style="color:gray;" lang="EN-US">…</span><span style="font-family:新細明體;color:gray;">客人自己洗臉會比較乾淨</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">我個人也認為自己洗臉比較乾淨</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">但現在基於服務周到的立場</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">目前在別間診所</span><span style="color:gray;" lang="EN-US">…</span><span style="font-family:新細明體;color:gray;">還是會幫客人洗</span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">不知 宋 醫師的看法？</span><span style="font-family:新細明體;">」</span><span lang="EN-US">=></span><span style="font-family:新細明體;">對於這樣的問題，我其實沒有什麼預設立場。極緻對於清潔的態度一向是「<span style="color:fuchsia;">誰洗臉並不重要，重要的是要乾淨，又要安全</span>」。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">極緻對於來客有二種洗臉「方式」：如果是來極緻看診的病患，基於「觀察與教育」的目的，我們會請一位護理美容師全程觀看客戶自行洗臉，並予以相關衛教。如果是在極緻接受任何醫學</span><span lang="EN-US">/</span><span style="font-family:新細明體;">美容治療的受術者，我們會請護理美容師幫他清潔</span><span lang="EN-US">—</span><span style="font-family:新細明體;">這個目的是「<span style="color:fuchsia;">確保清潔的強度適當，不會干擾後續治療的結果</span>」；終究過度的清潔可能造成不必要的傷害，清潔不足則可能使治療效果打折。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">無論如何，我們的思考始終圍繞於醫療，與「<span style="color:gray;">基於服務周到的立場</span>」是不相關的。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">請詳見</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/article?mid=6065"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">主題：關於洗臉的簡單回答</span></span></a></span><span style="font-family:新細明體;">、</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/article?mid=5016"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">主題：如何正確洗臉</span></span></a></span><span style="font-family:新細明體;">、</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/article?mid=281"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">如何正確洗臉</span></span>—<span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">從一則禪宗公案談起</span></span></a></span><span style="font-family:新細明體;">、</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/article?mid=5620"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">主題：再談「正確洗臉」</span></span>—<span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">再次提出「完全洗臉」的更新版本</span></span></a></span><span style="font-family:新細明體;">。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">「<span style="color:gray;">清粉刺前要先幫客人導入或敷面膜嗎？</span>」</span><span lang="EN-US">=></span><span style="font-family:新細明體;color:fuchsia;">可以</span><span style="font-family:新細明體;">這樣做。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">「<span style="color:gray;">打柔膚雷射後粉刺也會有浮出的現象</span></span><span style="color:gray;" lang="EN-US">...</span><span style="font-family:新細明體;color:gray;">你覺得要清嗎？還是等他自己代謝？</span><span style="font-family:新細明體;">」</span><span lang="EN-US">=></span><span style="font-family:新細明體;color:fuchsia;">這個部份應該由您的醫師決定</span><span style="font-family:新細明體;">。每位醫師都有自己的治療習慣，與醫學生理</span><span lang="EN-US">/</span><span style="font-family:新細明體;">病理</span><span lang="EN-US">/</span><span style="font-family:新細明體;">解剖等觀念息息相關，我不應該給您建議。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">如果是極緻的受術者，因為我們術前一定經過了多次的檢測與準備</span><span lang="EN-US">—</span><span style="font-family:新細明體;">包括</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/article?mid=1815"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">瑞昇</span></span>PGA<span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">的敷面行為</span></span></a></span><span style="font-family:新細明體;">等</span><span lang="EN-US">—</span><span style="font-family:新細明體;">以確保雷射治療的安全。在角質柔軟與</span><span lang="EN-US"><a href="http://tw.myblog.yahoo.com/doctor-skin123/searchblog?p=%E9%85%B8%E6%80%A7%E4%BF%9D%E8%AD%B7%E8%86%9C&my=1"><span style="font-family:新細明體;" lang="EN-US"><span lang="EN-US">酸性保護膜</span></span></a></span><span style="font-family:新細明體;">初步完整的前提下，目前很少發生「<span style="color:gray;">雷射後粉刺也會有浮出的現象</span>」。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">「<span style="color:gray;">你說貴診所沒有</span></span><span style="color:gray;" lang="EN-US">IV</span><span style="font-family:新細明體;color:gray;">和</span><span style="color:gray;" lang="EN-US">IM...</span><span style="font-family:新細明體;color:gray;">那為何貴診所的員工一定要是護理師或護士呢？美容師做的美容及服務不是比較好嗎？</span><span style="font-family:新細明體;">」</span><span lang="EN-US">=></span><span style="font-family:新細明體;">這部份是我個人領導與管理能力的問題</span><span lang="EN-US">—</span><span style="font-family:新細明體;">我不知道如何與美容師</span><span lang="EN-US">/</span><span style="font-family:新細明體;">護理美容師共同工作。身為醫師，我與護理人員共同工作的經驗比較多，與美容師的共同工作經驗較少；但是在幾次交叉工作（三者同時存在一個機構中）的經驗中，我發現自己沒有處理這種錯縱複雜關係的能力。</span></p> <p class="a" style="margin-bottom:8.55pt;"><span style="font-family:新細明體;">這單純是個人的能力問題，與工作職務設計無關。</span></p> </div>
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