Two Laser Combination Treatment Methods

Moles are pigmented lesions that appear when melanocytes proliferate excessively in the epidermis or dermis.

Although they may appear simple on the surface, the removal method for moles can vary depending on their location and depth.

The Er:YAG laser is suitable for precisely and thinly abrading skin layers. Utilizing this laser allows for the natural removal of shallow moles in the epidermis without significant skin damage.

It reduces the risk of scarring and ensures clean treatment results, making it particularly suitable for mole removal on the face. The subsequent process of using a CO2 laser to thermally ablate the base of the mole helps reduce the likelihood of moles reappearing by treating melanocytes that might remain in deeper layers. This can decrease 'recurrent moles' that appear to be removed but still have their roots intact, leading to re-emergence.

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

-When moles are slightly raised or feel thick to the touch

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

-When deemed to be a dermal nevus located deep within the dermis (e.g., blue moles, grayish-brown moles, etc.)

Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They tend to spread within the epidermal layer and appear to the naked eye as thin, widespread, small, brownish or flesh-colored lesions. They are particularly prone to appearing when immunity is compromised and can spread through self-contact, making early management crucial.

The Er:YAG laser is useful for uniformly ablating the epidermal layer. Therefore, it is effective for widely spread flat warts.

It is effective for managing them all at once. It can evenly remove lesions while minimizing skin damage. However, viral lesions carry a risk of recurrence if only the surface is removed. In such cases, the finishing process of applying thermal stimulation to the periphery of the lesion with a CO2 laser can clinically help reduce the recurrence rate by further ablating virus-infected cells that may remain in the epidermis and its surroundings.

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

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

-If you have already experienced multiple recurrences

-When the lesion area is frequently touched, such as on the hands or face, or is prone to spreading to other areas

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

The Er:YAG laser can be suitably used for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer of the milium, creating a channel for the safe expulsion of the internal keratin. Subsequently, a light finishing ablation with a CO2 laser can help reduce the possibility of remaining keratinocytes re-proliferating and prevent milia from repeatedly appearing in the same spot. However, precise intensity control is necessary, as excessive thermal damage to the skin can lead to post-inflammatory hyperpigmentation.

CO2 laser finishing is particularly recommended in the following cases:

-When milia repeatedly occur in the same location

-If you have experienced the lesion re-emerging during the recovery process after a previous procedure

-When aiming for uniform skin texture during recovery after removing multiple milia

Syringomas are benign lesions caused by the excessive proliferation of sweat gland tissue within the dermis. They characteristically appear as multiple small, bead-like lesions under the eyes, on the cheeks, and forehead. They are particularly common in individuals with genetic factors or women in their 20s and 30s.

The Er:YAG laser can thinly and delicately remove the epidermis, making it suitable for treating syringomas in sensitive areas like around the eyes. It refines the skin surface and removes the upper part of the sweat gland lesions, offering cosmetic benefits with less risk of scarring or pigmentation after recovery. Subsequently, applying heat with a CO2 laser

The finishing method of inflicting micro-damage to the deeper parts of the lesion can help weaken the excessive activity of intradermal sweat glands.

This is clinically significant in preventing syringomas from regrowing in the same area. However, since lesions are often deeply situated, multiple treatment sessions may be required.

In the following cases, combining CO2 laser finishing can positively impact treatment results:

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

-If you have a history of lesions recurring despite multiple previous laser treatments

-When aiming to reduce the possibility of recurrence with a single treatment

Skin tags are benign lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermis. They commonly occur in skin fold areas such as the neck, armpits, under the breasts, and on the eyelids, appearing as small, skin-colored protrusions. While painless, they can be irritated by friction. Generally, CO2 lasers are useful for excising skin tags, quickly removing multiple lesions with excellent cutting and hemostatic effects. However, for small and thin skin tags, precisely ablating the lesion first with an Er:YAG laser, followed by finishing ablation of the lesion's base 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 can weaken fibrous cells and microvessels within the tissue, thus inhibiting the regenerative environment.

Cases where considering a CO2 laser may be beneficial include:

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

-If there is a history of skin tags recurring in the same area after excision

-When the lesion has deep and wide roots (the type that leaves a thick trace on the skin even after removal)

Thus, considering the depth and characteristics of the lesion,

using two lasers in combination,

the 'Dual Laser Technique' is

an approach that helps enhance the completeness of treatment.

How long should DuoDERM be applied after mole removal?

Mole removal is a procedure that modifies the superficial layer of the skin, which can lead to subtle changes.

Therefore, properly protecting and managing the treated area is extremely important.

In particular, keeping the treated area moist helps skin recovery and reduces the likelihood of scar formation.

For this purpose, the use of hydrocolloid dressings, such as DuoDERM, is recommended.

DuoDERM can contribute to maintaining a moist environment in the treated area, promoting cell regeneration, delaying scab formation, and thus lowering the risk of scarring.

Applying DuoDERM immediately after mole removal, changing it every 3-5 days, and consistently managing the area for at least 7 days helps effective recovery.

We recommend an overall management period of about 10 days.

If DuoDERM use is uncomfortable or an allergic reaction occurs, other management methods are needed. In such cases, apply an ample amount of regenerative cream or moisturizing 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 skin care is an important step that goes beyond simple protection to improve treatment outcomes.

If adequate care is not provided, it can lead to scar formation, so continuous attention is needed even after the procedure.

Our medical staff meticulously explains post-procedure care methods to ensure healthy skin recovery for all our visitors.

Recommended for

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• 1. Individuals who have experienced discomfort due to moles, seborrheic keratoses, milia, syringomas, or skin tags.
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• 2. Individuals who have previously undergone mole removal but have experienced the mole reappearing.
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Procedure Steps

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• STEP 01. Individual Cleansing
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• STEP 02. Anesthetic Ointment Application
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• STEP 03. Mole Removal Procedure
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Post-Procedure Precautions

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• ㆍAvoid direct contact with water on the treated area. (Light cleansing is possible when DuoDERM is applied.)
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• ㆍDuring skin regeneration, it is recommended to consistently replace and apply the regenerative tape. (Recommended for about 10 days.)
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• ㆍThere is a possibility that moles may reappear in the treated area. If re-treatment is necessary, it can usually be considered after 4-6 weeks.
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• ㆍFor deep-rooted moles, one procedure may not be sufficient, and additional treatments might be necessary.
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• ㆍMinimizing UV exposure is important. Sunscreen must be used, and it is also advisable to apply it over DuoDERM if possible.
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