[Protruding Lesion Laser Removal] Skin tags, Milia, Seborrheic Keratosis, Warts, etc.

Understanding the Principle of Dual Laser Treatment.

*A mole is a lesion that appears when melanocytes proliferate excessively in the epidermis or dermis.

Although it may appear to be a common pigmented lesion on the surface, the actual treatment method can vary depending on its depth and location.

Erbium YAG laser excels at precisely ablating the superficial layers of the skin. This is advantageous for removing shallow moles in the epidermis, as it naturally shaves off the lesion while minimizing damage to the surrounding skin.

By minimizing scarring, you can expect aesthetic results when removing moles from exposed areas like the face. Subsequently, delicately cauterizing the base of the mole with a CO2 laser can help remove any residual melanocytes in the deeper layers, thereby reducing the possibility of recurrence. This method lowers the chance of 'recurrent moles' that grow back because their roots remain even after the surface has been removed.

In such cases, it is particularly advisable to consider finishing with a CO2 laser.

-If the mole is slightly raised or feels thick when pressed

-If you have previously experienced a mole reappearing in the same spot

-If diagnosed with a dermal nevus (e.g., blue mole, gray-brown mole, etc.)

*Flat warts are viral skin conditions caused by human papillomavirus (HPV) infection. They typically spread widely in the epidermis and are often observed as small, flat, brown or flesh-colored lesions. They tend to appear when immunity is weakened and can spread through self-contact, so prompt management upon discovery is important.

Erbium YAG laser is advantageous for uniformly removing the epidermal layer, making it helpful for

managing widespread flat warts in one go. It allows for uniform removal of the lesioned area while reducing skin damage. However, viral lesions may carry a risk of recurrence if only the surface is removed. In such cases, the finishing process of applying thermal energy around the lesion with a CO2 laser can clinically have a positive impact on reducing the likelihood of recurrence by additionally cauterizing any remaining virus-infected cells in the epidermis and its vicinity.

In these cases, finishing with a CO2 laser can be considered particularly important.

-If the lesion's border is indistinct or feels flat and spread out when touched, or for individuals with weakened immunity (e.g., due to stress, lack of sleep, etc.)

-If you have experienced the lesion reappearing multiple times

-If the lesion is located in an area frequently touched, such as hands or face, or an area with a high likelihood of spreading to other parts

*Milia are lesions that appear as small, white cysts due to the accumulation of keratin (a type of skin protein) beneath the skin. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are cosmetic in nature and unrelated to infection or inflammation.

Erbium YAG laser is one suitable method for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer of the milia, creating an opening for the trapped keratin to be safely expelled. After removal, a light finishing cauterization with a CO2 laser can help reduce the possibility of keratinocytes re-proliferating, thereby decreasing the recurrence of milia in the same spot. However, strong thermal stimulation to the skin can cause hyperpigmentation, requiring precise intensity control during the procedure.

Cases where finishing with a CO2 laser can be particularly beneficial are as follows:

-If milia repeatedly reappear in the same location

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

-When expecting a more even skin texture during recovery after removing multiple milia

*Syringoma is a benign lesion caused by an excessive increase in sweat glands (eccrine glands) within the dermal layer. It is characterized by multiple small, bead-like skin lesions found under the eyes, on the cheeks, and forehead. It is a common skin condition often seen in women in their 20s and 30s or with genetic factors.

Erbium YAG laser can delicately remove thin epidermal layers, which can be useful for managing syringomas in sensitive areas like around the eyes. It helps refine the skin surface and remove the upper part of the sweat gland lesions, with a lower likelihood of scarring or hyperpigmentation during recovery, thus positively impacting aesthetic results. Subsequently, applying thermal energy with a CO2 laser

The finishing method of creating micro-thermal damage to the deeper parts of the lesion can weaken the activity of the sweat glands in the dermis,

and can be a clinically significant approach to prevent syringomas from re-proliferating in the same area. However, due to the depth of the lesions, multiple treatment sessions may be required.

In the following situations, combining with CO2 laser finishing can further enhance the treatment results:

-If multiple syringomas are relatively deeply embedded under the eyes or on the cheeks

-If you have undergone multiple laser treatments previously but experienced recurrence

-When aiming for the highest possible recurrence prevention effect with just one treatment session

*Skin tags are benign skin lesions caused by excessive proliferation of fibrous tissue and blood vessels in the dermal layer. They commonly occur in areas where the skin folds, such as the neck, armpits, under the breasts, and eyelids, appearing as small, skin-colored protrusions. They are painless but can be irritated by friction. Generally, CO2 lasers can be more effectively used for skin tag removal, as their excellent cutting and hemostatic effects help quickly remove multiple lesions. However, for small and thin skin tags, precisely ablating the lesion first with an Erbium YAG laser, followed by finishing cauterization of the base with a CO2 laser, can help remove the root tissue of the skin tag and contribute to reducing the likelihood of recurrence in that area. Thermal stimulation can positively influence the regulation of fibrous cells and microvessels within the tissue, inhibiting the regenerative environment.

Cases where combining with CO2 laser finishing can be particularly beneficial are listed below:

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

-If you have previously experienced the lesion reappearing in the area where a skin tag was removed

-If the lesion's root is deep or wide (a type that may leave a raised mark even after removal)

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

combining two types of lasers,

'Dual Laser Treatment',

can be a significant approach in enhancing the completeness of the treatment.

After mole removal, for how long should DuoDERM (adhesive patch) be applied?

The procedure to remove moles subtly alters the skin's surface and may cause temporary irritation to the skin.

Therefore, it is necessary to meticulously protect and care for the treated area after the procedure.

Maintaining a moist environment to prevent the treated area from drying out can aid recovery and help reduce the likelihood of scarring.

Using a hydrocolloid dressing like Duoderm can be one way to manage this moist healing environment.

Duoderm keeps the wound area moist, helping skin cells regenerate naturally and delaying scab formation, which can reduce the risk of scarring.

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

The total care period may be approximately 10 days.

If using Duoderm is uncomfortable or causes an allergic reaction, you can frequently apply a regenerating cream or hydrating gel to prevent dryness. Additionally, it is important to carefully apply sunscreen with SPF 50 or higher and avoid touching the treated area.

Post-mole removal care is more than just protecting the treated area; it is a crucial step that can affect the overall outcome of the procedure.

Neglecting care can increase the risk of scarring, so it's advisable to continue paying attention to the treated area even after the procedure.

We provide detailed explanations of post-procedure care methods to ensure a smooth recovery for our patients.

Who might consider this procedure

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• 1. Those who wish to change their skin due to moles, age spots, milia, syringomas, skin tags, etc.
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• 2. Those who have had moles removed previously but have experienced recurrence.
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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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Important Post-Procedure Notes

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• ㆍIt is advisable to avoid direct contact of water with the treated area. (Light cleansing is possible while Duoderm is applied)
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• ㆍDuring skin regeneration, it is recommended to consistently replace and apply the healing tape for about 10 days.
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• ㆍThere is a possibility of moles recurring in the treated area, and re-treatment may be considered after 4-6 weeks if necessary.
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• ㆍFor moles with deep roots, multiple procedures may be necessary.
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• ㆍIt is important to avoid sun exposure as much as possible. (Sunscreen use is essential, and we recommend applying it even over Duoderm.)
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