Laser removal of various protruding skin lesions such as skin tags, milia, seborrheic keratosis, and warts

Lesion-Specific Dual Laser Approach

Moles are skin lesions that appear due to the excessive proliferation of melanin pigment cells in the epidermis or dermis of the skin.

While they may appear to be simple pigmented spots, the treatment approach varies depending on the depth and characteristics of the mole.

Erbium-YAG laser is suitable for precisely ablating the superficial layers of the skin. Utilizing this laser allows for delicate removal of shallow moles located in the epidermis, while minimizing damage to surrounding skin.

This procedure can reduce the risk of scarring and lead to aesthetically pleasing results, making it a useful consideration, especially for mole removal on the face. Following this, a finishing step is added using a CO2 laser to thermally cauterize the root of the mole. This can help destroy any melanin cells that might remain in the deeper skin layers, thereby reducing the likelihood of the mole reappearing. This means it can help prevent 'recurrent moles' that grow back because only the surface was removed while the root remained.

It is particularly advisable to consider CO2 laser finishing in the following cases:

-When the mole is slightly raised or feels thick to the touch

-If there has been a previous experience of a mole recurring in the same area

-When it is suspected to be a nevus located deep within the dermis, such as a blue mole or a grayish-brown mole

Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. These lesions appear as thin, widely spread forms in the epidermis and may look like small brown or flesh-colored lesions to the naked eye. They are more likely to occur when immunity is weakened, and there is a possibility of spreading to other areas by touching them, so early intervention is recommended.

Erbium-YAG laser is suitable for uniformly ablating the epidermal layer of the skin, making it effective for widely spread flat warts,

It can be used to treat them comprehensively in one go. This method has the advantage of evenly removing lesions while reducing the burden of skin damage. However, due to the nature of viral lesions, there may be a possibility of recurrence if only the surface is removed. Therefore, a finishing process using a CO2 laser to apply subtle thermal stimulation around the lesion can be a clinically beneficial approach to help reduce the possibility of recurrence by further cauterizing virus-infected cells that may remain in the epidermis and nearby areas.

Especially in the following situations, CO2 laser finishing can be considered:

-When the borders of the lesion are not clear, or it feels wide and flat to the touch - When immunity is weakened due to stress or lack of sleep, etc.

-If there has been a history of the lesion recurring multiple times

-When lesions occur in areas that are frequently touched or prone to virus spread, such as the hands or face

Milia are skin lesions that appear as small white sac-like structures due to the accumulation of keratin (a type of skin protein) beneath the skin. They are commonly observed around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are a cosmetic concern not directly related to infection or inflammation.

Erbium-YAG laser can be effectively used to remove milia. It precisely ablates the skin surface to remove the thin epidermal layer of the milia and creates an exit pathway for the trapped keratin. Light finishing cauterization with a CO2 laser after the procedure can help reduce the possibility of remaining keratinocytes re-proliferating and prevent milia from recurring in the same area. However, delicate control of intensity is crucial, as excessive thermal stimulation to the skin can lead to hyperpigmentation.

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

-When milia continuously reappear in the same location

-If there has been an experience of lesions reappearing during the recovery process after a previous procedure

-When desiring a more even and clean result during the recovery process after removing multiple milia

Syringomas are benign skin lesions caused by the abnormal proliferation of sweat glands (eccrine glands) in the dermis. They are characterized by multiple small, firm, bead-like lesions appearing under the eyes, on the cheeks, and forehead. They may have a genetic predisposition or are commonly found in women in their 20s and 30s.

Erbium-YAG laser can precisely and thinly remove the epidermal layer, making it useful for managing syringomas in sensitive areas like around the eyes. This laser helps refine the skin surface while removing the upper part of the sweat gland lesions, and can lead to aesthetically pleasing results by reducing the risk of scarring or hyperpigmentation after the procedure. Following this, a finishing process using a CO2 laser to apply subtle thermal stimulation to the deeper parts of the lesion can be an

clinically meaningful approach to weaken the activity of sweat glands in the dermis and

inhibit the recurrence of syringomas in the same area. However, due to the inherent depth of these lesions, multiple treatment sessions are often required.

More effective treatment results can be expected when CO2 laser finishing is performed together in the following cases:

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

-If recurrence has been experienced despite having received multiple laser treatments previously

-When aiming for results that help reduce the risk of recurrence with a single procedure

Skin tags are benign skin lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermis. They primarily appear in areas where the skin folds, such as the neck, armpits, under the breasts, and on the eyelids, and are observed as small, skin-colored protrusions. They are usually painless but can become irritated due to friction. Generally, CO2 laser is effective for skin tag removal, with good cutting and hemostatic effects, allowing for rapid treatment of multiple lesions. However, for small and thin skin tags, a method of precisely ablating the lesion with an Erbium-YAG laser, followed by CO2 laser finishing cauterization of the root, can be useful. This helps remove the root tissue of the skin tag, contributing to a reduced possibility of recurrence in that area. Such thermal stimulation can regulate the regenerative environment by decreasing the activity of fibrous cells and microvessels within the tissue.

CO2 laser finishing can be particularly helpful in the following cases:

-When skin tags are 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 previous removal

-When the root of the lesion is deep or wide, which might leave a slightly raised mark even after removal

Thus, considering the depth and characteristics of skin lesions,

using a combination of two types of lasers

the 'Dual Laser Technique' is an

important approach that can contribute to enhancing the completeness of the procedure.

After mole removal, what are DuoDERM (healing stickers) and their appropriate application duration?

Since mole removal procedures involve removing the outer layer of the skin, they cause minor damage to the skin.

Therefore, it is necessary to carefully protect and manage the treated area until it heals.

Keeping the treated area moisturized can promote smooth skin recovery and reduce the likelihood of scarring.

For this purpose, we recommend using a moist dressing like DuoDERM, which contains hydrocolloid.

DuoDERM helps new cells grow by maintaining a moist environment around the wound, and it can reduce the risk of scarring by preventing scabs that form when the skin dries out.

After applying DuoDERM immediately after mole removal, it is recommended to change it every 3-5 days and continue management for at least 7 days.

The total management period is generally recommended to be about 10 days.

If using DuoDERM causes discomfort or an allergic reaction, alternative management methods are necessary. In this case, it is important to frequently apply a regenerating cream or a highly moisturizing gel to prevent skin dryness, and to diligently apply sunscreen with SPF 50 or higher. Additionally, care must be taken not to touch or irritate the treated area.

Post-mole removal care is more than just protecting the treated area; it is a crucial process that affects the final condition of your skin.

If proper care is not followed, there is a possibility of scarring, so you should continue to pay close attention after the procedure.

Our medical team provides detailed explanations of post-procedure care methods to help our patients achieve healthy skin recovery.

Recommended Candidates

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• 1. Individuals who have experienced skin concerns due to issues such as moles, seborrheic keratosis, milia, syringomas, or skin tags.
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• 2. Individuals who are considering re-treatment because moles have reappeared after a mole removal procedure.
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Procedure Steps

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• STEP 01. Upon arrival, wash your face yourself.
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• STEP 02. Anesthetic cream is applied to the treatment area.
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• STEP 03. The mole removal procedure is performed.
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Post-Procedure Precautions

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• ㆍCare must be taken to prevent water from directly touching the treated area. It is recommended to gently wash your face with DuoDERM applied.
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• ㆍDuring the skin regeneration period, it is recommended to consistently replace and apply the regenerative tape for about 10 days.
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• ㆍThere is a possibility that moles may reappear in the removed area, and if re-treatment is necessary, it can usually be performed after 4-6 weeks.
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• ㆍEspecially for moles with deep roots, complete removal may not be achieved with a single procedure, and multiple treatments may be necessary.
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• ㆍIt is important to avoid exposure to UV light as much as possible. Always use sunscreen, and it is also good to apply it over DuoDERM.
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