模块一 · 理论Module 1 · Theory
皮肤结构与功能Skin Structure & Function
Skin Structure & Function皮肤结构与功能
对应单元 SHBBSSC001
将皮肤结构与功能的知识融入美容疗法 Unit SHBBSSC001
Incorporate knowledge of skin structure and functions into beauty therapy
将皮肤结构与功能的知识融入美容疗法 Unit SHBBSSC001
Incorporate knowledge of skin structure and functions into beauty therapy
学习目标Learning Outcomes
Learning Outcomes学习目标
完成本模块后，你应该能够：By the end of this module you will be able to:
- 说出皮肤三大层的名称、位置与主要功能Name the three layers of skin, where they sit and what they do
- 描述表皮五层的排列顺序与角质更新周期Describe the five epidermal layers and the cell renewal cycle
- 辨认表皮中四种主要细胞及其作用Identify the four key cells of the epidermis and their roles
- 解释胶原蛋白与弹力蛋白在皮肤老化中的角色Explain the role of collagen and elastin in skin ageing
- 说明酸性保护膜的作用及被破坏后的后果Explain the acid mantle and what happens when it is damaged
- 区分皮肤「类型」与皮肤「状态」Distinguish a skin type from a skin condition
- 使用 Fitzpatrick 分型评估客户的紫外线反应Use the Fitzpatrick scale to assess a client's UV response
- 识别常见禁忌症并判断何时应转介医生Recognise contraindications and know when to refer to a doctor
第一部分 · 皮肤的整体结构Part One · The Structure of Skin
The Structure of Skin皮肤的整体结构
1.1 皮肤三大层1.1 The three layers
皮肤是人体最大的器官，成人皮肤总面积约 1.5–2 平方米，重量约占体重的 15%。它由外到内分为三层。 Skin is the body's largest organ — roughly 1.5–2 m² in an adult and about 15% of body weight. It has three layers, from the outside in.
| 层次Layer | 英文中文 | 主要特点Key features |
|---|---|---|
| 表皮Epidermis | Epidermis表皮 | 最外层，无血管，负责屏障与肤色；美白、去角质类项目作用于此Outermost, no blood supply. Barrier and skin colour. Where peels and exfoliation work. |
| 真皮Dermis | Dermis真皮 | 含胶原蛋白、弹力蛋白、血管、神经；HIFU、射频微针、激光的目标层Collagen, elastin, blood vessels, nerves. The target layer for HIFU, RF microneedling and laser. |
| 皮下组织Hypodermis | Hypodermis皮下组织 | 脂肪与结缔组织，负责保温、缓冲、储能，决定面部饱满度Fat and connective tissue. Insulation, cushioning, energy store, facial volume. |
1.2 表皮的五层结构1.2 The five layers of the epidermis
表皮不断更新：细胞在基底层诞生，一路向上推移、逐渐角化，最后在角质层脱落。这个过程称为「角化」。 Cells are born in the basal layer, travel upward, keratinise, and shed from the corneum. This process is called keratinisation.
| 由外到内Outside in | English中文 | 功能Function |
|---|---|---|
| 角质层Stratum corneum | Stratum corneum角质层 | 已死亡的角化细胞，皮肤最重要的屏障；果酸、磨砂作用于此Dead keratinised cells. The main barrier. Acids and scrubs act here. |
| 透明层Stratum lucidum | Stratum lucidum透明层 | 仅存在于手掌与脚底，提供额外保护Palms and soles only. Extra protection. |
| 颗粒层Stratum granulosum | Stratum granulosum颗粒层 | 细胞开始死亡并释放脂质，形成防水层Cells begin to die and release lipids, forming the waterproofing layer. |
| 棘层Stratum spinosum | Stratum spinosum棘层 | 最厚的一层，含朗格汉斯细胞，负责免疫防御Thickest layer. Holds Langerhans cells for immune defence. |
| 基底层Stratum basale | Stratum basale基底层 | 唯一能分裂的一层；含黑色素细胞，新细胞由此诞生The only dividing layer. Holds melanocytes. All new cells start here. |
重点 Key point
健康成人的角质更新周期约为 28 天。随年龄增长会延长至 40–60 天 — 这是熟龄肌暗沉、粗糙的主要原因，也是去角质与刷酸类项目的理论依据。
The renewal cycle is about 28 days in a healthy adult, slowing to 40–60 days with age. That slowdown is why mature skin looks dull and rough, and it is the reason exfoliation works.
1.3 表皮中的四种主要细胞1.3 Four key cells of the epidermis
| 细胞Cell | English中文 | 作用Role |
|---|---|---|
| 角质形成细胞Keratinocyte | Keratinocyte角质形成细胞 | 占表皮细胞约 90%，生成角蛋白，构成屏障About 90% of epidermal cells. Produces keratin and forms the barrier. |
| 黑色素细胞Melanocyte | Melanocyte黑色素细胞 | 位于基底层，生成黑色素，决定肤色并吸收紫外线保护 DNASits in the basal layer. Makes melanin, which sets skin colour and absorbs UV to protect DNA. |
| 朗格汉斯细胞Langerhans cell | Langerhans cell朗格汉斯细胞 | 免疫细胞，识别外来病原并启动免疫反应Immune cell. Detects pathogens and triggers the immune response. |
| 默克尔细胞Merkel cell | Merkel cell默克尔细胞 | 触觉感受器，负责轻触觉Touch receptor. Responsible for light touch. |
临床关联 In the clinic
所有人的黑色素细胞数量其实差不多，肤色差异来自黑色素的产量与类型，而不是细胞数量。这解释了为什么深肤色客户做激光更容易出现色沉 — 不是细胞更多，而是更活跃、更易被刺激。
Everyone has roughly the same number of melanocytes. Skin colour comes from how much melanin they make and which type, not how many cells there are. That is why darker skin pigments more readily after laser — the cells are more reactive, not more numerous.
1.4 真皮层1.4 The dermis
真皮是皮肤的支撑结构，也是所有抗衰治疗真正的目标层。它分为乳头层（上层，含毛细血管，负责营养输送）与网状层（下层，含大量胶原与弹力纤维）。 The dermis is the skin's support structure and the real target of every anti-ageing treatment. It has a papillary layer on top, carrying capillaries and nutrients, and a reticular layer below, packed with collagen and elastin.
| 成分Component | English中文 | 作用Role |
|---|---|---|
| 胶原蛋白Collagen | Collagen胶原蛋白 | 占真皮约 70%，提供支撑力与紧致度；流失即产生松弛与皱纹About 70% of the dermis. Gives support and firmness. Losing it means laxity and lines. |
| 弹力蛋白Elastin | Elastin弹力蛋白 | 提供回弹力；受损后皮肤失去「弹回」的能力Gives recoil. Once damaged, skin no longer springs back. |
| 成纤维细胞Fibroblast | Fibroblast成纤维细胞 | 生产胶原与弹力蛋白的工厂；HIFU 与射频微针即通过刺激它发挥作用The factory that makes collagen and elastin. HIFU and RF microneedling work by stimulating it. |
| 基质／透明质酸Ground substance | Ground substance / HA基质／透明质酸 | 填充纤维之间，锁水保湿，决定皮肤饱满度Fills the space between fibres, holds water, sets plumpness. |
临床关联 In the clinic
HIFU 将超声能量聚焦于 SMAS 筋膜层与真皮深层，通过可控热损伤刺激成纤维细胞启动新生胶原。这就是为什么效果不是立刻出现，而是在 2–3 个月内逐步显现 — 咨询时一定要把这点讲清楚，否则客户会失望。
HIFU focuses ultrasound energy on the SMAS and deep dermis, using controlled thermal injury to make fibroblasts build new collagen. That is why results appear over 2–3 months rather than immediately — say this clearly at consultation or the client will be disappointed.
1.5 皮肤附属器1.5 Skin appendages
| 附属器Appendage | English中文 | 功能与临床意义Function and relevance |
|---|---|---|
| 皮脂腺Sebaceous gland | Sebaceous gland皮脂腺 | 开口于毛囊，分泌皮脂润滑皮肤；分泌过多＋角化异常＝粉刺、痤疮Opens into the hair follicle and secretes sebum. Excess sebum plus abnormal keratinisation equals congestion and acne. |
| 小汗腺Eccrine gland | Eccrine gland小汗腺 | 遍布全身，分泌汗液调节体温，参与形成酸性保护膜All over the body. Sweat for temperature control, and part of the acid mantle. |
| 大汗腺Apocrine gland | Apocrine gland大汗腺 | 集中于腋下、腹股沟，青春期后活跃，与体味相关Underarms and groin. Active after puberty and linked to body odour. |
| 毛囊Hair follicle | Hair follicle毛囊 | 毛发生长处；脱毛与激光脱毛作用于此Where hair grows. The target of waxing and laser hair reduction. |
第二部分 · 皮肤的七大功能Part Two · What Skin Does
What Skin Does皮肤的七大功能
记忆口诀 SHAPES：Sensation, Heat regulation, Absorption, Protection, Excretion, Secretion，再加上维生素 D 合成。 Remember SHAPES: Sensation, Heat regulation, Absorption, Protection, Excretion, Secretion — plus vitamin D synthesis.
| 功能Function | English中文 | 说明Detail |
|---|---|---|
| 保护Protection | Protection保护 | 抵御细菌、紫外线、化学物质与机械损伤Defends against bacteria, UV, chemicals and physical damage. |
| 感觉Sensation | Sensation感觉 | 感知触、痛、温、压；治疗中客户的反馈依赖于此Touch, pain, temperature, pressure. Client feedback during treatment depends on it. |
| 体温调节Heat regulation | Heat regulation体温调节 | 通过出汗与血管收缩／扩张维持体温Sweating and vessel constriction or dilation maintain body temperature. |
| 分泌Secretion | Secretion分泌 | 分泌皮脂，润滑并形成保护膜Sebum lubricates and forms part of the protective film. |
| 排泄Excretion | Excretion排泄 | 通过汗液排出水分、盐分与少量废物Water, salts and small amounts of waste leave through sweat. |
| 吸收Absorption | Absorption吸收 | 可吸收部分小分子成分 — 这是所有护肤品有效的前提Small molecules can pass through. This is why skincare works at all. |
| 合成维生素 DVitamin D | Vitamin D synthesis合成维生素 D | 阳光照射下由皮肤合成，参与钙吸收Made in the skin under sunlight and needed for calcium absorption. |
第三部分 · 酸性保护膜与皮肤屏障Part Three · The Acid Mantle
The Acid Mantle & Skin Barrier酸性保护膜与皮肤屏障
皮脂与汗液在皮肤表面混合，形成一层弱酸性薄膜，称为酸性保护膜。 Sebum and sweat mix on the surface to form a slightly acidic film called the acid mantle.
- 健康 pH 值：4.5 – 5.5（弱酸性）Healthy pH: 4.5 – 5.5, slightly acidic
- 作用：抑制有害细菌繁殖、维持屏障完整、锁住水分Job: holds back harmful bacteria, keeps the barrier intact, holds water in
- 破坏因素：过度清洁、碱性皂、过度去角质、频繁刷酸、热水洗脸Damaged by: over-cleansing, alkaline soap, over-exfoliation, frequent acids, hot water
- 破坏后果：泛红、刺痛、干燥脱屑、敏感、易长痘Result: redness, stinging, flaking, sensitivity, breakouts
临床关联 In the clinic
很多客户自述「敏感肌」，其实是屏障受损，属于可修复的状态而非天生肤质。第一步永远是停止刺激、修复屏障，而不是继续加项目。
Many clients who describe themselves as sensitive actually have a damaged barrier — a condition you can repair, not a skin type they were born with. Step one is always to stop the irritation and rebuild the barrier, not to add another treatment.
第四部分 · 皮肤类型与皮肤状态Part Four · Type vs Condition
Skin Type vs Skin Condition皮肤类型与皮肤状态
| 皮肤类型 TypeSkin type | 皮肤状态 ConditionSkin condition | |
|---|---|---|
| 定义What it is | 由遗传决定，相对稳定Genetic and relatively fixed | 由环境、生活方式、护理造成，可改变Caused by environment, lifestyle and care — and changeable |
| 举例Examples | 干性、油性、中性、混合性Dry, oily, normal, combination | 缺水、敏感、色沉、痤疮、老化Dehydration, sensitivity, pigmentation, acne, ageing |
| 能否改变Can it change | 基本不变Largely no | 可以改善 — 这正是我们的价值所在Yes — and that is exactly where our value lies |
最常见的判断错误 The most common mistake
把「缺水」当成「干性」。油性皮肤同样会缺水 — 出油多不代表水分足。缺油是类型（dry），缺水是状态（dehydrated）。
Confusing dehydrated with dry. Oily skin gets dehydrated too — plenty of oil does not mean plenty of water. Lacking oil is a type. Lacking water is a condition.
Fitzpatrick 皮肤分型The Fitzpatrick scale
这是激光、光疗、强脉冲光治疗前的必要评估，直接决定能量参数与色沉风险。 A required assessment before laser, LED and IPL. It sets your energy parameters and your pigmentation risk.
| 分型Type | 特征Characteristics | 紫外线反应UV response |
|---|---|---|
| I | 极白皙，红发或金发，多雀斑Very fair, red or blonde hair, freckles | 总是晒伤，从不晒黑Always burns, never tans |
| II | 白皙，蓝／绿眼Fair, blue or green eyes | 容易晒伤，很少晒黑Burns easily, tans minimally |
| III | 米色至浅棕，常见于南欧与部分亚裔Beige to light brown, common in southern Europe and parts of Asia | 有时晒伤，逐渐晒黑Sometimes burns, tans gradually |
| IV | 浅棕／橄榄色，常见于东亚、地中海Olive to light brown, common in East Asia and the Mediterranean | 很少晒伤，容易晒黑Rarely burns, tans easily |
| V | 深棕Brown | 极少晒伤，很容易晒黑Very rarely burns, tans very easily |
| VI | 深棕至黑Deeply pigmented brown to black | 从不晒伤，色素沉着深Never burns, deeply pigmented |
临床关联 In the clinic
Fitzpatrick IV–VI 型客户做激光与强脉冲光时，炎症后色素沉着（PIH）风险显著升高，必须降低能量、延长间隔、术前术后严格防晒。车士活地区亚裔客户多为 III–IV 型，这是日常评估的重点。
Types IV–VI carry a much higher risk of post-inflammatory hyperpigmentation after laser and IPL. Lower the energy, lengthen the intervals, and insist on sun protection before and after. Most Asian clients in Chatswood sit at III–IV, so this is a daily assessment, not a rare one.
第五部分 · 皮肤老化机制Part Five · How Skin Ages
How Skin Ages皮肤老化机制
| 类型Type | English中文 | 成因与表现Cause and appearance |
|---|---|---|
| 内源性老化Intrinsic | Intrinsic ageing内源性老化 | 自然年龄增长；细胞更新变慢、胶原每年减少约 1%、皮肤变薄Chronological. Slower renewal, roughly 1% collagen lost per year, thinning skin. |
| 外源性老化Extrinsic | Extrinsic ageing外源性老化 | 紫外线、吸烟、污染、糖化、压力、睡眠不足；表现为色斑、粗纹、粗糙、松弛UV, smoking, pollution, glycation, stress, poor sleep. Shows as pigmentation, coarse lines, roughness, laxity. |
- UVA = Ageing — 波长长，穿透至真皮，破坏胶原与弹力蛋白，全年存在，可穿透玻璃与云层 UVA = Ageing — longer wavelength, reaches the dermis, breaks down collagen and elastin, present all year, passes through glass and cloud
- UVB = Burning — 波长短，作用于表皮，造成晒伤与晒黑，夏季与正午最强 UVB = Burning — shorter wavelength, acts on the epidermis, causes burning and tanning, strongest in summer and at midday
临床关联 In the clinic
可见老化中约 80% 由紫外线造成。任何抗衰疗程若客户不防晒，效果都会大打折扣 — 防晒教育是每一次咨询的必讲内容。
Around 80% of visible ageing is UV driven. Any anti-ageing course of treatment underperforms if the client skips sunscreen, so sun protection belongs in every single consultation.
第六部分 · 禁忌症与转介Part Six · Contraindications
Contraindications & Referral禁忌症与转介
绝对禁忌症 — 不可治疗Absolute — do not treat
- 治疗部位有活动性单纯疱疹或带状疱疹Active herpes simplex or shingles at the treatment site
- 开放性伤口、未愈合的破损Open wounds or unhealed skin
- 细菌或真菌性皮肤感染（如脓疱疮、癣）Bacterial or fungal skin infection, such as impetigo or ringworm
- 疑似恶性皮损（不规则痣、快速变化的色素斑）Any lesion you suspect could be malignant
- 近期接受手术或注射后未达安全间隔Recent surgery or injectables inside the safe interval
- 对拟用产品或成分有明确过敏史Known allergy to a product or ingredient you plan to use
相对禁忌症 — 需谨慎或需医生许可Relative — proceed with caution or with medical clearance
- 怀孕或哺乳期Pregnancy or breastfeeding
- 糖尿病（愈合能力下降）Diabetes, because healing is impaired
- 正在服用异维 A 酸或近 6 个月内停药Currently on isotretinoin, or within six months of stopping
- 自身免疫性疾病、正在使用免疫抑制剂Autoimmune conditions or immunosuppressant medication
- 体内有金属植入物或心脏起搏器（射频类项目）Metal implants or a pacemaker, for radiofrequency treatments
- 近期日晒或使用美黑产品Recent sun exposure or fake tan
- 瘢痕疙瘩体质History of keloid scarring
何时必须转介医生 — ABCDEWhen to refer — ABCDE
| EnglishSign | 中文含义Meaning | |
|---|---|---|
| A | Asymmetry | 不对称The two halves do not match |
| B | Border | 边缘不规则、模糊Irregular or blurred edges |
| C | Colour | 颜色不均匀、多色混杂Uneven or multiple colours |
| D | Diameter | 直径大于 6 毫米Wider than 6 mm |
| E | Evolving | 近期在变大、变色、出血或瘙痒Recently growing, changing colour, bleeding or itching |
职业底线 Where the line sits
美容师不得诊断。转介不是「推走客户」，而是保护客户，也是保护你自己。任何不确定的皮损，都写进记录并建议就医。
A therapist does not diagnose. Referring is not losing a client — it protects her and it protects you. Record anything you are unsure about and advise her to see a doctor.
理论测验Knowledge Check
Knowledge Check · 15 questions理论测验 · 15 题
共 15 题，每题一个正确答案。答对 12 题（80%）以上为通过。提交后会显示答案与解析。 Fifteen questions, one correct answer each. Twelve correct is a pass. Answers and explanations appear after you submit.
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