Dual Laser Technique for Skin Lesion Improvement

Moles are pigmented lesions that form when melanin cells accumulate excessively in the epidermis or dermis of the skin.

Unlike what appears on the surface, the effective treatment method for moles can vary depending on their depth and location.

The Erbium-YAG laser is used to precisely ablate the skin surface. This can help to naturally remove shallow moles in the epidermal layer while minimizing damage to surrounding skin.

This laser lowers the possibility of scarring, and significant aesthetic improvement can be expected, especially when removing facial moles. Subsequently, the process of thermally cauterizing the base of the mole using a CO2 laser helps to remove melanin cells that may remain in deeper layers, reducing the likelihood of mole recurrence. This method prevents recurrent moles that appear to have vanished but have a remaining 'root'.

Specifically, finishing with a CO2 laser may be considered in the following cases:

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

-If the mole has recurred in the same area previously.

-When it is determined to be a nevus located in the deep dermal layer (e.g., blue moles, grayish-brown moles).

Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They appear as thin, widely spread, small brown or flesh-colored growths in the epidermal layer. They tend to occur easily when immunity is low and can spread through self-contact, making early management important.

The Erbium-YAG laser is useful for uniformly ablating the epidermal layer.

It can help to clear widely spread flat warts in a single session. The goal of this procedure is to evenly remove the lesions while reducing the burden of skin damage. However, since viral lesions can recur if only the surface is removed, it is beneficial to finish by applying precise thermal stimulation around the lesion with a CO2 laser. This can contribute to lowering the recurrence rate by further cauterizing virus-infected cells that might remain in the epidermal layer and its surroundings.

Specifically, CO2 laser finishing may be considered necessary in the following cases:

-When the lesion's border is unclear or feels widely spread to the touch, or for individuals whose immunity may be weakened due to stress, lack of sleep, etc.

-If you have a history of flat warts recurring multiple times.

-If lesions are present on areas frequently touched or where the virus can easily spread, such as hands or face.

Milia are lesions that appear as small, white, pocket-like bumps when keratin, a horny protein, becomes trapped beneath the skin. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are cosmetic concerns unrelated to infection or inflammation.

The Erbium-YAG laser can be effectively used for milia removal. It precisely ablates the skin surface to open the thin epidermis of the milia, helping to safely expel the trapped keratin. A light final cauterization with a CO2 laser after the procedure helps to reduce the possibility of remaining keratinocytes re-proliferating and prevents milia from recurring in the same area. However, if excessive heat damage occurs to the skin, pigmentation may appear, requiring precise intensity control by the medical staff.

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

-When milia frequently recur in the same location.

-If you have experienced lesions reappearing during the regeneration process after a previous treatment.

-When you want to achieve a more uniform result during skin regeneration after removing multiple milia.

Syringomas are benign lesions caused by the excessive proliferation of eccrine sweat gland tissue (sweat glands) in the dermal layer of the skin. They are characterized by multiple small, bead-like growths felt under the eyes, on the cheeks, or forehead. They tend to have a genetic predisposition and are relatively common in women in their 20s and 30s.

The Erbium-YAG laser can precisely remove the epidermis thinly, making it suitable for managing syringomas in sensitive areas like around the eyes. It refines the skin surface and removes the upper part of the sweat gland lesions, reducing the possibility of scarring or hyperpigmentation during recovery, thus offering aesthetic improvement. Subsequently, by applying thermal energy with a CO2 laser,

the finishing process, which involves applying microscopic thermal damage to the deeper parts of the lesion, can help weaken the activity of sweat glands in the dermal layer.

This is a clinically significant approach for preventing syringomas from proliferating again in the same area. However, due to the depth of the lesions, multiple treatment sessions may be required.

Combining CO2 laser finishing can enhance treatment effectiveness in the following cases:

-When syringomas are located relatively deeply in multiple areas such as under the eyes or on the cheeks.

-If you have experienced syringomas recurring despite having received multiple laser treatments previously.

-When you wish to focus on recurrence prevention as much as possible with a single treatment.

Skin tags are benign skin lesions caused by the excessive growth of fibrous tissue and blood vessels in the dermal layer. They primarily appear in skin folds such as the neck, armpits, under the breasts, and on the eyelids, presenting as small, skin-colored protrusions. While painless, they can become irritated by friction. Generally, the CO2 laser is suitable for removing multiple skin tags quickly due to its excellent cutting and hemostatic effects. However, for small and thin skin tags, a method of precisely ablating the lesion first with an Erbium-YAG laser, followed by cauterization of the base with a CO2 laser, can help remove the root tissue of the skin tag. This contributes to reducing the possibility of recurrence in that area, and thermal stimulation is significant in regulating the regeneration environment of fibrous cells and microvessels within the tissue.

The following cases may benefit more from combining CO2 laser finishing:

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

-If you have experienced skin tags recurring in the same area after removal.

-When the lesion's root is deep or wide, potentially leaving a noticeable trace even after excision.

Thus, by considering the depth and characteristics of the lesion,

using two laser methods together,

the 'Dual Laser Technique' is

an approach that helps to enhance the completeness of the treatment.

How long should I use a hydrocolloid dressing after mole removal?

Mole removal is a procedure that affects the superficial layer of the skin. During this process, the skin may experience temporary damage.

Therefore, it is necessary to protect and manage the treated area to ensure proper recovery.

Maintaining a moist environment in the treated area, in particular, can help facilitate faster recovery and reduce the likelihood of scar formation.

For this, we recommend managing the area by applying a hydrocolloid dressing called DuoDerm.

DuoDerm helps maintain an appropriately moist environment in the treated area, aiding cell regeneration and reducing unnecessary scab formation, which can lower the chance of scarring.

After applying DuoDerm immediately after mole removal, it is recommended to manage the area for at least a week, replacing the dressing every 3-5 days.

Overall, a management period of approximately 10 days can be considered.

If DuoDerm use is difficult or a skin reaction occurs, other management methods should be considered. Frequently apply a regenerating cream or moist gel to prevent the treated area from drying out, and consistently use sunscreen with an SPF of 50 or higher. Additionally, avoiding direct touching of the wound area helps with recovery.

Post-mole removal care is not merely about protecting the treated area; it is a crucial step that determines the overall outcome of the procedure.

Neglecting aftercare can increase the likelihood of unwanted scars, so it's advisable to continue to pay close attention to the area even after the procedure.

To help facilitate a fast and healthy recovery after the procedure, we provide our patients with detailed guidance on aftercare methods.

Recommended for

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• 1. Individuals who wish to improve skin concerns such as moles, seborrheic keratosis, milia, syringomas, or skin tags.
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• 2. Individuals who have experienced moles reappearing after a mole removal procedure.
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Procedure Steps

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• STEP 01. Self-cleansing
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• STEP 02. Application of Anesthetic Cream
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• STEP 03. Mole Removal Procedure
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Post-Procedure Precautions

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• ㆍBe careful not to let water directly touch the treated area. Facial cleansing is possible with DuoDerm applied.
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• ㆍDuring skin regeneration, it is recommended to consistently replace and apply the regeneration tape for about 10 days.
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• ㆍThere is a possibility that moles in the treated area may reappear, and if re-treatment is necessary, it can be performed 4-6 weeks later.
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• ㆍFor moles with deep roots, complete removal may be difficult with a single procedure, and additional treatments may be considered.
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• ㆍIt is important to avoid exposure to ultraviolet rays as much as possible. Sunscreen use is essential, and applying it over DuoDerm can also be helpful.
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