Dual Laser Treatment: A Delicate Approach to Skin Lesions

Moles are skin changes caused by excessive proliferation of melanin pigment in the epidermal or dermal layers.

Outwardly, they may appear as simple pigmented lesions. However, the treatment method needs to vary depending on the mole's depth and location.

Er:YAG laser can be used to precisely refine the skin surface. This allows for the removal of shallow moles in the epidermal layer while minimizing irritation to the surrounding skin.

Er:YAG laser treatment is carefully applied for facial mole removal, as it can reduce the likelihood of scarring and improve cosmetic appearance. At this point, precisely treating the root of the mole with a CO2 laser can help remove melanin cells that might remain deep within the skin. This approach can help prevent so-called 'recurrent moles' that reappear because root cells remain even after the surface appears clear.

Especially in the following cases, combining a finishing treatment with a CO2 laser can be beneficial.

- If the mole is slightly raised above the skin surface or feels lumpy when touched

- If you have a history of moles reappearing in the same area

- If diagnosed with a nevus located in the deep dermal layer (e.g., blue nevus, gray-brown nevus, etc.)

Flat warts are one of the viral skin diseases caused by human papillomavirus (HPV) infection. They primarily appear spread widely in the epidermal layer, observed as thin, flat, small brown or flesh-colored lesions. They are prone to occurring when immunity is lowered and can spread to other parts of the body, so early intervention is recommended.

Er:YAG laser helps to evenly refine the epidermal layer. It is useful for flat warts that are widely spread.

It is useful for neatly clearing them in one go. It can uniformly remove lesions while reducing the burden on the skin. However, due to the nature of viral diseases, if only the visible lesions are removed, there is a possibility of recurrence. At this point, finishing with a gentle thermal stimulus around the lesion using a CO2 laser can help remove additional virus-infected cells that might remain in the epidermal layer and surrounding areas. This method can positively impact the reduction of recurrence.

In the following situations, a more meticulous approach with CO2 laser finishing treatment is necessary:

- When the borders of the lesion are indistinct or feel flat and spread out upon touch. It may also be considered for individuals with weakened immunity (e.g., due to stress, sleep deprivation).

- If there is a history of warts reappearing multiple times

- If the lesion is located in an area prone to frequent contact and spread, such as the hands or face

Milia are lesions that appear as small white sacs formed by the accumulation of keratin protein within the skin. They are commonly found around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are considered a cosmetic concern unrelated to inflammation or infectious diseases.

Er:YAG laser can be delicately applied for milia treatment. It finely refines the skin surface to remove the thin epidermal layer covering the milia, creating a pathway for the inner keratin material to emerge easily. Subsequently, a gentle finishing process with a CO2 laser can reduce the re-proliferation of any remaining keratin cells and positively prevent milia from reappearing in the same area. However, excessive heat stimulation can lead to hyperpigmentation, so extremely precise intensity control is crucial.

Cases where CO2 laser finishing treatment can be considered include:

- When milia frequently reappear in the same location

- If there was a history of lesions re-emerging during recovery after previous treatment

- When desiring to maintain even skin during the recovery phase after removing multiple milia

Syringomas are benign skin lesions caused by the abnormal proliferation of sweat gland tissue (eccrine glands) in the dermal layer of the skin. They are typically characterized by multiple small, round lesions appearing under the eyes, on the cheeks, and forehead. Genetic factors may play a role, and they are relatively common in women in their 20s and 30s.

Er:YAG laser can delicately treat the epidermal layer, making it useful for managing syringomas in sensitive areas like around the eyes. It works by refining the skin surface and removing the upper part of the sweat gland lesion, with a low chance of scarring or pigmentation during recovery, leading to positive cosmetic outcomes. Subsequently, by applying heat via CO2 laser,

a finishing process that provides subtle thermal stimulation to the deeper parts of the lesion can contribute to regulating the activity of dermal sweat gland tissue,

and can be a clinically significant approach to preventing syringomas from recurring in the same area. However, due to the characteristic deep location of the lesions in the skin, multiple treatments may be necessary.

In the following cases, considering CO2 laser finishing treatment can lead to even more positive improvement:

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

- If there is a history of lesions reappearing despite multiple past laser treatments

- When focusing on reducing recurrence after treatment

Skin tags are benign skin lesions caused by the excessive growth of fibrous tissue and blood vessels in the dermal layer. They commonly occur in areas where skin folds or experiences frequent friction, such as the neck, armpits, under the breasts, and eyelids. They appear as small, raised, skin-colored lesions and are usually painless, but can become irritated by friction. CO2 laser is commonly used for skin tag removal. This laser offers precise cutting power and hemostatic effects, aiding in the rapid treatment of multiple lesions. However, for small and thin skin tags, an approach might be considered where the lesion surface is first precisely refined with an Er:YAG laser, followed by finishing the root part of the lesion with a CO2 laser. This can contribute to removing the skin tag's root tissue and reducing the likelihood of recurrence in that area. Thermal stimulation can help regulate regeneration by weakening fibrous cells and microvessels within the tissue.

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

- If skin tags are located in body areas prone to frequent friction, such as the neck or armpits

- If there is a history of skin tags reappearing in the same area after previous treatment

- If the lesion has a deep and wide root, making it a type that may leave a raised mark even after treatment

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

using two laser methods together

this dual laser technique

is an approach that can help increase satisfaction with treatment results.

DuoDERM (Adhesive Dressing) Care After Mole Removal: How Long Should It Be Applied?

Mole removal involves gentle treatment of the skin's outermost layer, which might cause some mild irritation in the treated area.

Therefore, properly protecting and caring for the treated area after your procedure is crucial for a smooth recovery.

Specifically, keeping the treated area adequately moist can aid in skin regeneration and help minimize the chance of scarring.

For this kind of care, we recommend applying a hydrocolloid dressing like Duoderm.

Duoderm helps keep the treated area moist, supporting new skin growth. It also prevents thick scabs from forming, which can reduce the likelihood of scars.

It's best to apply Duoderm immediately after mole removal, replacing it every 3-5 days, and continue this care for at least one week.

You can expect the total care period to be approximately 10 days.

If you find Duoderm difficult to use or experience an allergic reaction, apply a regenerating cream or moisturizing gel frequently to prevent dryness. Make sure to apply SPF 50+ sunscreen thoroughly and avoid touching the treated area.

Aftercare following mole removal is a crucial step that goes beyond just protecting the wound; it can significantly influence the final appearance of your skin after the procedure.

Insufficient care can lead to unwanted marks or scars, so continuous attention is needed even after your procedure.

At our clinic, we provide detailed guidance on post-procedure care to help you recover well.

Candidates for the procedure

• 
  
• 
  
• 1. Individuals who have concerns about moles, age spots, milia, syringomas, or skin tags on their face or body.
• 
  
• 
  
• 
  
• 2. Individuals who have had moles removed before but are concerned about their reappearance.
• 
  
• 
  

Procedure Steps

• 
  
• 
  
• STEP 01. Self-cleansing (washing your face)
• 
  
• 
  
• 
  
• STEP 02. Application of anesthetic cream
• 
  
• 
  
• 
  
• STEP 03. Mole Removal Procedure
• 
  
• 
  

Important Post-Procedure Precautions

• 
  
• 
  
• ㆍ Avoid direct water contact with the treated area. However, you may wash your face with DuoDERM attached.
• 
  
• 
  
• 
  
• ㆍ During skin regeneration, regularly replace and reapply the regeneration dressing for approximately 10 days.
• 
  
• 
  
• 
  
• ㆍ Moles may reappear in the treated area. If another procedure is needed, it can usually be considered after 4–6 weeks.
• 
  
• 
  
• 
  
• ㆍ Deep-rooted moles may require several sessions to achieve satisfactory results.
• 
  
• 
  
• 
  
• ㆍ Avoid ultraviolet exposure as much as possible. Sunscreen is essential, and applying it over DuoDERM is also advisable.
• 
  
•