Utilizing Customized Dual Laser for Skin Lesions

Moles are pigmented lesions caused by the excessive proliferation of melanin cells. They typically appear in the epidermis or dermis.

While they may appear as simple pigmentation on the surface, moles may require different treatment methods depending on their depth and location.

The Er:YAG laser is effective for precise, shallow ablation. When removing shallow moles in the epidermis, a natural removal can be expected while minimizing stress on the surrounding skin.

This laser reduces the possibility of scar formation and can be utilized for facial mole removal due to its potential for good cosmetic results. Subsequently, a CO2 laser is used to thermally ablate the base of the mole. This can help destroy remaining melanin cells in deeper areas, reducing the likelihood of mole recurrence. This lowers the concern of recurrent moles that occur when the surface is removed but root tissue remains.

Particularly in the following cases, adding a CO2 laser finish may be desirable:

-When the mole appears visibly raised or feels softly protruding upon touch

-If you have experienced mole recurrence in the same area in the past

-When diagnosed as a nevus located deep within the dermis (e.g., blue nevus, gray-brown nevus, etc.)

Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They typically appear as small, thin, brownish or skin-colored lesions widely spread across the epidermal layer. They are prone to develop when immunity is weakened and can spread to other parts of the body, so early intervention is recommended.

The Er:YAG laser has the advantage of uniformly removing the epidermal layer. It can be suitable for managing widely distributed flat wart lesions

with a single treatment session. It helps reduce the burden on the skin while uniformly removing the lesions. However, viral lesions may recur if only the superficial part is removed. In such cases, a follow-up procedure of applying subtle thermal stimulation to the periphery of the lesion with a CO2 laser can help further ablate remaining virus-infected cells in the epidermis and surrounding areas, thereby reducing the recurrence rate.

In the following situations, a CO2 laser finish may be particularly recommended:

-When the lesion's borders are unclear or feel flat and spread out upon touch. Also, when immunity is weakened (e.g., due to stress, lack of sleep, etc.).

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

-When the lesion is on areas prone to frequent contact or easy spreading, such as the hands or face

Milia are small, white, pocket-like lesions formed by the accumulation of keratin (a type of skin protein) beneath the skin's surface. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are aesthetic concerns not directly related to infection or inflammation.

The Er:YAG laser is effective for milia removal. It can precisely ablate the skin's surface to remove the thin epidermal layer of the milia, creating a pathway for the trapped keratin to be smoothly discharged. Subsequently, performing a light finishing ablation with a CO2 laser can help reduce the concern of residual keratinocyte proliferation and prevent milia from recurring in the same area. However, excessive heat damage to the skin can lead to hyperpigmentation, so delicate intensity control is crucial.

Situations where a CO2 laser finish is particularly recommended are as follows:

-When milia tend to recur repeatedly in the same location

-If there has been an experience of the lesion reappearing during the recovery process after treatment

-When expecting a smooth skin condition after recovery, especially after removing multiple milia

Syringomas are benign skin lesions caused by the excessive proliferation of sweat glands (eccrine glands) in the dermis. They typically appear as multiple small, raised, bead-like lesions under the eyes, on the cheeks, and forehead. They can have a genetic predisposition or are relatively common in women in their 20s and 30s.

The Er:YAG laser can thinly and delicately remove the epidermis, making it a consideration for syringoma treatment in sensitive areas like around the eyes. It is effective for smoothing the skin surface and removing the upper part of sweat gland lesions, and it can lead to good cosmetic results by reducing the burden of scars or hyperpigmentation after recovery. Next, by applying heat using a CO2 laser,

the method of applying subtle thermal damage to the deeper parts of the lesion can help reduce the activity of intradermal sweat glands,

and may be clinically significant in reducing the recurrence of syringomas 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 finish can lead to positive treatment outcomes: -When multiple syringomas are deeply distributed under the eyes, on the cheeks, etc. -If there is a history of lesions recurring despite having received multiple laser treatments previously -When aiming to reduce the risk of recurrence with just a single treatment session

Skin tags are benign skin lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermis. They primarily occur in skin folds such as the neck, armpits, under the breasts, and on the eyelids, appearing as small, skin-colored protrusions. They are painless but can become irritated by friction. Generally, CO2 laser is suitable for skin tag removal, efficiently eliminating multiple lesions with excellent cutting and hemostatic effects. However, for small and thin skin tags, a method of delicately ablating the lesion surface with an Er:YAG laser, followed by finishing ablation of the lesion base with a CO2 laser, can help remove the root tissue and reduce the likelihood of recurrence in that area. Thermal stimulation can contribute to weakening fibrous cells and microvessels within the tissue, thereby inhibiting the regenerative environment.

Situations where considering a CO2 laser finish together can be effective are as follows: -When skin tags occur in areas of frequent friction, such as the neck or armpits -If there is a history of skin tags reappearing in the same area after removal -For types where the lesion's root is deep and wide, potentially leaving noticeable marks even after removal

As such, considering the depth and characteristics of each lesion,

applying two types of laser treatments together

the 'Dual Laser Technique'

can help increase treatment satisfaction.

How long should DuoDERM be applied after mole removal?

-병변의 뿌리가 깊고 넓게 자리 잡아 제거 후에도 자국이 도드라지게 남을 수 있는 유형

이처럼 각 병변의 깊이나 특성을 고려하여

두 종류의 레이저 시술을 함께 적용하는

‘듀얼 레이저 기법’은

시술의 만족도를 높이는 데 도움이 될 수 있습니다.

점 제거 후 듀오덤 부착 기간은 어떻게 될까요?

Mole removal procedures involve a process of microscopically exfoliating the skin's surface, which may cause slight irritation to the treated area.

Therefore, properly protecting and managing the treated area is crucial for the recovery process.

Specifically, maintaining a moist environment to prevent the treated area from drying out can help with faster regeneration and reduce the likelihood of scarring.

For this reason, applying hydrocolloid moist wound dressings may be recommended.

These moist dressings help keep the wound hydrated, aid in cell regeneration, and prevent dry scabs from forming, thereby reducing the chances of scarring.

Applying a moist dressing immediately after mole removal, changing it every 3-5 days, and managing the area for at least 7 days can positively impact recovery.

Generally, a total management period of about 10 days is recommended.

If using moist dressings is difficult or if a skin allergic reaction occurs, you should apply a regenerating cream or moisturizing gel frequently to prevent dryness. Additionally, it is important to meticulously apply sunscreen with an SPF of 50 or higher and to avoid touching the treated area directly.

Post-mole removal care is not just about protecting the treated area; it is a crucial process that can affect the final outcome.

Neglecting care can lead to unwanted marks, so it is advisable to consistently pay attention to the area even after the procedure.

Here, we provide detailed guidance on post-procedure care to help our patients achieve a quick and healthy recovery.

Recommended for

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• 1. Those who wish to improve their skin due to moles, seborrheic keratosis, milia, syringomas, skin tags, etc.
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• 2. Those concerned about lesions reappearing in the same area after mole removal.
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Procedure Steps

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

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• ㆍAvoid direct contact of water with the treated area. (Facial cleansing is possible with a moist dressing applied.)
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• ㆍDuring the skin regeneration phase, it is advisable to consistently replace and apply regenerative dressings. (Approximately 10 days)
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• ㆍMoles may reappear in the removed area, and re-treatment can be considered after 4-6 weeks if necessary.
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• ㆍFor deeply rooted moles, more than one treatment may be required.
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• ㆍBe careful to avoid excessive exposure to ultraviolet rays. (Sunscreen use is essential, and applying it over the moist dressing is also recommended.)
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