Dual Laser Technique

Moles are skin lesions caused by an abnormal accumulation of melanin pigment in the epidermis or dermis.

While their appearance may be similar, treatment methods vary depending on the depth and location of the mole.

Erbium YAG laser is useful for precisely refining the skin surface. Especially for shallow moles in the epidermis, it can selectively ablate only the mole area while minimizing strain on the surrounding skin.

This technique helps reduce concerns about scarring and can lead to aesthetic improvement, making it suitable for mole removal on the face. Subsequently, precisely treating the root of the mole with heat using a CO2 laser can help eliminate any melanin cells that might remain deeper, thereby reducing the possibility of recurrence. This process helps reduce the risk of what is known as 'recurrent moles,' where only the surface is removed, but the root remains, leading to regrowth.

In situations like the following, it is advisable to combine the finishing process using a CO2 laser:

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

- When you have experienced a mole recurring in the same spot previously

- When identified as a nevus deeply embedded in the dermis (e.g., blue nevus, brown-black nevus, etc.)

Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They spread widely across the epidermal layer and appear as small, thin, flat, brownish or flesh-colored lesions. They often occur when immunity is weakened and can spread to other parts of the body, so early intervention upon discovery is recommended.

Erbium YAG laser is used to uniformly remove the epidermal layer. It can help clear flat warts spread over a wide area

in one go. This offers the advantage of uniformly treating the lesion area while reducing the burden of skin damage. However, due to the nature of viral lesions, there is a possibility of recurrence if only the surface is removed. In such cases, a finishing process involving applying subtle heat stimulation around the lesion with a CO2 laser can further treat virus-infected cells that might remain in the epidermal layer and its surroundings, thereby helping to lower the recurrence rate.

In the following cases, a finishing process using a CO2 laser may be particularly necessary:

- If the lesion's border is not clear, or it feels widely spread when touched - 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 in an area that is frequently touched or can easily spread, such as the hands or face

Milia are lesions that appear as small white cysts where keratin (a type of skin protein) accumulates under the skin. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are a skin concern unrelated to infection or inflammation.

Erbium YAG laser can be used for milia removal. It precisely refines the skin surface to open the thin epidermal layer of the milia, helping to safely expel the trapped keratin inside. After the procedure, a light finishing treatment with a CO2 laser can help reduce the possibility of remaining keratinocytes proliferating again and prevent milia from recurring in the same area. However, excessive heat damage to the skin can cause hyperpigmentation, so meticulous intensity control during the procedure is crucial.

A finishing process using a CO2 laser is particularly recommended in the following cases:

- When milia repeatedly occur in the same area

- When there has been an experience of lesions reappearing during the recovery process after laser treatment

- When desiring an even and natural skin result during recovery after removing multiple milia

Syringomas are benign skin lesions caused by the excessive proliferation of sweat gland tissue in the dermis. They are characterized by multiple small, firm, bead-like lesions appearing under the eyes, on the cheeks, and forehead. They often have a genetic tendency or are frequently observed in women in their 20s and 30s.

Erbium YAG laser precisely treats the skin surface thinly, making it suitable for treating syringomas in sensitive areas like around the eyes. It helps refine the upper part of the sweat gland lesion and can reduce concerns about scarring or hyperpigmentation during the recovery process, allowing for aesthetic improvement. After the procedure, applying heat stimulation with a CO2 laser

as a finishing method that applies micro-thermal damage to the deeper parts of the lesion, contributes to regulating the excessive activity of sweat glands within the dermis,

and can help prevent syringomas from recurring in the same area. However, due to the depth of the lesions, multiple treatment sessions may be required.

In the following cases, combining a finishing procedure using a CO2 laser can yield even better results:

- When multiple syringomas are relatively deeply seated under the eyes or on the cheeks

- When there has been a history of multiple laser treatments previously but with recurrence

- When desiring maximum help in preventing recurrence with a single treatment session

Skin tags are benign lesions that result from the abnormal proliferation of dermal fibrous tissue and blood vessels. They primarily occur in areas where skin folds, such as the neck, armpits, under the breasts, and eyelids, appearing as small, raised, skin-colored growths. They are usually painless but can become irritated due to friction. Generally, CO2 laser is primarily used for skin tag removal, aiding in tissue excision and hemostasis, allowing for the relatively quick removal of many lesions. However, for small and thin skin tags, precisely ablating the lesion area with an Erbium YAG laser, followed by a finishing treatment of the skin tag's root with a CO2 laser, can help remove deeper tissues and reduce the possibility of recurrence in that area. Thermal stimulation can affect fibroblast cells and microvessels within the lesion, helping to suppress the environment for recurrence.

Combining a finishing procedure using a CO2 laser is recommended in the following cases:

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

- When skin tags were previously removed but recurred in the same area

- When the root of the lesion was deep or wide, leaving a residual thickness even after removal

In this way, the 'Dual Laser Technique,' which uses two types of lasers tailored to the depth and characteristics of each lesion, can help enhance the completeness of the procedure.

How long should DuoDERM (stickers) be applied after mole removal?

Mole removal is a process that delicately exfoliates the skin surface. During this process, the skin undergoes temporary physical changes.

Therefore, appropriate protection and management of the treated area are crucial.

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

For this aftercare, applying a hydrocolloid dressing like Duoderm is recommended.

Duoderm creates a moist environment for the wound, helping new skin grow and preventing unnecessary scabs, which can reduce scarring.

Immediately after mole removal, apply Duoderm, change it every 3 to 5 days, and protect the area for at least 7 days.

A total aftercare period of approximately 10 days can be considered.

If Duoderm use is difficult or a skin reaction occurs, apply a regenerative cream or moisturizing gel frequently to prevent dryness. Additionally, it is important to carefully apply sunscreen with SPF 50 or higher and avoid touching the treated area.

Aftercare following mole removal is an important process that goes beyond simply protecting the treated area; it can also affect the outcome of the procedure.

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

We provide detailed guidance on post-procedure aftercare methods to help our patients recover healthily.

Recommended for these cases

• 1. Individuals who have experienced skin concerns such as moles, age spots, milia, syringomas, or skin tags.
• 2. Individuals who have experienced moles reappearing after removal.

Procedure Steps

• STEP 01. Self-cleansing
• STEP 02. Apply anesthetic cream
• STEP 03. Mole removal procedure

Post-Procedure Precautions

• ㆍBe careful not to let water directly touch the treated area. (Washing your face is possible with Duoderm applied.)
• ㆍDuring the skin regeneration period, please consistently replace and apply the regenerative tape if possible. (For approximately 10 days)
• ㆍThere is a possibility that moles in the removed area may reappear, and re-treatment can be considered after approximately 4 to 6 weeks.
• ㆍDeep-rooted moles may be difficult to remove completely with a single procedure, and multiple treatments may be necessary.
• ㆍIt is best to avoid exposure to ultraviolet rays as much as possible. (Always apply sunscreen, and it's even better if you apply it over the Duoderm.)