Kkeuthan Clinic's Dual Laser Technique

*Moles are lesions that occur when melanocytes excessively proliferate in the epidermis or dermis.

Although they may appear to be simple pigmentation on the surface, the treatment approach varies depending on their location and depth.

The Erbium YAG laser is specialized for precise, superficial ablation, allowing for the natural removal of shallow moles located in the epidermis without skin damage.

Furthermore, it minimizes scarring and offers excellent cosmetic results, making it particularly effective 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 recurrence rate by destroying melanocytes that may remain in deeper layers. This reduces the possibility of 'recurrent moles' that appear to be removed on the surface but regenerate from remaining roots.

CO2 finishing is strongly considered in the following cases:

-If the mole is slightly raised or feels thick when pressed

-If there is a history of the mole recurring in the same area

-If it is determined to be a deep dermal nevus (e.g., blue moles, grayish-brown moles, etc.)

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

The Erbium YAG laser is effective for uniformly ablating the epidermal layer, making it useful for extensively spread flat warts.

It is useful for clearing them all at once. It allows for uniform removal of lesions with minimal skin damage. However, due to the nature of viral lesions, removing only the surface lesions carries a risk of recurrence. In such cases, the finishing process of applying thermal damage around the lesion with a CO2 laser can be a clinically significant treatment to further cauterize virus-infected cells that may remain in and around the epidermal layer, thereby reducing the recurrence rate.

CO2 finishing is particularly important in the following cases:

-If the lesion's border is unclear, or if it feels flat and spread out when touched, or for individuals with weakened immunity (due to stress, lack of sleep, etc.)

-If there has been a history of multiple recurrences

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

*Milia are lesions that appear as small, white cysts when keratin (a type of skin protein) becomes trapped within the skin. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are cosmetic lesions unrelated to infection or inflammation.

The Erbium YAG laser is highly suitable for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer of the milia, creating an opening for the trapped keratin to be safely extracted. Afterward, a light thermal cauterization with a CO2 laser helps reduce the possibility of remaining keratinocytes regenerating and prevents milia from recurring in the same area. However, precise intensity control is necessary, as excessive thermal damage to the skin can lead to hyperpigmentation.

CO2 finishing is particularly helpful in the following cases:

-If milia repeatedly appear in the same location

-If the lesion re-emerged during the regeneration process after previous treatment

-When expecting consistent results during the regeneration process after removing multiple milia

*Syringomas are benign lesions formed by the overgrowth of sweat glands (eccrine glands) in the dermis. They are characterized by multiple small, bead-like skin lesions that appear under the eyes, on the cheeks, and forehead. They are particularly common in individuals with genetic factors or in women in their 20s and 30s.

The Erbium YAG laser is suitable for treating syringomas in sensitive areas like around the eyes because it can remove the epidermis thinly and precisely. It refines the skin surface, removes the upper part of the sweat gland lesions, and results in minimal scarring or pigmentation during recovery, making it excellent from a cosmetic perspective. Subsequently, applying heat with a CO2 laser

The finishing method of causing microscopic damage to the deeper parts of the lesion weakens the activity of the sweat glands within the dermis,

and is clinically significant in preventing syringomas from re-proliferating in the same area. However, because the lesions are deep, repeated treatments are often necessary.

The treatment effect is enhanced when CO2 finishing is combined in the following cases:

-If multiple syringomas are located relatively deep under the eyes, on the cheeks, etc.

-If recurrence has been experienced despite previous laser treatments

-When aiming for maximum recurrence prevention effect with a single treatment

*Skin tags are benign lesions resulting from the overgrowth of fibrous tissue and blood vessels in the dermis. They commonly appear in skin folds such as the neck, armpits, under the breasts, and eyelids, presenting as small, protruding lesions similar in color to the skin. They are typically painless but can be irritated by friction. Generally, CO2 laser is more suitable for skin tag excision, offering excellent cutting and hemostatic effects, allowing for rapid removal of multiple lesions. However, for small and thin skin tags, precisely ablating the lesion first with an Erbium YAG laser, followed by thermal cauterization of the lesion's base with a CO2 laser, helps remove the root tissue of the skin tag and reduces the likelihood of recurrence in that area. Thermal stimulation has the effect of destroying fibrous cells and microvessels within the tissue, thereby inhibiting the regenerative environment.

It is highly recommended to combine CO2 finishing in the following cases:

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

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

-If the lesion has deep and wide roots (the type where a raised mark remains even after excision)

Thus, depending on the depth and nature of the lesion,

combining two types of lasers

the ‘Dual Laser Technique’

is a key strategy to enhance the completeness of treatment.

After mole removal, how long should I keep the DuoDERM (sticker) on?

Mole removal procedures exfoliate the skin's surface, which results in minor physical damage to the skin.

Therefore, it is very important to properly protect and manage the treated area.

Keeping the treated area moist, in particular, significantly impacts recovery speed and scar prevention.

For this purpose, applying Duoderm, a hydrocolloid dressing, is recommended.

Duoderm keeps the wound moist, promoting cell regeneration and slowing scab formation, thereby reducing the possibility of scarring.

Ideally, apply Duoderm immediately after mole removal, replace it every 3-5 days, and manage the area for at least 7 days or more.

A total management period of about 10 days is recommended.

If Duoderm use is difficult or an allergic reaction occurs, you should manage the area by frequently applying a regenerating cream or moisturizing gel to prevent dryness, diligently using SPF 50+ sunscreen, and avoiding touching the wound.

Post-mole removal care is not just about protecting the wound; it's a crucial process that determines the outcome.

Neglecting aftercare can lead to scarring, so continuous attention is required even after the procedure.

Kkeut Korean Medicine Clinic provides detailed guidance on post-procedure care methods to ensure our patients' fast and healthy recovery.

Recommended for

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• 1. Those who have been concerned about moles, seborrheic keratosis, milia, syringomas, or skin tags.
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• 2. Those who have experienced mole recurrence after removal.
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Procedure Steps

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

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• ㆍPlease be careful not to let water touch the treated area. (Please wash your face with Duoderm applied.)
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• ㆍDuring the skin regeneration phase, please continue to replace and apply the regeneration tape if possible. (for about ~10 days)
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• ㆍMoles in the removed area may recur and can be removed again after 4-6 weeks.
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• ㆍMoles with deep roots may require repeated procedures.
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• ㆍPlease avoid sun exposure as much as possible. (Sunscreen is essential; apply it over Duoderm if possible.)
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