Dual Laser Technique

Moles are skin lesions that occur due to an abnormal increase of melanin pigment in the epidermis or dermis.

While they may appear similar on the surface, treatment methods vary depending on the depth and location of the mole.

The 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.

It is used for facial mole removal, as it reduces the burden of scars and allows for aesthetic improvement. Subsequently, precisely treating the root of the mole with a CO2 laser can help remove melanin cells that may remain deep within, thereby contributing to a reduction in recurrence. This process helps minimize the risk of so-called 'recurrent moles,' where only the surface is removed, and the root remains, causing them to reappear.

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

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

- When there is a history of the mole reappearing in the same spot

- When determined to be a nevus deeply situated in the dermis (e.g., blue nevus, black-brown mole, etc.)

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

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

in a single session. This has the advantage of evenly treating the affected area 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 superficial part is removed. In such cases, a finishing process using a CO2 laser to apply micro-thermal stimulation around the lesion can further treat virus-infected cells that might remain in the epidermis and its surroundings, helping to lower the recurrence rate.

A finishing process using a CO2 laser may be particularly necessary in the following cases:

- When the border of the lesion is unclear or feels widely spread to the touch - For individuals with weakened immunity (e.g., due to stress, lack of sleep, etc.)

- When there has been a history of multiple recurrences

- When the lesion is on areas frequently touched or easily spread, such as hands or face

Milia are lesions that appear as small white sacs due to the accumulation of keratin (a type of skin protein) beneath the skin. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are a skin concern that arises independently of infection or inflammation.

An Erbium YAG laser can be used for milia removal. It precisely refines the skin surface to open the thin epidermal layer of the milium, helping to safely expel the trapped keratin. After the procedure, light finishing with a CO2 laser can reduce the possibility of remaining keratinocytes proliferating again and help prevent the recurrence of milia 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 even and natural skin results 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-shaped lesions appearing under the eyes, on the cheeks, and forehead. They typically have a genetic predisposition or are frequently observed in women in their 20s and 30s.

The Erbium YAG laser precisely treats the skin surface thinly, making it suitable for syringoma treatment in sensitive areas like around the eyes. It helps to smooth the upper part of the sweat gland lesions and reduce the burden of scars or hyperpigmentation during recovery, allowing for aesthetic improvement. After the procedure, applying thermal stimulation with a CO2 laser

as a finishing method that applies micro-thermal damage to the deep parts of the lesion, contributes to regulating the excessive activity of sweat glands in 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 treatment using a CO2 laser can lead to even better results:

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

- When there is a history of recurrence despite receiving multiple laser treatments previously

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

Skin tags are benign lesions that appear due to the abnormal proliferation of fibrous tissue and blood vessels in the dermis. They primarily occur in areas where the skin folds, such as the neck, armpits, under the breasts, and eyelids, and are observed as small, raised growths similar in color to the skin. While painless, they can be irritated by friction. Typically, CO2 lasers are primarily used for skin tag removal, aiding in tissue excision and hemostasis, allowing for relatively quick removal of many lesions. However, for small and thin skin tags, a method of precisely ablating the lesion area with an Erbium YAG laser, followed by finishing treatment of the skin tag's root with a CO2 laser, can contribute to removing deeper tissues and help reduce the possibility of recurrence in that area. Thermal stimulation can affect fibrous cells and microvessels within the lesion, helping to suppress the environment for recurrence.

It is advisable to incorporate a finishing treatment using a CO2 laser in the following cases:

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

- When there is a history of skin tags reappearing in the same area after previous removal

- When the root of the lesion is deep or wide, resulting in residual thickness even after removal

Thus, tailored to the depth and characteristics of each lesion,

the combined use of two lasers

the 'Dual Laser Technique'

can help enhance the completeness of the procedure.

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

The procedure to remove moles is a process of delicately exfoliating the skin's surface. During this process, the skin temporarily undergoes physical changes.

Therefore, proper protection and care of the treated area are crucial.

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

For this care, it is recommended to apply DuoDERM, a hydrocolloid dressing.

DuoDERM creates a moist environment for the wound, helping new skin to form and preventing unnecessary scabs, which can reduce the appearance of scars.

Immediately after mole removal, apply DuoDERM and replace it every 3 to 5 days, protecting the area for at least 7 days.

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

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

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

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

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

Cases where the procedure is recommended

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• 1. Those who have experienced skin concerns such as moles, seborrheic keratosis, milia, syringomas, or skin tags.
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• 2. Those who have experienced moles reappearing after 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 Procedure
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Important Post-Procedure Instructions

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• ㆍEnsure water does not directly touch the treated area. (Washing your face is possible while DuoDERM is applied.)
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• ㆍDuring the skin regeneration period, consistently replace and apply the regenerative tape if possible. (Approximately 10 days)
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• ㆍMoles in the removed area may reappear, and re-treatment can be considered after approximately 4 to 6 weeks.
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• ㆍDeep-rooted moles are difficult to completely remove in a single session, and multiple treatments may be necessary.
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• ㆍIt is best to avoid exposure to UV rays as much as possible. (Always apply sunscreen, and it's even better if you apply it over the DuoDERM.)
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