Lesion-specific Dual Laser Approach

Moles are lesions that appear when melanin pigment cells proliferate in the epidermal or dermal layers of the skin.

Although they may appear similar to the naked eye, appropriate treatment approaches must be applied differently depending on the location and depth of penetration of the mole.

Erbium-YAG laser is effective for ablation procedures that precisely shave off the skin surface. This allows for the delicate removal of superficial moles in the epidermal layer, reducing the burden on surrounding skin.

It is considered particularly for facial mole removal as it can reduce scars and lead to cosmetic improvement. The post-treatment process of thermally coagulating the root part of the mole using a CO2 laser helps destroy melanin cells that may remain deep within, preventing mole recurrence. This can lower the risk of 'recurrent moles' that reappear due to deep roots even after the surface has been removed.

Especially for moles with the following characteristics, it is recommended to consider CO2 laser finishing treatment together:

If the mole is slightly raised to the naked eye or feels voluminous when touched

If there is a history of the mole reappearing in the same area

If diagnosed as a nevus located in the deep dermal layer, such as a blue mole or a gray-brown mole

Flat warts are skin diseases caused by human papillomavirus (HPV) infection. They typically spread widely in the epidermal layer and appear as small, thin, brown or flesh-colored lesions. They primarily occur when immunity is weakened and are self-contagious, requiring early management.

Erbium-YAG laser is effective in uniformly removing the epidermal layer, making it suitable for widespread flat warts

It helps in managing them simultaneously. This procedure facilitates uniform removal of lesions while reducing the burden on the skin. However, due to the nature of viral diseases, there is a possibility of recurrence even if only the surface is removed. In such cases, the finishing process of applying thermal stimulation around the lesion using a CO2 laser can positively impact reducing the possibility of recurrence by coagulating virus-infected cells that may remain in the epidermal layer and surrounding tissues.

In the following situations, it is advisable to carefully consider CO2 laser finishing treatment:

If the lesion's borders are not distinct or it feels flat and spread out when touched

Individuals with weakened immunity due to stress, lack of sleep, etc.

If there has been a history of multiple recurrences

If lesions have appeared in areas prone to frequent contact, such as the hands or face, where viruses can easily spread

Milia are small white cysts formed when keratin protein becomes trapped within the skin. They are commonly observed around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are a cosmetic concern not directly related to infection or inflammation.

Erbium-YAG laser is usefully employed for milia removal. It delicately ablates the skin surface to remove the thin epidermal layer covering the milia, creating an exit pathway for the trapped keratin. After the procedure, light finishing coagulation with a CO2 laser can help reduce the possibility of remaining keratinocytes proliferating again and prevent milia recurrence in the same area. However, excessive thermal stimulation can cause hyperpigmentation, so precise intensity control is crucial.

CO2 laser finishing may be even more effective in the following cases:

If milia have repeatedly occurred in the same location

If there has been an experience of the lesion reappearing during the recovery process after treatment

When aiming for a more even and smoother skin outcome during the recovery process after removing multiple milia

Syringomas are benign lesions that appear when the sweat gland (eccrine gland) tissue in the dermal layer of the skin proliferates excessively. They are characterized by multiple small, millet-seed-like lesions appearing around the eyes, cheeks, and forehead. They have a genetic predisposition or are relatively common in women in their 20s and 30s.

Erbium-YAG laser can delicately and thinly remove the epidermis, making it suitable for treating syringomas in sensitive areas like around the eyes. This procedure refines the skin surface, removes the upper part of the sweat gland lesions, and offers cosmetic improvement with less burden of scars or hyperpigmentation during recovery. Subsequently, applying thermal energy using a CO2 laser,

the finishing step of providing subtle stimulation to the deeper parts of the lesion helps weaken the excessive activity of dermal sweat glands, and

it can help reduce the recurrence of syringomas in the same area. However, due to the depth of the lesions, multiple treatments may be necessary.

In the following cases, combining CO2 laser finishing may lead to more effective improvement:

If multiple syringomas are relatively deeply distributed under the eyes or on the cheeks, etc.

If there has been a history of recurrence despite receiving multiple laser treatments in the past

When wishing to enhance expectations for recurrence prevention after treatment

Skin tags are benign skin lesions that appear when fibrous tissue and blood vessels in the dermis proliferate. They primarily occur in areas where skin folds, such as the neck, armpits, under the breasts, and eyelids, and appear as small, skin-colored protuberances. They are typically painless but can be irritated by friction. CO2 laser is generally used for skin tag removal, being useful for quickly and effectively removing lesions. However, for small and thin skin tags, precisely ablating the lesion surface with an Erbium-YAG laser, followed by coagulating the base of the skin tag with a CO2 laser, can help clear the root tissue and reduce the possibility of recurrence. This thermal stimulation may have the effect of suppressing the activity of fibroblasts and microvessels within the tissue.

Specifically, in the following situations, it is recommended to consider CO2 laser finishing:

If skin tags are located in areas with high friction, such as the neck or armpits

If there is a history of skin tags recurring in the same area after removal treatment

If the lesion's root is deep or wide, potentially leaving a raised mark on the skin after removal

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

combining two types of laser treatments,

the 'Dual Laser Technique'

is a method that can help increase treatment satisfaction.

How long should Duoderm (healing patch) be kept on after mole removal?

Mole removal is a procedure that removes the outer layer of the skin, causing minor damage to the skin.

Therefore, properly protecting and managing the treated area after the procedure significantly impacts recovery.

In particular, keeping the treated area moist can aid in faster recovery and help reduce the likelihood of scarring.

For this kind of care, it is recommended to apply Duoderm, a type of hydrocolloid dressing.

Duoderm helps keep the wound area moist, promoting cell regeneration. It delays scab formation, thereby reducing the risk of scarring.

Immediately after mole removal, apply Duoderm and replace it every 3-5 days, maintaining care for at least 7 days.

We recommend a total care period of approximately 10 days.

If Duoderm application is uncomfortable or causes an allergic reaction, frequently apply a regenerating cream or moisturizing gel to keep the skin from drying out. Additionally, be sure to apply sunscreen with SPF 50 or higher thoroughly and manage the area carefully, avoiding touching the treated site.

Post-mole removal care is more than just protecting the wound; it's a process that can significantly influence the outcome of the procedure.

Neglecting aftercare can lead to scarring, so it's important to continue to pay attention and be cautious even after the procedure.

At Kkeut Korean Medicine Clinic, we provide detailed explanations of post-procedure care methods to help our patients recover quickly and healthily.

Recommended for

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• 1. Those who have experienced discomfort due to moles, lentigo, milia, syringomas, skin tags, etc.
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• 2. Those who have had moles removed but they have reappeared and are considering re-treatment.
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Procedure Steps

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• STEP 01. Personal Cleansing
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• STEP 02. Anesthetic Ointment Application
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• STEP 03. Mole Removal Procedure
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Post-Procedure Precautions

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• ㆍEnsure water does not directly touch the treated area. (It is best to wash your face with Duoderm applied.)
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• ㆍDuring skin regeneration, it is recommended to consistently replace the healing tape for about 10 days.
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• ㆍThere is a possibility that moles removed by the procedure may reappear. Re-treatment can usually be considered after 2-3 months.
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• ㆍIf the mole has deep roots, one procedure may not be sufficient, and multiple procedures might be necessary.
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• ㆍIt is best to avoid sun exposure as much as possible. (Sunscreen must be used, and applying it over Duoderm can also be helpful.)
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