Laser removal of protruding lesions, from skin tags to milia and warts

Dual Laser Treatment Technique

*Moles are a type of lesion that appears when melanin pigment cells proliferate in the epidermis or dermis.

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

Erbium YAG laser is effective for precisely ablating shallow skin layers. Therefore, when removing shallow moles in the epidermis, it allows for natural removal while minimizing stress on the surrounding skin.

This procedure can reduce scar formation and offer aesthetic improvement, making it suitable for removing facial moles. Subsequently, carefully cauterizing the base of the mole with a CO2 laser can destroy melanin cells that may remain in deeper layers, helping to reduce the risk of mole recurrence. This lowers the likelihood of so-called ‘recurrent moles’ that reappear due to their roots, even after the visible part has been removed.

A finishing treatment using a CO2 laser may be particularly considered in the following cases:

- When the mole is slightly raised or feels softly protruding when touched

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

- When diagnosed as a nevus located in the deep dermal layer (e.g., blue nevus, grayish-brown nevus, etc.)

*Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They primarily appear as widely spread lesions in the epidermal layer, presenting as small, flat, widespread brown or flesh-colored lesions to the eye. They often occur when immunity is weakened and can spread to other areas through self-contact, so early treatment is recommended.

Erbium YAG laser can be used to evenly ablate the epidermal layer, making it suitable for treating widely spread flat warts.

This procedure can be used to treat them in a single session. It offers the advantage of minimizing skin burden while evenly removing the affected area. However, viral lesions may recur if only the surface is removed. In such cases, a finishing process involving thermal stimulation around the lesion with a CO2 laser can further eliminate virus-infected cells that may remain in the epidermal layer and its surroundings, clinically proving to be a viable method for reducing recurrence.

CO2 laser finishing may be particularly beneficial in the following situations:

- When the lesion's borders are unclear and feel widely spread when touched, especially in individuals with weakened immunity (due to stress, sleep deprivation, etc.)

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

- When the lesion is in an area frequently touched or easily spread, such as the hands or face

*Milia are small, white, pocket-like lesions formed by the accumulation of keratin protein within the skin. They are commonly observed around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are benign lesions unrelated to infection or inflammation.

Erbium YAG laser is one of the methods that can be considered for milia removal. It precisely ablates the skin surface, removing the thin epidermal layer covering the milia and creating a pathway for the trapped keratin to be effectively discharged. After milia removal, a light finishing cauterization with a CO2 laser can reduce the possibility of residual keratin cells proliferating, thereby helping to prevent milia from recurring in the same spot. However, excessive heat stimulation to the skin can cause hyperpigmentation, so delicate intensity control during the procedure is crucial.

Situations where CO2 laser finishing can be particularly beneficial are as follows:

- When milia continuously recur in the same location

- If there is a history of lesions reappearing during the recovery process after treatment

- When expecting an overall smoother skin result during recovery after removing multiple milia

*Syringomas are benign skin lesions caused by the excessive proliferation of sweat gland (eccrine gland) tissue in the dermal layer of the skin. They tend to appear as multiple small, round, palpable lesions under the eyes, on the cheeks, and forehead. They are often seen in individuals with a genetic background or in women in their 20s and 30s.

Erbium YAG laser can delicately and thinly remove the epidermis, making it suitable for treating syringomas in sensitive areas like around the eyes. It is used to refine the upper part of the lesions on the skin surface, and the low possibility of scarring or hyperpigmentation during recovery can provide aesthetic satisfaction. Subsequently, applying heat with a CO2 laser to

the finishing process of applying subtle thermal stimulation to the deeper parts of the lesion contributes to weakening the activity of sweat gland tissue within the dermal layer,

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

In the following situations, combining CO2 laser treatment can have an even more positive impact on the treatment outcome:

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

- If there is a history of multiple laser treatments followed by recurrence

- When aiming to heighten expectations for recurrence prevention even with a single treatment

*Skin tags are benign lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermal layer. They primarily occur in areas where skin folds, such as the neck, armpits, under the breasts, and eyelids, and are characterized by small, skin-colored protrusions. While painless, they can be irritated by friction. Typically, CO2 laser is more suitable for skin tag removal due to its excellent cutting ability and hemostatic effect, allowing for quick treatment of many lesions. However, for small and thin skin tags, precisely ablating the lesion first with an Erbium YAG laser, followed by finishing cauterization of the base of the lesion with a CO2 laser, can help remove the root tissue of the skin tag and reduce the likelihood of recurrence in that area. Thermal stimulation can damage fibrous cells and microvessels within the tissue, having an inhibitory effect on the regenerative environment.

Situations where CO2 laser finishing can be particularly helpful are as follows:

- When 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 removal

- When the lesion's root is deep and widely spread (the type that leaves a raised mark on the skin surface even after removal)

Thus, considering the depth and characteristics of the lesion,

combining two types of lasers

the ‘Dual Laser Technique’

can contribute to enhancing the completeness of treatment results.

How long should I keep the DuoDerm (healing patch) on after mole removal?

Mole removal procedures meticulously treat the skin's superficial layer, which can cause minor damage to the skin.

Therefore, protecting and managing the treated area well after the procedure is of utmost importance.

Keeping the treated area moist, in particular, aids skin recovery and significantly reduces the likelihood of scarring.

For this reason, we recommend using hydrocolloid moist dressings, such as DuoDERM.

DuoDERM gently covers the wound area, keeping it moist to aid natural cell regeneration and delay scab formation, thereby helping to reduce the risk of scarring.

It is effective to apply DuoDERM immediately after mole removal and consistently manage the area for at least 7 days, replacing it every 3 to 5 days.

Generally, a total management period of about 10 days can be considered.

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

Post-mole removal care is not just about protecting the treated area; it is a crucial process for achieving satisfactory results.

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

We provide detailed guidance on post-procedure care methods for quick recovery and healthy skin.

Recommended for

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• 1. Recommended for those who have concerns due to moles, seborrheic keratoses, milia, syringomas, or skin tags.
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• 2. Those who have previously undergone mole removal but have experienced their return may also consider it.
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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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• ㆍ시술 부위에 직접 물이 닿지 않도록 주의하는 것이 좋습니다. 듀오덤을 부착한 상태에서는 세안이 가능합니다.
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• ㆍ피부 재생이 이루어지는 동안에는 재생 테이프를 약 10일 정도 꾸준히 교체하여 부착하는 것이 좋습니다.
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• ㆍ제거된 부위의 점이 다시 나타날 가능성도 있으며, 재시술이 필요할 경우 4~6주 정도 경과 후 고려해볼 수 있습니다.
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• ㆍ뿌리가 깊은 점의 경우 한 번의 시술로는 부족하여, 여러 차례 시술이 필요할 수도 있습니다.
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• ㆍ자외선 노출은 가능한 한 피해주시기 바랍니다. 자외선 차단제는 필수적으로 사용해야 하며, 듀오덤 위에도 덧바르는 것이 권장됩니다.
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