[Low Recurrence] Flat Wart Laser

Guide to Dual Laser Technique

*Moles are skin lesions caused by an accumulation of melanin pigment in the epidermis or dermis.

Even if they appear simple on the surface, treatment methods can vary depending on the depth and location of the mole.

Erbium-YAG laser allows for precise exfoliation and is used to remove shallow moles in the epidermis while minimizing skin burden.

It can be considered for facial mole removal as it aims to reduce scarring and achieve cosmetic results. Subsequently, the process of thermocoagulating the root of the mole with a CO2 laser helps eliminate deeply remaining melanin cells, reducing the likelihood of the mole reappearing. This helps to lessen the risk of 'recurrent moles' that can regenerate if the root remains after surface removal.

CO2 laser finishing is particularly recommended in the following situations:

- If the mole is slightly raised or feels thick to the touch

- If you have a history of the mole reappearing in the same area

- If it is determined to be a deeply located nevus in the dermis (e.g., blue moles, grayish-brown moles, etc.)

*Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They appear to spread across the epidermal layer, presenting as thin, widely spread, brown or flesh-colored small lesions. They are particularly prone to occur when immunity is low and can spread through self-contact, necessitating early management.

The Erbium-YAG laser can be used for uniformly exfoliating the epidermal layer, making it helpful for widely spread flat warts

when treating them at once. It can be used to evenly remove lesions while minimizing skin burden. However, due to the nature of viral diseases, there is a possibility of recurrence if only the surface lesions are removed. In such cases, the finishing step of applying thermal stimulation to the periphery of the lesion using a CO2 laser can be clinically considered to further coagulate remaining virus-infected cells in and around the epidermis, thereby reducing the likelihood of recurrence.

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

- If the lesion's border is unclear, or it feels flat and spread out to the touch, or if immunity is weakened (e.g., due to stress, lack of sleep, etc.)

- If you have experienced multiple recurrences previously

- If the lesion is in an area that is frequently touched or can easily spread, such as the hands or face

*Milia are lesions that appear as small white cysts formed when keratin (a type of skin protein) becomes trapped beneath the skin. They are commonly observed around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are considered a cosmetic concern unrelated to infection or inflammation.

Erbium-YAG laser can be effectively used for milia management. It precisely exfoliates the skin surface to remove the thin epidermis covering the milium and creates an exit pathway for the internal keratin. The finishing process of lightly coagulating with a CO2 laser after the procedure can lower the possibility of residual keratinocytes regenerating and help reduce the recurrence of milia in the same area. However, excessive thermal stimulation to the skin can cause hyperpigmentation, so delicate intensity control is crucial.

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

- If milia repeatedly appear in the same location

- If you have experienced the lesion reappearing during the recovery process after treatment

- When seeking an even result during recovery after removing multiple milia

*Syringomas are benign lesions caused by an excessive proliferation of sweat glands (eccrine glands) in the dermal layer. They are characterized by multiple small, bead-like skin lesions appearing under the eyes, on the cheeks, and forehead. They can be genetically influenced or are often found in women in their 20s and 30s.

The Erbium-YAG laser can delicately remove the epidermis, making it useful for managing syringomas in sensitive areas like around the eyes. It refines the skin surface, removing the upper part of the sweat gland lesions, and can be considered for cosmetic reasons due to a lower risk of scarring or pigmentation during recovery. Subsequently, applying heat with a CO2 laser

in a finishing process that provides subtle stimulation to the deeper parts of the lesion can reduce the activity of sweat glands within the dermis,

and can be clinically considered to reduce the recurrence of syringomas in the same area. However, due to the depth of the lesions, multiple treatment sessions may be required.

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

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

- If you have experienced recurrences after undergoing multiple laser treatments previously

- When seeking assistance with recurrence prevention through a single treatment session

*Skin tags are benign lesions caused by an excessive proliferation of fibrous tissue and blood vessels in the dermal layer. They primarily appear in skin folds such as the neck, armpits, under the breasts, and on the eyelids, observed as small, skin-colored protrusions. They are usually painless but can become irritated by friction. CO2 lasers are commonly used for skin tag removal, efficiently eliminating multiple lesions due to their cutting ability and hemostatic effect. However, for small and thin skin tags, a method of precisely exfoliating the lesion with an Erbium-YAG laser, followed by CO2 laser finishing of the root, can be beneficial for removing the root tissue. This can contribute to reducing the likelihood of recurrence in that area. Thermal stimulation can help weaken fibrous cells and microvessels within the tissue, inhibiting regeneration.

Situations where CO2 laser finishing is advisable include:

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

- If you have a history of skin tags reappearing in the same area after treatment

- If the lesion's root is deep or wide (a form where a thick trace remains even after removal)

Thus, tailored to the depth and characteristics of skin lesions,

the combined use of two lasers,

the 'Dual Laser Technique',

can help enhance the completeness of management.

How long should I apply Duoderm after mole removal?

Mole removal procedures involve abrading the skin's surface, which can cause some damage to the skin.

Therefore, it is crucial to protect and manage the treated area well after the procedure.

Keeping the treated area from drying out is particularly important for faster recovery and scar prevention.

For this reason, applying a hydrocolloid dressing like DuoDERM is recommended.

DuoDERM can help keep the wound moist, which can be beneficial for cell regeneration, and can slow scab formation, thereby reducing the risk of scarring.

After applying DuoDERM immediately following mole removal, it is advisable to change it every 3-5 days and maintain it for at least 7 days.

The overall care period may be recommended for about 10 days.

If using DuoDERM is uncomfortable or causes an allergic reaction, you should frequently apply a recovery cream or moisturizing gel to prevent the skin from drying out, and consistently use sunscreen with SPF 50 or higher. Additionally, it is important not to touch the treated area.

Post-procedure care after mole removal is a crucial process that goes beyond simply protecting the treated area; it can also affect the final outcome.

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

Our clinic provides detailed guidance on post-procedure care to help our patients achieve a swift and healthy recovery.

Recommended for

• 
  
• 
  
• 1. Those bothered by various skin concerns such as moles, seborrheic keratosis (age spots), milia, syringomas, or skin tags.
• 
  
• 
  
• 
  
• 2. Those who previously had moles removed but are concerned about their recurrence.
• 
  
• 
  

Procedure Steps

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

Post-Procedure Precautions

• 
  
• 
  
• ㆍAvoid direct contact with water on the treated area. (Washing your face is possible while DuoDERM is applied)
• 
  
• 
  
• 
  
• ㆍDuring the skin regeneration period, it is advisable to consistently replace and apply the recovery tape (DuoDERM) whenever possible. (For approximately 10 days)
• 
  
• 
  
• 
  
• ㆍMoles on the treated area may reappear in some cases, and re-treatment can be considered after 4-6 weeks if necessary.
• 
  
• 
  
• 
  
• ㆍFor deep-rooted moles, multiple treatments may be necessary to achieve satisfactory results.
• 
  
• 
  
• 
  
• ㆍMinimize exposure to UV rays. (Sunscreen use is essential and recommended even over DuoDERM.)
• 
  
•