Mole, Protruding Mole, Recurrent Mole Removal

Dual Laser Combination Treatment

*Moles are skin lesions that occur when melanin pigment cells proliferate excessively in the epidermis or dermis.

While they may appear as simple hyperpigmentation to the naked eye, the treatment method can vary depending on the depth and location of the mole.

Erbium-YAG laser is useful for precise epidermal ablation, which involves delicately shaving off the skin surface. Especially when removing shallow moles located in the epidermis, it can help eliminate the mole while minimizing damage to the surrounding skin.

This can reduce the risk of scarring and lead to aesthetic improvements, making it suitable for facial mole removal. Subsequently, using a CO2 laser to cauterize the root of the mole with heat helps destroy melanin cells that might remain in deeper skin layers. This lowers the chance of mole recurrence and can reduce the incidence of 'recurrent moles' that appear to be removed but regrow because their roots remain.

The following situations may warrant a finishing process using a CO2 laser:

- If the mole is somewhat raised or feels thick to the touch

- If you have a history of the mole recurring in the same location

- If diagnosed or suspected to be a dermal nevus (e.g., blue nevus, gray-brown mole, etc.)

*Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They typically spread widely in the epidermis, appearing as thin, broad, brownish or skin-colored small lesions. They are more common when immunity is weakened, and early management is crucial as they can spread to other parts of the body.

Erbium-YAG laser can be used for uniform epidermal ablation. Therefore, it is beneficial when treating widely distributed flat wart lesions

simultaneously. This treatment can help remove the affected area evenly while reducing skin damage. However, viral lesions may recur if only the surface is removed. In such cases, the finishing step of applying thermal stimulation to the periphery of the lesion with a CO2 laser has clinical significance as it can further eliminate virus-infected cells that may remain in the epidermis and surrounding areas, thereby helping to reduce recurrence rates.

CO2 laser finishing can be particularly useful in the following situations:

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

- If there has been a history of multiple recurrences

- If the lesion is located on frequently touched areas like hands or face, or areas where the virus can easily spread

*Milia are small, white cysts that form when keratin, a horny protein, gets trapped within the skin. They primarily appear around the eyes, cheeks, and forehead. Unlike sebaceous cysts, they are aesthetic lesions not associated with infection or inflammation.

Erbium-YAG laser can be effectively used for milia removal. It precisely ablates the skin surface, removing the thin outer wall of the milia and creating a channel for the trapped keratin to safely exit. After the procedure, a light cauterization with a CO2 laser can help prevent milia from recurring in the same area by reducing the possibility of residual keratinocytes proliferating. However, excessive thermal stimulation to the skin can cause hyperpigmentation, so careful intensity control is crucial.

The following situations may particularly benefit from a finishing treatment with CO2 laser:

- If milia frequently recur in the same location

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

- If you desire uniform skin improvement after removing multiple milia and during recovery

*Syringomas are benign skin tumors caused by the excessive proliferation of eccrine sweat glands in the dermis. They typically appear as multiple small, round bumps around the eyes, cheeks, and forehead. They are often hereditary or relatively common in women in their 20s and 30s.

Erbium-YAG laser can precisely and thinly remove the epidermis, making it suitable for treating syringomas in sensitive areas like around the eyes. By refining the skin surface and removing the upper part of the sweat gland lesions, there is a lower chance of scarring or hyperpigmentation after recovery, offering aesthetic benefits. Subsequently, applying heat with a CO2 laser

as a finishing method to induce microscopic thermal damage to the deeper parts of the lesion can help suppress the abnormal activity of sweat glands within the dermis.

This has clinical significance in preventing syringomas from regrowing in the same area. However, due to the depth of the lesions, multiple treatments may be necessary.

Combining CO2 laser in the following situations can contribute to enhancing the treatment's effectiveness:

- If multiple syringomas are located relatively deep, such as under the eyes or on the cheeks

- If there has been a history of recurrence despite receiving multiple laser treatments previously

- If you wish to increase the expected effect of preventing recurrence with a single treatment

*Skin tags (Acrochordons) are benign skin tumors resulting from the excessive proliferation of fibrous tissue and blood vessels in the dermis. They typically occur in areas where skin folds, such as the neck, armpits, under the breasts, and eyelids, appearing as small, flesh-colored protuberances. While not painful, they can become irritated by friction. Usually, CO2 laser is primarily used for skin tag removal due to its excellent excision and hemostatic capabilities, allowing for quick removal of multiple lesions. However, for small and thin skin tags, precisely ablating the lesion with an Erbium-YAG laser followed by cauterizing the base of the lesion with a CO2 laser can help manage the root tissue of the skin tag. This can contribute to lowering the recurrence rate in that area, and the thermal stimulation can damage fibrous cells and microvessels within the tissue, which may help inhibit the environment for recurrence.

Combining a finishing treatment with CO2 laser may be advisable in the following cases:

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

- If there has been a history of skin tags recurring in the same area after removal

- If the root of the lesion is deep and widely formed (a type where a thick trace remains even after removal)

Thus, tailoring

the two types of laser treatments

to the depth and characteristics of the skin lesion,

this 'Dual Laser Treatment'

can be a key approach contributing to increasing treatment satisfaction.

Since mole removal involves delicately exfoliating the outermost layer of the skin, minor damage may occur.

Therefore, it is important to properly protect and care for the treated area.

Keeping the treated area moist helps accelerate recovery and reduces the likelihood of scarring.

We recommend applying a hydrocolloid dressing such as Duoderm.

Duoderm provides moist protection to the wound area, aiding cell regeneration and delaying scab formation, thereby reducing the likelihood of scarring.

It is advisable to apply Duoderm immediately after mole removal and manage the area for at least 7 days, changing it every 3 to 5 days.

We recommend a total care period of about 10 days.

If using Duoderm is difficult or if a skin allergic reaction occurs, you should frequently apply a regenerative cream or moisturizing gel to prevent the skin from drying out. Additionally, consistently apply sunscreen with SPF 50 or higher, and carefully manage the area, taking care not to touch the treated spot.

Proper care after mole removal is a process that goes beyond simply protecting the wound and can significantly impact the treatment outcome.

Neglecting aftercare can lead to scarring, so it's important to continue caring for the area diligently even after the procedure.

At our clinic, we provide detailed explanations of post-procedure care methods to help our patients recover.

We recommend this procedure for those who:

• 
  
• 
  
• 1. Have experienced discomfort due to moles, lentigines, milia, syringomas, skin tags, etc.
• 
  
• 
  
• 
  
• 2. Have had moles removed previously but experienced recurrence.
• 
  
• 
  

Procedure Steps

• 
  
• 
  
• STEP 01. Personal Cleansing
• 
  
• 
  
• 
  
• STEP 02. Anesthetic Cream Application
• 
  
• 
  
• 
  
• STEP 03. Mole Removal Procedure
• 
  
• 
  

Post-Procedure Precautions

• 
  
• 
  
• ㆍBe careful not to let water directly touch the treated area. (It is recommended to wash your face with Duoderm applied.)
• 
  
• 
  
• 
  
• ㆍDuring skin regeneration, it is recommended to consistently replace and apply regenerative tape for about 10 days.
• 
  
• 
  
• 
  
• ㆍThere is a possibility of moles recurring in the removed area, and re-treatment can usually be considered after 2-3 months.
• 
  
• 
  
• 
  
• ㆍFor moles with deep roots, a single procedure may be insufficient, and multiple treatments might be necessary.
• 
  
• 
  
• 
  
• ㆍTake extra care to minimize exposure to ultraviolet light. (Sunscreen must be used, and it's also good to apply it over Duoderm.)
• 
  
•