Dual Laser Removal of Flat Warts, Considering Recurrence

Our Clinic's Unique Dual Laser Treatment Method

Moles are skin lesions that appear when melanin pigment cells proliferate unnecessarily in the epidermis or dermis of the skin.

Unlike what appears on the surface, the method of mole removal can vary depending on its location and depth.

Erbium YAG laser is advantageous for precisely ablating the epidermal layer. This allows for the clean removal of superficial moles while minimizing damage to surrounding skin.

This treatment reduces the risk of scarring and provides aesthetic satisfaction, making it particularly suitable for facial mole removal. Subsequently, a CO2 laser is used to carefully cauterize the base of the mole with heat. This process helps remove any remaining melanin cells in deeper skin layers, potentially lowering the chance of the mole reappearing. It can help reduce the risk of 'recurrent moles' that appear to be removed but regrow because their roots remain.

We recommend a finishing treatment with CO2 laser in the following situations:

- If the mole appears slightly raised on the surface or feels thick when touched

- If there is a history of a mole recurring in the same location

- If diagnosed as a nevus located in the deep dermal layer (e.g., blue nevus, nevus of Ota, etc.)

Flat warts are skin conditions caused by human papillomavirus (HPV) infection. They typically appear widespread in the epidermal layer and can be seen with the naked eye as thin, small, brownish or skin-colored lesions. They are prone to occur when immunity is weakened and can spread to other areas through self-contact, so early management is necessary.

Erbium YAG laser helps to uniformly remove the epidermal layer. Utilizing this characteristic, it is suitable for improving widespread flat wart lesions

in one go. It can uniformly remove lesions while reducing skin irritation. However, viral lesions can recur if only the surface is removed. In such cases, applying heat around the lesion with a CO2 laser as a finishing step can help remove additional virus-infected cells remaining in the epidermal layer and surrounding areas. This treatment method can positively impact reducing the recurrence rate.

In the following cases, considering a CO2 laser finish together is especially beneficial:

- If the lesion's borders are unclear, or it feels flat and spread out when touched - Individuals with weakened immunity (due to stress or lack of sleep, etc.)

- If there is a history of flat warts recurring multiple times

- If the lesion is in an area prone to spread due to frequent contact, such as hands or face

Milia are small, white cysts that form when keratin protein is trapped in tiny pockets within the skin. They primarily appear around the eyes, on the cheeks, and forehead. Unlike sebaceous cysts, they are benign lesions unrelated to infection or inflammation.

Erbium YAG laser is effectively used for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer of the milium and creates a small pathway for the trapped keratin to safely exit. After removal, a light cauterization with a CO2 laser can help reduce the possibility of remaining keratinocytes re-proliferating, thereby contributing to preventing milia from recurring in the same area. However, excessive heat damage to the skin can lead to hyperpigmentation, so careful intensity control is crucial.

A finishing treatment using a CO2 laser can be particularly helpful in the following cases:

- If milia frequently recur in the same spot

- If lesions reappeared during the recovery process after treatment

- If you desire an even skin texture during the recovery phase after removing multiple milia

Syringomas are benign skin tumors resulting from the abnormal proliferation of sweat glands (eccrine glands) in the dermal layer of the skin. They typically appear as multiple small, round skin lesions, primarily around the eyes, cheeks, and forehead. They show a genetic predisposition and are relatively common in women in their 20s and 30s.

Erbium YAG laser is advantageous for delicate and thin removal of the epidermis, making it suitable for treating syringomas in sensitive areas like around the eyes. It can refine the skin surface and remove the upper part of the sweat gland lesions. With a low risk of scarring or hyperpigmentation during recovery, good cosmetic results can be expected. Next, using a CO2 laser to apply thermal energy

a finishing process that provides a delicate stimulus to the deeper parts of the lesion contributes to weakening the activity of sweat glands within the dermal layer,

thereby providing clinical assistance in preventing syringomas from spreading again in the same area. However, due to the depth of the lesion, multiple treatment sessions are often required.

In the following situations, combining CO2 laser finishing can help improve treatment outcomes:

- If multiple syringomas are located relatively deep, such as under the eyes or on the cheeks

- If you have a history of syringomas repeatedly recurring despite multiple previous laser treatments

- If you wish to help reduce the possibility of recurrence with a single treatment session

Skin tags are benign skin tumors formed 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 usually painless but can be irritated by friction. Generally, CO2 laser is predominantly used for skin tag removal, as its excellent cutting and hemostatic capabilities make it efficient for quickly removing many lesions. However, for small and thin skin tags, the Erbium YAG laser can first be used to precisely ablate the lesion, followed by CO2 laser to cauterize the root of the lesion as a finishing touch. This method helps remove the underlying tissue of the skin tag, thereby reducing the risk of recurrence in that area. Thermal energy can destroy fibrous cells and microvessels within the tissue, potentially inhibiting regrowth.

It is particularly recommended to consider CO2 laser finishing in the following cases:

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

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

- If the lesion had deep or wide roots and retained thickness even after removal

Thus, considering the depth and characteristics of each lesion,

the use of two types of lasers together,

'Dual Laser Treatment',

plays an important role in enhancing treatment satisfaction.

Guide to Using DuoDERM (Healing Bandage) After Mole Removal

During the process of mole removal, subtle physical changes occur on the skin surface.

It is crucial to properly protect and care for the treated area to ensure good recovery.

Keeping the treated area moist can especially aid in skin recovery and reduce the risk of scarring.

For this reason, we recommend applying a hydrocolloid dressing, specifically Duoderm.

Duoderm helps keep the wound area moist to aid cell regeneration, reduces unnecessary scab formation, and contributes to lowering the chance of scarring.

It is recommended to apply Duoderm immediately after mole removal and to manage it for at least 7 days, replacing it every 3-5 days.

We recommend an overall care period of about 10 days.

If Duoderm use is uncomfortable or causes an allergic reaction, you should consistently apply a regenerative cream or moisturizing gel to prevent skin dryness. Additionally, it is necessary to diligently apply sunscreen with SPF 50 or higher and to manage the treated area carefully, avoiding touching it.

Post-mole removal care is more than just protecting the wound; it is a crucial step that determines the overall outcome of the procedure.

Neglecting care can lead to unwanted scarring, so it's important to continue paying attention after the procedure.

Our medical team will provide detailed explanations of post-procedure care methods to help our patients achieve a smooth recovery.

Recommended for

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• 1. Those who have experienced discomfort due to moles, seborrheic keratosis, milia, syringomas, skin tags, etc.
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• 2. Those who have had moles removed previously, but they have reappeared.
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Procedure Steps

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

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• ㆍBe careful not to let water directly touch the treated area. (Facial cleansing is possible while Duoderm is applied)
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• ㆍDuring the skin regeneration phase, it is recommended to consistently replace and apply the regenerative tape. (Approximately 10 days)
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• ㆍThere is a possibility that moles may reappear in the removed area, and re-treatment can be considered 4-6 weeks later.
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• ㆍFor moles with deep roots, multiple treatments may be necessary for satisfactory results.
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• ㆍIt is best to avoid sun exposure as much as possible. (Sunscreen use is essential, and we recommend applying it even over Duoderm.)
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