Dual Laser Treatment Method Utilized at Kkeuthan Clinic

*A mole is a skin lesion that appears when melanin-producing cells excessively proliferate in the epidermis or dermis.

Although it may appear as a simple pigment on the surface, the treatment method for moles can vary depending on their location and depth.

The Er:YAG laser is suitable for precise, shallow ablation of the skin surface. Using this laser can help to naturally remove shallow moles in the epidermal layer while minimizing damage to the surrounding skin.

This procedure can lead to cosmetic improvement while reducing the possibility of scarring, making it particularly useful for facial mole removal. Subsequently, the process of thermocoagulating the root of the mole with a CO2 laser can destroy melanin cells that may remain in deeper layers, helping to prevent the mole from recurring. This reduces the likelihood of so-called ‘recurrent moles,’ where the surface has been removed but the root tissue remains, leading to recurrence.

Specifically, consider applying a finishing process with a CO2 laser in the following cases:

- When the mole is slightly raised or feels somewhat thick to the touch

- If the mole has recurred in the same area after previous treatment

- When diagnosed as a dermal nevus requiring deep treatment (e.g., blue moles, grayish-brown moles, etc.)

*Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection.

They typically appear spread out in the epidermal layer and may look like small, thin, flat, brown or skin-colored lesions. Their incidence increases when immunity is weakened, and they can self-spread, so early treatment is advisable.

The Er:YAG laser can be usefully employed for uniform ablation of the epidermal layer. This can be used to treat widespread flat warts

in one go. This method helps to uniformly remove the lesional area while reducing the burden of skin damage. However, due to the nature of viral diseases, there is a possibility of recurrence if only the surface is removed. Therefore, a finishing process that applies thermal energy around the lesion with a CO2 laser can be a clinically significant approach to reduce the likelihood of recurrence by further cauterizing virus-infected cells that may remain in the epidermis and its surroundings.

Specifically, a finishing process with a CO2 laser is considered even more important in the following situations:

- When the lesion's border is not clear, or it feels broadly spread out to the touch. Or for individuals with weakened immunity (e.g., due to stress, lack of sleep, etc.).

- If there is a history of multiple recurrences

- When the lesion is located on frequently touched areas in daily life, such as hands or face, where the virus can easily spread

*Milia are lesions that appear as small, white, cyst-like bumps when keratin (a type of skin protein) becomes trapped beneath the skin.

They are primarily found around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are a cosmetic issue unrelated to inflammation or infection.

The Er:YAG laser can be effectively used to remove milia. This laser precisely ablates the skin surface to remove the thin superficial layer of the milia, creating a safe pathway for the trapped keratin to be expelled. A light finishing cauterization with a CO2 laser after the procedure can help reduce the possibility of residual keratinocytes regenerating and prevent milia from recurring in the same area. However, careful intensity control is necessary, as excessive thermal stimulation to the skin can cause hyperpigmentation.

A finishing process using a CO2 laser is particularly recommended in the following cases:

- When milia continuously occur in the same location

- When there is experience of the lesion reappearing during the regeneration process after treatment

- When aiming for a more even and natural result during the recovery process after removing multiple milia

*Syringomas are benign skin lesions that arise from an excessive proliferation of sweat gland tissue (eccrine glands) within the dermis.

They are characterized by appearing as multiple small, bead-like formations, typically under the eyes, on the cheeks, and forehead. They are especially common in individuals with a genetic predisposition or in women in their 20s and 30s.

The Er:YAG laser can precisely remove the skin's surface thinly, making it useful for managing syringomas in sensitive areas like around the eyes. By refining the skin surface and removing the upper tissue of the sweat gland lesions, it can help reduce the possibility of scarring or hyperpigmentation during the recovery process, thus increasing cosmetic satisfaction. Subsequently, applying thermal energy with a CO2 laser

A finishing method that induces micro-thermal damage to the deep tissue of the lesion weakens the abnormal activity of sweat glands within the dermis, and

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

In the following situations, combining a CO2 laser can lead to further improved results:

- When multiple syringomas are located relatively deep under the eyes or on the cheeks

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

- When aiming to maximize the recurrence prevention effect with a single treatment session

*Skin tags are benign skin growths that appear due to the excessive proliferation of fibrous tissue and blood vessels in the dermal layer.

They commonly occur in areas where skin folds, such as the neck, armpits, under the breasts, and on the eyelids, and are observed as small, protruding lesions similar in color to the skin. They are usually painless but can become irritated by friction. Generally, CO2 lasers are considered more suitable for skin tag removal. CO2 lasers can quickly treat multiple lesions with excellent cutting and hemostatic effects. However, for small and thin skin tags, a method involving precise ablation of the lesion's surface with an Er:YAG laser first, followed by a finishing cauterization of the root with a CO2 laser, can be considered. This method helps remove the source tissue of the skin tag, contributing to a reduced chance of recurrence in that area. Thermal stimulation is expected to destroy fibrous cells and microvessels within the tissue, inhibiting regrowth.

Situations where applying a finishing process with a CO2 laser can be even more beneficial include the following:

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

- When there is a history of skin tags recurring in the same area after previous removal

- If the root tissue of the lesion is deep and widely spread (a type that leaves a slightly thick mark on the skin even after removal)

Thus, tailored to the depth or characteristics of the lesion,

Combining two types of laser treatments

‘Dual Laser Treatment’ can be

a crucial approach to enhancing the completeness of treatment results.

How long should I keep a Duoderm (healing patch) on after mole removal?

Mole removal procedures involve gently shaving off the outer layer of the skin. During this process, small, temporary wounds may appear on the skin.

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

Specifically, maintaining a moist environment around the treated area helps promote faster healing and reduces the likelihood of scarring.

For these reasons, the use of Duoderm, a hydrocolloid moist dressing, is often recommended.

Duoderm helps maintain a moist environment for the wound, aiding cell regeneration. It can also delay scab formation, which may reduce the chance of scarring.

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

The total management period is generally recommended to be around 10 days.

If using Duoderm is uncomfortable or if an allergic reaction occurs, you can continue management using other methods. It is recommended to frequently apply a regenerating cream or moisturizing gel to prevent the skin from drying out, and to diligently use sunscreen with SPF 50 or higher. It is also important not to touch the treated area.

The results of mole removal can vary significantly depending on how you manage the area afterward. It's an important step in skin recovery, beyond just wound protection.

Inadequate care may lead to unwanted scarring. It's best to continue to pay close attention to the treated area even after the procedure.

At our clinic, we provide detailed explanations of post-procedure care methods to help patients recover healthily.

Recommended for

• 1. Individuals who have experienced discomfort due to moles, seborrheic keratosis, milia, syringoma, skin tags, etc.

• 2. Individuals who had moles removed previously, but they have reappeared and are bothering them.

Procedure Steps

• STEP 01. Self-cleansing

• STEP 02. Anesthetic cream application

• STEP 03. Mole removal procedure

Post-Procedure Precautions

• ㆍBe careful to avoid direct contact with water on the treated area. Facial cleansing is possible with Duoderm applied.

• ㆍIt is recommended to consistently replace and apply the healing tape for about 10 days while skin regeneration occurs.

• ㆍOccasionally, moles may reappear in the treated area. Re-treatment can be considered after 4-6 weeks.

• ㆍFor deep-rooted moles, complete removal in a single session may be difficult, and multiple sessions might be required.

• ㆍIt is important to avoid sun exposure as much as possible. Sunscreen with SPF 50 or higher is essential, and it is beneficial to apply it over the Duoderm as well.