Dual Laser Technique

Moles are skin lesions that appear when melanin pigment cells proliferate in the epidermis or dermis.

While they may appear to be simple hyperpigmentation, the appropriate treatment method can vary depending on the depth and type of mole.

Erbium YAG laser is useful for precisely ablating the skin surface. This can be used to remove shallow moles in the epidermis while minimizing skin burden.

It is useful for removing moles on the face, as it can reduce the risk of scarring and lead to cosmetic improvement. Subsequently, precisely cauterizing the root of the mole with heat using a CO2 laser can help remove melanin cells that may remain deep in the skin, thereby lowering the possibility of recurrence. This contributes to reducing the risk of moles reappearing when only the surface is removed and root cells remain.

It is particularly advisable to consider whether CO2 laser finishing is needed in the following cases:

If the mole is slightly raised above the skin or feels gently convex when touched

If a mole has previously reappeared in the same location

If it appears to be a nevus located deep within the dermis, such as a blue nevus or grayish-brown nevus

Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They appear as small, thin, widespread brown or flesh-colored lesions on the epidermal layer, and are particularly prone to occur when immunity is weakened. Since they can spread to other areas through self-contact, it is advisable to seek early medical attention.

Erbium YAG laser helps uniformly ablate the epidermal layer. This can be used to remove widespread flat warts cleanly.

This procedure can evenly remove lesions while reducing the burden on the skin. However, due to the nature of viral diseases, there is a possibility of recurrence if only the superficial part is removed. Therefore, the finishing process of applying fine thermal stimulation around the lesion with a CO2 laser can be clinically helpful in further cauterizing any remaining virus-infected cells in the epidermis and surrounding areas, thereby lowering the recurrence rate.

In the following cases, considering CO2 laser finishing together may be advisable:

If the borders of the lesion are not clear, or if it feels widely spread when touched, or for those with weakened immunity due to stress or lack of sleep

If there have been multiple recurrences in the same area

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

Milia are small, white cysts that form when keratin (a type of skin protein) gets trapped beneath the skin surface. They are typically found around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they do not involve infection or inflammation, making them primarily a cosmetic concern.

Erbium YAG laser is a useful procedure for removing milia. It precisely ablates the skin surface to remove the thin epidermal layer of the milia and creates a small passage to allow the trapped keratin to be effectively discharged. After the procedure, a light finishing cauterization with a CO2 laser is expected to reduce the proliferation of remaining keratinocytes, thereby reducing the recurrence of milia in the same area. However, excessive heat stimulation on the skin can cause hyperpigmentation, so precise intensity control is crucial.

CO2 laser finishing is particularly necessary in these cases:

If milia repeatedly occur in the same location

If the lesion has reappeared during the recovery process after laser treatment

When desiring a more even result during the skin regeneration process after removing multiple milia

Syringomas are benign skin lesions that form when sweat glands (eccrine glands) in the dermis proliferate abnormally. They commonly appear as small, round, pearl-like bumps in areas such as under the eyes, on the cheeks, and forehead. There may be a genetic predisposition, and they are often found in women in their 20s and 30s.

Erbium YAG laser can precisely and thinly ablate the skin surface, making it suitable for treating syringomas in sensitive areas like around the eyes. It offers the advantage of minimizing the risk of scarring or hyperpigmentation during recovery by treating the upper part of the sweat gland lesions. Subsequently, applying heat with a CO2 laser

the finishing process of applying fine thermal stimulation to the deeper parts of the lesion calms the activity of sweat glands in the dermis,

and can be clinically helpful in reducing the recurrence of syringomas in the same area. However, due to the depth of the lesions, multiple treatments may be necessary.

In the following situations, applying CO2 laser together can lead to even better results:

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

If there has been a history of recurrence despite multiple previous laser treatments

When expecting an effect that helps reduce recurrence with a single treatment

Skin tags are benign skin lesions caused by the abnormal proliferation of fibrous tissue and blood vessels in the dermis. They commonly occur in skin folds such as the neck, armpits, under the breasts, and eyelids, appearing as small, skin-colored, raised bumps. They are usually painless but can become irritated due to friction. CO2 laser is generally used for skin tag removal due to its excellent cutting and hemostatic effects, which can help quickly eliminate multiple lesions. However, for small and thin skin tags, precisely ablating the lesion first with an Erbium YAG laser, followed by cauterizing the root with a CO2 laser, can help address the root tissue of the skin tag and reduce the possibility of recurrence. Thermal stimulation affects fibrous cells and microvessels within the tissue, contributing to inhibiting regrowth.

In the following cases, applying CO2 laser finishing together may be advisable:

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

If skin tags have reappeared in the same area after previous removal

If the root of the lesion is deep or widely spread (a type where a slightly raised mark may remain even after removal)

Thus, considering the depth and characteristics of skin lesions,

the method of combining two types of lasers

known as 'Dual Laser Technique',

can help increase treatment satisfaction.

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

Mole removal procedures involve minor stimulation to the skin's surface, and this process can cause temporary changes to the skin.

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

In particular, keeping the treated area moist can help with skin regeneration, shortening the recovery period and reducing the likelihood of scar formation.

Using a hydrocolloid dressing like Duoderm can be beneficial for maintaining this moist environment.

Duoderm helps maintain a moist environment in the treated area, promoting new cell generation and delaying unnecessary scab formation, which can reduce the possibility of scarring.

It is advisable to apply Duoderm immediately after mole removal, replacing it every 3-5 days, and consistently managing the area for at least 7 days.

We recommend an overall care period of approximately 10 days.

If Duoderm use is difficult or if a skin allergic reaction occurs, other care methods should be used. In this case, apply a regenerative cream or moist gel regularly to prevent the treated area from drying out, carefully use SPF 50+ sunscreen to avoid UV exposure, and it is important not to touch the wound.

Aftercare following mole removal is more than just protecting the treated area; it is a crucial process that affects the final skin condition.

Inadequate care can lead to unwanted scarring, so continued attention and effort after the procedure are important.

Our medical institution provides detailed guidance on post-procedure care methods to help patients achieve healthy skin recovery.

Those Considering This Procedure

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• 1. Those who wished for improvement due to moles, seborrheic keratoses, milia, syringomas, skin tags, etc.
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• 2. Those who previously underwent mole removal but experienced discomfort due to moles reappearing.
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Procedure Steps

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• STEP 01. Personal 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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• ㆍPlease avoid direct contact with water on the treated area. (Light cleansing is possible while Duoderm is applied.)
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• ㆍIt is advisable to consistently replace and apply the regenerative tape during the skin regeneration period. (Approximately 10 days)
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• ㆍThere is a possibility of moles reappearing in the treated area, and re-treatment can be considered after 4-6 weeks if necessary.
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• ㆍFor deep moles, complete removal may not be achieved with a single procedure, and multiple treatments may be required.
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• ㆍUV exposure to the treated area must be minimized. (Sunscreen is essential, and application over Duoderm is recommended.)
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