Removal of various moles, from common moles to protruding moles and recurrent moles

Dual Laser Combination Treatment

*Moles are lesions that occur when melanocytes abnormally proliferate in the epidermal or dermal layers of the skin.

Although they may appear to be common pigmentation on the surface, the location and depth of moles are important considerations when formulating a treatment plan.

The Er:YAG laser is suitable for shallow and precise epidermal peeling. This can help remove moles on the skin's surface without damaging surrounding tissue.

This laser can be usefully employed for facial mole removal, as it reduces the risk of scarring while offering cosmetic improvements. The subsequent process of carefully cauterizing the base of the mole with heat using a CO2 laser aims to destroy melanocytes that may remain deep within the skin. This can help lower the possibility of 'recurrent moles,' where the mole seems to disappear on the surface but reappears due to remaining roots.

A finishing process using a CO2 laser may be particularly helpful in the following cases:

-When the mole lesion is slightly raised above the surface or feels thick to the touch.

-If you have previously experienced a mole recurring in the same area.

-If diagnosed with a nevus located deep in the dermis, such as a blue mole or a grayish-brown mole.

*Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They primarily spread widely in the epidermal layer and appear as small, thin, flat, brown or flesh-colored lesions to the naked eye. They are more likely to occur when immunity is low, and can spread to other areas by touching, so early treatment is recommended.

The Er:YAG laser is useful for uniformly peeling the epidermal layer, making widely spread flat wart lesions

helpful for efficient removal in one session. The goal of this procedure is to evenly remove lesions while minimizing skin damage. However, since flat warts are viral diseases, there is a possibility of recurrence if only the visible lesions are removed. In such cases, a finishing process involving subtle thermal stimulation around the lesion with a CO2 laser can help further cauterize virus-infected cells that may remain in and around the epidermal layer, thereby reducing the likelihood of recurrence.

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

-When the lesion's border is unclear, or it feels flat and spread out to the touch. Or for individuals with weakened immunity (e.g., due to stress, lack of sleep).

-If there is a history of multiple recurrences of flat warts.

-When lesions occur in areas frequently touched or where viruses can easily spread, such as the hands or face.

*Milia appear as small, white, pearl-like lesions when keratin (a type of skin protein) becomes trapped in tiny pockets within the skin. They typically form around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are benign lesions not directly associated with infection or inflammation.

The Er:YAG laser can be effectively used for milia removal. It precisely peels the skin surface to open the thin epidermal layer of the milia, helping to expel the trapped keratin. A light cauterization finish with a CO2 laser after the procedure can help inhibit the recurrence of milia in the same area by reducing the possibility of keratinocytes re-proliferating. However, precise intensity control is important as excessive thermal stimulation to the skin carries a risk of hyperpigmentation.

A CO2 laser finish is particularly useful in the following cases:

-If milia continuously recur in the same area.

-If you have experienced lesions reappearing during the regeneration period after a previous treatment.

-When seeking more uniform and satisfying results during the regeneration process after removing multiple milia.

*Syringomas are benign skin lesions caused by the excessive proliferation of sweat gland (eccrine gland) tissue within the dermis. They typically appear as multiple small, millet-seed-like bumps around the eyes, on the cheeks, and forehead. They are often observed in women in their 20s and 30s or those with genetic predispositions.

The Er:YAG laser can precisely and thinly remove the epidermis, making it a viable option for treating syringomas in sensitive areas like around the eyes. By refining the skin's surface and removing the upper part of the sweat gland lesions, it helps reduce the risk of scarring or pigmentation during the post-treatment recovery process, leading to good cosmetic outcomes. Subsequently, using heat from a CO2 laser,

a finishing process that applies subtle thermal damage to the deeper part of the lesion can weaken the activity of sweat glands within the dermis,

and help inhibit the re-proliferation of syringomas in the same area. However, due to the depth of the lesions, multiple treatment sessions may be required.

Considering a CO2 laser finish in the following cases can positively influence treatment outcomes:

-When there are multiple relatively deep syringoma lesions located under the eyes, on the cheeks, etc.

-If you have experienced syringomas recurring despite multiple previous laser treatments.

-When seeking to help reduce the possibility of recurrence with a single treatment.

*Skin tags are benign skin lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermis. They typically occur in skin folds such as the neck, armpits, under the breasts, and eyelids, appearing as small, skin-colored protrusions. While painless, they can be irritated by friction. Generally, CO2 lasers are primarily used for skin tag removal, being useful for rapidly removing many lesions due to their excellent cutting and hemostatic effects. However, for small and thin skin tags, precisely ablating the lesion first with an Er:YAG laser, followed by cauterizing the base of the lesion with a CO2 laser, can help remove the root tissue of the skin tag, thereby reducing the possibility of recurrence in that area. Thermal stimulation has the effect of destroying fibrous cells and microvessels within the tissue, inhibiting an unnecessary regenerative environment.

Considering a CO2 laser finish together is beneficial in the following cases:

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

-If you have experienced skin tags recurring in the same area after a removal procedure.

-When the lesion's root is deep or wide, making it prone to leaving a noticeable mark even after treatment.

Thus, tailored to the depth and characteristics of each lesion,

by combining two types of lasers,

the 'Dual Laser Technique'

can help enhance treatment effectiveness and improve satisfaction.

After mole removal, how long should I use DuoDERM (healing patch)?

Since mole removal procedures involve treating the outer layer of the skin, temporary microscopic wounds may occur at the treatment site.

Therefore, proper protection and care are crucial to aid the recovery of the treated area.

In particular, keeping the treated area moist can help with smooth skin regeneration and reduce the likelihood of scarring.

For these reasons, applying DuoDerm, a hydrocolloid dressing, is often recommended.

DuoDerm helps maintain a moist environment at the wound site, promoting the creation of new cells and suppressing unnecessary scab formation, thereby contributing to reducing the risk of scarring.

It is recommended to apply DuoDerm immediately after mole removal, replacing it every 3-5 days, and maintaining this care for at least one week.

The overall care period of about 10 days is appropriate.

If DuoDerm use is uncomfortable or causes an allergic reaction, you should regularly apply a regenerative cream or moisturizing gel to prevent skin dryness. Additionally, apply sunscreen with SPF 50 or higher thoroughly, and be careful not to touch the treated area during care.

Post-mole removal care is not merely about protecting the treated area; it is a crucial step that can influence the final skin condition.

Neglecting post-procedure care can lead to scarring, thus requiring continuous attention even after the treatment.

Here, we provide detailed guidance on care methods to help patients with a smooth recovery after the procedure.

Recommended for

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• 1. Those who have experienced skin concerns due to moles, lentigines, milia, syringomas, skin tags, etc.
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• 2. Those who have had moles removed previously but have experienced their reappearance.
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Procedure Steps

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• STEP 01. Self-cleansing
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• STEP 02. Apply anesthetic cream
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• STEP 03. Proceed with mole removal treatment
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Post-Procedure Precautions

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• ㆍYou should avoid direct contact of water with the treated area. (It is best to wash your face while DuoDerm is applied.)
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• ㆍDuring skin regeneration, consistently replace and apply the regenerative tape. (Approximately 10 days)
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• ㆍThere is a possibility that moles may reappear in the treated area, and re-treatment can be considered approximately 2-3 months later.
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• ㆍFor moles with deep roots, multiple treatment sessions may be required.
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• ㆍIt is best to avoid UV exposure as much as possible. Sunscreen must be used, and applying it over DuoDerm can also be helpful.
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