Customized Dual Laser Treatment for Individual Skin Lesions

Moles are lesions that appear due to excessive proliferation of melanocytes in the epidermal or dermal layer of the skin.

Although they may seem like simple pigmented lesions, the method of removal can vary depending on the mole's location and depth.

Erbium-YAG laser is suitable for precisely ablating shallow layers. Therefore, when removing shallow moles on the epidermis, it can shave them off naturally while minimizing damage to the surrounding skin.

This procedure reduces the risk of scarring and can yield positive cosmetic results, making it especially considered for facial mole removal. Subsequently, the process of thermocoagulating the base of the mole with a CO2 laser helps treat melanocytes that may remain deep within, thereby lowering the possibility of mole recurrence. This helps reduce situations where moles appear to be removed superficially but recur due to remaining root tissue.

CO2 laser finishing may be particularly considered in the following cases:

-When a mole is slightly raised or feels thick and not smooth to the touch

-If there has been a history of moles recurring in the same area

-When a lesion is identified as a deep dermal nevus, such as a blue or grayish-brown mole

Flat warts are skin diseases caused by human papillomavirus (HPV) infection. They appear as small, flat, brown or flesh-colored lesions that spread widely in the epidermal layer. They are particularly prone to developing when immunity is weakened and can spread to other areas through physical contact, making early management crucial.

Erbium-YAG laser is suitable for evenly ablating the epidermal layer. This makes it effective for widespread flat warts,

helping to remove them relatively neatly in one session. It helps to remove lesions uniformly while minimizing skin damage. However, due to the nature of viral diseases, there is a possibility of recurrence if only the surface is removed. In such cases, applying thermal stimulation to the periphery of the lesion with a CO2 laser can be a clinically significant approach to reduce recurrence rates by additionally coagulating remaining virus-infected cells in and around the epidermal layer.

CO2 laser finishing may be carefully considered in the following cases:

-When the lesion's border is unclear and feels flat and spread out to the touch, or for individuals who believe their immunity is weakened (due to stress, lack of sleep, etc.)

-If there has been a history of multiple recurrences

-If the lesion is located in areas prone to frequent contact or spread, such as hands or face

Milia are small, white, cyst-like lesions formed when keratin protein is trapped beneath the skin. They primarily occur around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are cosmetic concerns not directly related to infection or inflammation.

Erbium-YAG laser can be effectively used for milia removal. It precisely ablates the skin surface, opening the thin epidermal layer of the milia and helping to safely release the trapped keratin. Subsequently, a gentle finishing coagulation with a CO2 laser can help reduce the possibility of remaining keratinocytes re-proliferating and prevent milia from recurring in the same area. However, excessive thermal stimulation on the skin can cause hyperpigmentation, requiring precise intensity control.

CO2 laser finishing may be particularly helpful in the following cases:

-When milia repeatedly appear in the same area

-If there has been a history of lesions protruding again during the recovery process after treatment

-When desiring uniform skin results during recovery after removing multiple milia

Syringomas are benign lesions resulting from the overgrowth of sweat glands (eccrine glands) in the dermal layer. They are characterized by multiple small, bead-like lesions typically appearing under the eyes, on the cheeks, and forehead. They are relatively common, often due to genetic factors or observed in women in their 20s and 30s.

Erbium-YAG laser can precisely and delicately remove the epidermis, making it suitable for managing syringomas in sensitive areas like around the eyes. It helps to refine the skin surface and remove the upper part of the sweat gland lesions, with less risk of scarring or hyperpigmentation during recovery, leading to favorable cosmetic outcomes. Subsequently, applying heat with a CO2 laser

to create micro-damage in the deeper parts of the lesion can weaken the activity of sweat glands in the dermis,

and may be clinically significant in inhibiting the recurrence of syringomas in the same area. However, since lesions are often deep, multiple treatment sessions may be required.

Considering CO2 laser finishing together may be beneficial for treatment in the following cases:

-When multiple syringomas are relatively deeply embedded under the eyes, on the cheeks, etc.

-If there has been a history of recurrence despite multiple previous laser treatments

-When hoping to reduce the possibility of recurrence even with a single treatment session

Skin tags are benign skin lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermal layer. They primarily occur in areas where skin folds, such as the neck, armpits, under the breasts, and eyelids, appearing as small, skin-colored protrusions. They are painless but can be irritated by friction. Generally, CO2 laser is suitable for skin tag removal, as it precisely cuts and coagulates the lesions, allowing for quick treatment of multiple lesions. However, for small and thin skin tags, precisely ablating the lesion surface with an Erbium-YAG laser first, followed by coagulating the base of the lesion with a CO2 laser, helps manage the root tissue of the skin tag and can reduce the possibility of recurrence in that area. Thermal stimulation contributes to improving the recurrence environment by inhibiting the activity of fibrous cells and microvessels within the tissue.

Combining CO2 laser finishing may be helpful in the following cases:

-When skin tags are located in areas prone to frequent friction, such as the neck or armpits

-If there has been a history of skin tags recurring in the same area

-When the lesion has deep or wide roots, potentially leaving a raised mark even after removal

Thus, considering the depth and characteristics of the skin lesion,

utilizing a combination of two types of lasers

the ‘Dual Laser Technique’

is an approach that can help enhance the completeness of the treatment.

How long should I apply Duoderm (sticker) after mole removal?

Mole removal is a procedure that delicately exfoliates the skin's surface. During this process, the skin may temporarily undergo physical changes.

Therefore, properly protecting and managing the treated area is extremely important.

Keeping the treated area moist, in particular, can help skin recovery and reduce the likelihood of scarring.

For this kind of care, applying a hydrocolloid dressing like Duoderm is often recommended.

Duoderm can help maintain a moist environment for the wound, aiding in the regeneration of new cells. This can slow down scab formation, contributing to a reduced chance of scarring.

Applying Duoderm immediately after mole removal and replacing it usually every 3-5 days, managing it for at least 7 days, can be beneficial.

Generally, a total management period of about 10 days can be considered.

If you find it difficult to use Duoderm or experience an allergic reaction, it is recommended to frequently apply a regenerating cream or moisturizing gel to prevent dryness. Additionally, meticulously apply sunscreen with SPF 50 or higher, and be careful not to touch the treated area.

Post-care after mole removal is more than just protecting the wound; it is an important process that can affect the outcome of the procedure.

Neglecting aftercare can lead to scarring, so continuous attention and caution are required even after the procedure.

We carefully guide our patients through post-procedure care methods to help them recover quickly and healthily.

Recommended for

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• 1. Recommended for those who have experienced discomfort due to moles, seborrheic keratosis (age spots), milia, syringomas, or skin tags.
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• 2. Consultation is also available if moles have reappeared after a previous mole removal procedure.
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Procedure Steps

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• STEP 01. Self-cleansing for personal hygiene
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• STEP 02. Application of anesthetic cream
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• STEP 03. Mole removal procedure
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Post-Procedure Precautions

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• ㆍPlease try to keep the treated area from getting wet. (You can gently wash your face while Duoderm is applied.)
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• ㆍIt is recommended to consistently replace and apply regenerative tape during skin regeneration. (Approximately 10 days)
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• ㆍThere is a possibility that moles may reappear in the treated area; in such cases, another procedure can be considered after about 4-6 weeks.
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• ㆍFor moles with deep roots, multiple procedures may be necessary.
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• ㆍIt is important to avoid exposure to ultraviolet rays as much as possible. (Sunscreen must be used, and applying it over Duoderm can also be helpful.)
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