Our Clinic's Dual Laser Technique

Moles are skin lesions that occur due to the excessive proliferation of melanin pigment cells in the epidermal or dermal layers.

While they may appear to be simple pigmentations, the treatment approach for moles varies depending on their location and depth.

The Erbium-YAG laser specializes in precise and shallow ablation, allowing for the natural removal of moles located superficially in the epidermis while minimizing damage to surrounding skin.

This procedure minimizes the possibility of scarring and can contribute to aesthetic outcomes, making it particularly useful for mole removal on the face. Subsequently, the process of thermocoagulating the root of the mole with a CO2 laser can help destroy melanin cells that may remain in the deeper layers of the skin, thereby reducing the likelihood of mole recurrence. This contributes to reducing the chance of 'recurrent moles' that reappear after only superficial removal.

Especially in the following cases, CO2 laser finishing can be actively considered:

- When the mole lesion is slightly raised or feels thick when pressed

- If there is a history of mole recurrence in the same area

- When diagnosed as a dermal nevus located deep in the dermal layer (e.g., blue nevus, gray-brown nevus, etc.)

Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They appear to spread within the epidermal layer and are observed as thin, widely spread, small brown or flesh-colored lesions to the naked eye. They tend to occur particularly when immunity is weakened and can spread through self-contact, making early and appropriate treatment important.

The Erbium-YAG laser is an effective device for uniformly ablating the epidermal layer, making it useful for

tidying up widely spread flat warts in a single session. This procedure can evenly remove lesions while minimizing skin damage. However, due to the nature of viral lesions, there is a risk of recurrence if only the superficial lesions are removed. In this case, the finishing process of applying thermal damage to the periphery of the lesion with a CO2 laser can be a clinically significant approach to further coagulate virus-infected cells that may remain in and around the epidermal layer, thereby reducing the likelihood of recurrence.

In the following situations, CO2 laser finishing is particularly important:

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

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

- If the lesion is located in areas prone to frequent contact and easy spread, such as hands or face

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

The Erbium-YAG laser is one of the effective methods for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer covering the milia, opening a pathway for the keratin inside to be safely expelled. Light thermocoagulation with a CO2 laser after removal can help reduce the possibility of remaining keratinocyte proliferation and alleviate the recurrent appearance of milia in the same area. However, excessive thermal damage to the skin can lead to hyperpigmentation, requiring precise intensity control.

CO2 laser finishing can be particularly helpful in the following cases:

- When milia repeatedly appear in the same location

- If there has been a history of the lesion re-protruding during the regeneration process after treatment

- When aiming for a uniform skin condition during the recovery process after removing multiple milia

Syringomas are benign lesions formed by the excessive proliferation of sweat glands (eccrine glands) within the dermal layer. They are characterized by the appearance of multiple small, bead-like skin lesions, especially under the eyes, on the cheeks, and forehead, and are commonly observed in women in their 20s and 30s, particularly with genetic factors.

The Erbium-YAG laser is capable of thin and precise epidermal removal, making it suitable for treating syringomas in sensitive areas like around the eyes. It refines the skin surface by removing the upper part of the sweat gland lesion, and with a low possibility of scarring or hyperpigmentation during recovery, it can have a positive impact on cosmetic outcomes. Subsequently, by applying thermal energy with a CO2 laser,

the finishing method of delivering subtle thermal stimulation to the deeper parts of the lesion can help weaken the activity of the dermal sweat glands.

This can be a clinically significant approach to suppress the regrowth of syringomas in the same area. However, since the lesions are often located deep, repeated treatments are frequently required.

In the following cases, combining CO2 laser finishing can have an even more positive impact on treatment results:

- When multiple syringomas are relatively deeply seated under the eyes, on the cheeks, etc.

- If there is a history of syringoma recurrence despite having received multiple laser treatments previously

- When hoping for the greatest possible recurrence prevention effect with a single procedure

Skin tags are benign lesions that result from the overgrowth 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. While painless, they can be irritated by friction. Generally, CO2 lasers are effective for skin tag removal, quickly treating multiple lesions with excellent cutting power and hemostasis. However, for small and thin skin tags, a method of precisely ablating the lesion first with an Erbium-YAG laser, followed by thermocoagulation of the lesion's base with a CO2 laser, can help reduce the possibility of recurrence in that area. This thermal stimulation can contribute to inhibiting the regeneration environment by damaging fibrous cells and microvessels within the tissue.

It is advisable to consider CO2 laser finishing together in the following cases:

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

- If there is a history of skin tags reappearing in the same area after previous removal

- When the lesion's root is deep or wide, potentially leaving a thick mark even after removal

Thus, by matching the depth and characteristics of the skin lesion,

the use of two types of lasers together,

'Dual Laser Technique',

is an approach that helps increase treatment satisfaction.

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

The process of mole removal causes minor irritation to the skin's surface.

Therefore, it is very important to properly protect and care for the treated area.

Maintaining a moist environment around the wound can help with skin recovery and reduce the likelihood of scarring.

For this, we recommend using DuoDerm, a hydrocolloid dressing.

DuoDerm keeps the wound area moist to aid cell regeneration and suppresses unnecessary scab formation, thereby reducing the possibility of scarring.

After mole removal, it is recommended to apply DuoDerm immediately and change it every 3-5 days, continuing care for at least 7 days.

Generally, we recommend about 10 days of care.

If DuoDerm use is difficult or an allergic reaction occurs, it is important to frequently apply a regenerating cream or moist gel to prevent skin dryness. Additionally, be sure to apply sunscreen with SPF 50 or higher thoroughly and be careful not to touch the treated area.

Post-care after mole removal is a crucial step that goes beyond mere wound protection and affects the outcome of the procedure.

Inadequate care can lead to scarring, so it's best to continue paying close attention even after the procedure.

At our clinic, we provide detailed explanations of post-procedure care methods to help our visitors achieve healthy skin recovery.

Those Considering the Procedure

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• 1. Those with skin concerns due to moles, lentigo, milia, syringoma, 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. Cleanse your face thoroughly.
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• STEP 02. Apply anesthetic ointment.
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• STEP 03. Remove the mole.
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Things to Observe After the Procedure

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• ㆍBe careful not to let water directly touch the treated area. (Washing your face with DuoDerm attached is recommended.)
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• ㆍIt is recommended to consistently change and apply the regeneration tape for about 10 days while skin regeneration occurs.
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• ㆍThere is a possibility that moles may reappear in the treated area, and re-treatment can be considered after 2-3 months.
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• ㆍDeep-rooted moles are difficult to remove completely in one session, and multiple treatments may be necessary.
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• ㆍMinimize exposure to UV rays. (Sunscreen use is essential, and applying it over DuoDerm is also recommended.)
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