Kkeut Han Clinic's Dual Laser Technique

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

Outwardly, they may appear as simple pigmentation, but the treatment approach varies depending on their location and depth.

The Er:YAG laser specializes in precise, shallow ablation, allowing for the natural removal of superficial moles located in the epidermis without skin damage.

It also minimizes scarring while offering excellent cosmetic results, making it particularly effective for mole removal on the face. Subsequently, the process of using a CO2 laser to thermally cauterize the base of the mole helps reduce the recurrence rate by destroying melanocytes that may remain in deeper layers. This diminishes the possibility of 'recurrent moles' that appear to be removed on the surface but regenerate from a remaining root.

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 nevus, gray-brown nevus, etc.)

*Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They spread within the epidermis and appear as thin, wide, brown or flesh-colored small lesions. They are particularly common when immunity is lowered and can spread through self-contact, making early treatment important.

The Er:YAG laser is effective in evenly ablating the epidermal layer, making it useful for treating widespread flat warts

in a single session. It can uniformly remove lesions while minimizing skin damage. However, due to the nature of viral lesions, there is a risk of recurrence if only the superficial lesion is removed. In such cases, the finishing process of applying thermal damage to the surrounding area with a CO2 laser can be a clinically significant treatment to reduce the recurrence rate by further cauterizing virus-infected cells that may remain in the epidermis and its vicinity.

CO2 finishing is particularly important in the following cases:

-If the lesion's border is unclear, or it feels flat and spread out when touched, especially 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 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 commonly occur around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are cosmetic lesions unrelated to infection or inflammation.

The Er:YAG laser is highly suitable for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer of the milia, creating a pathway for the safe discharge of trapped keratin. After removal, a light finishing cauterization with a CO2 laser helps reduce the possibility of remaining keratinocytes proliferating 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 post-inflammatory hyperpigmentation.

CO2 finishing is particularly beneficial in the following cases:

-If milia repeatedly appear in the same location

-If there has been an experience of the lesion reappearing during the regeneration process after surgery

-When desiring a uniform result during the regeneration process after removing multiple milia

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

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

in a finishing technique that causes microscopic damage to the deeper parts of the lesion weakens the activity of the dermal sweat glands,

and is clinically significant in preventing syringomas from regenerating in the same area. However, because the lesions are deep, repeated treatments are often required.

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

-If multiple syringomas are relatively deep-seated in areas such as under the eyes or on the cheeks

-If recurrence has occurred despite having received multiple laser treatments previously

-When aiming for maximum recurrence prevention with a single treatment

*Skin tags are benign lesions resulting from the overgrowth of fibrous tissue and blood vessels in the dermal layer. They commonly appear in skin folds such as the neck, armpits, under the breasts, and on the eyelids, presenting as small, flesh-colored, raised lesions. They are usually painless but can be irritated by friction. Generally, the CO2 laser is more suitable for skin tag excision, offering excellent cutting and hemostatic effects for rapid removal of multiple lesions. However, for small and thin skin tags, precisely ablating the lesion first with an Er:YAG laser, followed by finishing cauterization of the lesion's base with a CO2 laser, helps remove the root tissue of the skin tag and lowers the likelihood of recurrence in that area. Thermal stimulation has the effect of destroying fibrous cells and microvessels within the tissue, 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 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 that leaves a raised mark even after excision)

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

combining two lasers

this 'Dual Laser Technique'

is a core strategy for enhancing the completeness of treatment.

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

Mole removal treatment is a process that exfoliates the skin's surface, causing physical damage to the skin.

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

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

For this, attaching 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, change it every 3-5 days, and manage the area for at least 7 days.

A total management period of about 10 days is recommended.

If using Duoderm is difficult or an allergy 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 care can leave scars, so continuous attention is required even after the procedure.

Kkeut Korean Medicine Clinic carefully guides patients through post-procedure care methods for their quick 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 recurrence after mole 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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Post-Procedure Precautions

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• ㆍBe careful not to let water touch the treated area. (Please wash your face with Duoderm attached)
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• ㆍDuring the skin regeneration phase, if possible, continue to change and apply the regenerative tape. (For about 10 days)
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• ㆍMoles in the treated area may recur and can be removed again after 4-6 weeks.
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• ㆍDeep-rooted moles may require repeated procedures.
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• ㆍAvoid sun exposure as much as possible. (Sunscreen is essential, and apply it over Duoderm if possible.)
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