[Dual Laser] Removal of Moles, Protruding Moles, and Recurrent Moles

Skin Treatments Using Two Lasers

Moles on the skin are lesions that occur when melanin pigment accumulates excessively in the epidermal or dermal layers of the skin.

Although they may appear to be simple pigmented spots, the method of removal can vary depending on the mole's location and depth.

The Erbium YAG laser is used for precise ablation of the skin's surface. This allows for the natural removal of shallow moles in the epidermis with minimal stress to the skin.

This procedure lowers the chance of scarring and can lead to cosmetic improvement, making it particularly useful for mole removal on the face. Following this, the process of thermally treating the root of the mole with a CO2 laser can be beneficial in reducing the likelihood of recurrence by addressing melanin cells that might remain in deeper layers. This helps prevent situations where a mole appears to vanish but its root remains, leading to recurrence.

A CO2 laser finish can be carefully considered, especially 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 diagnosed as a deep dermal nevus (e.g., blue nevus, grey-brown nevus, etc.)

Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They typically spread widely in the epidermal layer, appearing as thin, flat, small brown or flesh-colored lesions visible to the naked eye. They often appear when immunity is lowered and can spread to other areas through self-contact, making early management crucial.

The Erbium YAG laser helps to uniformly ablate the epidermal layer, making it useful for widely distributed flat warts,

and can be effectively used to treat them all at once. This procedure can help remove lesions evenly while minimizing skin damage. However, viral lesions carry a risk of recurrence if only the surface is removed. In such cases, a finishing process involving subtle thermal stimulation to the periphery of the lesion with a CO2 laser can offer clinical benefits by further addressing virus-infected cells that might remain in or around the epidermal layer, thereby reducing the recurrence rate.

Considering a CO2 laser finish may be beneficial in the following cases:

-If the lesion's border is unclear, or it feels widely spread when touched, or for individuals with weakened immune function (due to stress, lack of sleep, etc.)

-If you have experienced multiple recurrences

-If the lesion is located in areas frequently touched or prone to spreading, such as hands or face

Milia are lesions that appear as small, white granular bumps when keratin protein gets trapped within the skin's epidermis. They are commonly observed around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are considered a cosmetic concern unrelated to infection or inflammation.

The Erbium YAG laser can be used for milia removal. It delicately shaves off the thin epidermal layer of the milia, creating a pathway for the trapped keratin inside to be smoothly discharged. After removal, a light thermal finish with a CO2 laser can offer benefits by reducing the potential for residual keratinocytes to regrow and preventing the repeated appearance of milia in the same area. However, precise intensity control is crucial as excessive thermal stimulation to the skin can lead to hyperpigmentation.

Situations where a CO2 laser finish can be particularly considered are as follows:

-If milia repeatedly appear in the same area

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

-When desiring a more even skin condition during recovery after removing multiple milia

Syringomas are benign skin lesions caused by the excessive proliferation of sweat glands (eccrine glands) within the dermal layer. They often appear as small, bead-like lesions, multiple in number, under the eyes, on the cheeks, and forehead. They are relatively common in individuals with a genetic predisposition or in women aged 20-30.

The Erbium YAG laser can delicately ablate the epidermis thinly, making it useful for managing syringomas in sensitive areas like around the eyes. By refining the skin's surface and treating the upper part of the sweat gland lesions, there can be cosmetic benefits due to a lower chance of scarring or hyperpigmentation during recovery. Following this, the CO2 laser applies heat to

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

can offer clinical assistance in preventing syringomas from recurring in the same area. However, due to the depth of the lesions, multiple treatment sessions may be required.

In the following cases, combining CO2 laser finishing can have a positive impact on improvement:

-If there are multiple syringomas located relatively deep under the eyes, on the cheeks, etc.

-If you have experienced recurrence despite having received multiple laser treatments previously

-When desiring to contribute to recurrence suppression with a single treatment

Skin tags (acrochordons) are benign skin lesions that form due to the excessive proliferation of fibrous tissue and blood vessels in the dermal layer. They commonly occur in areas where skin rubs together, such as the neck, armpits, under the breasts, and eyelids, appearing as small, raised, skin-colored lesions. While usually painless, they can be irritated by friction with clothing. Typically, the CO2 laser is primarily used for skin tag removal, as its excellent ability to cut and simultaneously coagulate allows for the swift treatment of many lesions. However, for smaller, thinner skin tags, a method involving delicately shaving off the lesion's surface with an Erbium YAG laser followed by final cauterization of the root with a CO2 laser can be advantageous in removing the entire root tissue of the skin tag, thereby helping to reduce the likelihood of recurrence in that area. Thermal stimulation can assist in managing the regenerative environment by treating fibrous cells and microvessels within the lesion.

Cases where combining a CO2 laser finish can be considered are as follows:

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

-If you have experienced recurrence of skin tags in an area previously treated

-If the lesion's root is deep or widely spread (a type that may leave a slightly raised mark even after treatment)

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

applying two types of laser treatments together

the 'Dual Laser Technique' can be

an approach that helps enhance the precision and satisfaction of the treatment.

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

Mole removal involves minor irritation to the skin's surface, which can lead to temporary physical changes in the skin.

After the procedure, it is crucial to carefully protect and manage the treated area.

In particular, maintaining an appropriate moist environment in the treated area helps promote faster healing and reduces the likelihood of scarring.

For this reason, we recommend using a hydrocolloid dressing like Duoderm.

Duoderm keeps the wound moist, aiding the growth of new skin and delaying scab formation, which can reduce the risk of scarring.

After applying Duoderm immediately after mole removal, it is recommended to change it every 3-5 days and continue management for at least 7 days.

A total management period of about 10 days can typically be considered.

If using Duoderm is difficult or an allergic reaction occurs, you should frequently apply a regeneration cream or moist gel to prevent the skin from drying out. Additionally, consistently use sunscreen with SPF 50 or higher, and be careful not to touch the treated area.

Post-care after mole removal is a crucial process that goes beyond simply protecting the wound; it can significantly influence the outcome of the procedure.

If proper care is not taken, there is a possibility of scarring, so continuous attention and caution are required even after the procedure.

We provide detailed guidance on post-procedure care methods to help our patients recover quickly and healthily.

Recommended for

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• 1. Individuals who have concerns about moles, lentigines, milia, syringomas, or skin tags may consider this procedure.
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• 2. Those who have experienced mole recurrence after previous removal and wish for improvement are also candidates.
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Procedure Steps

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• STEP 01. Self-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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• ㆍEnsure water does not directly touch the treated area. (Light facial cleansing is recommended when Duoderm is applied.)
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• ㆍDuring the skin regeneration process, 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 if re-treatment is needed, it can usually be considered after 2-3 months.
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• ㆍMoles with deep roots may require multiple treatment sessions.
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• ㆍIt is crucial to minimize exposure to UV radiation. (Always use sunscreen, and it is recommended to apply it even over Duoderm.)
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