Combined Laser Treatment for Various Skin Lesions

*Moles are skin lesions caused by an excessive proliferation of melanin pigment in the epidermis or dermis.

Although they may appear similar on the surface, the appropriate treatment method can vary depending on the depth and location of the mole.

Erbium-YAG laser is used to precisely refine the skin surface. This allows for the removal of shallow epidermal moles with minimal damage to the surrounding skin.

When removing facial moles, you can expect reduced scarring concerns and cosmetic improvement. Subsequently, precisely cauterizing the root of the mole with a CO2 laser can help remove melanin cells that may remain deep in the skin, reducing the likelihood of the mole reappearing. This can positively impact reducing the risk of moles recurring, which can happen even if the visible lesion is gone but the root remains.

In such cases, it is advisable to consider a finishing treatment using a CO2 laser.

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

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

- When assessed as a blue or grayish-brown nevus located deep in the dermis

*Flat warts are skin conditions caused by human papillomavirus (HPV) infection. They are characterized by thin, widespread lesions on the skin surface, appearing as small, brownish or flesh-colored lesions. They are prone to occur when immunity is low and can spread naturally, making early intervention crucial.

Erbium-YAG laser can help remove the skin surface uniformly. This can be suitable for efficiently refining widespread flat warts.

Its advantage is that it removes lesions evenly while reducing the burden on the skin. However, due to the nature of viral diseases, there is a possibility of recurrence if only the superficial part is removed. In such cases, finishing by applying heat around the lesion with a CO2 laser can help cauterize virus-infected cells that may remain in the epidermis or surrounding areas, contributing to a lower risk of recurrence.

In these cases, a finishing treatment using a CO2 laser can be even more beneficial.

- When the border of the lesion is indistinct or feels flat and spread out to the touch. It is advisable for individuals with weakened immunity due to stress or lack of sleep to pay closer attention.

- If you have a history of flat warts recurring multiple times

- When located in areas of frequent contact, such as hands or face, or areas where lesions can easily spread

*Milia are small, white, sac-like lesions caused by the accumulation of keratin, a protein, within the skin. They are commonly observed around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are benign lesions unrelated to infection or inflammatory reactions.

Erbium-YAG laser can be effectively used for milia removal. It precisely refines the skin surface, carefully removing the thin layer of milia and creating an outlet for trapped keratin to be expelled. After treatment, finishing with gentle cauterization using a CO2 laser can help reduce the possibility of keratinocytes re-proliferating and decrease the recurrence of milia in the same area. However, excessive thermal stimulation can cause hyperpigmentation, requiring delicate intensity control.

Situations where a finishing treatment with CO2 laser can be particularly helpful are as follows:

- When milia persistently recur in the same area

- If you have experienced lesions reappearing during the recovery phase after treatment

- When desiring more even and smooth skin during the recovery process after removing multiple milia

*Syringomas are benign skin conditions caused by the excessive proliferation of sweat gland tissue in the dermis. They are characterized by multiple small, bead-like lesions appearing mainly under the eyes, on the cheeks, and forehead. They can be relatively common in women in their 20s and 30s or those with genetic predispositions.

Erbium-YAG laser can be used to thin and precisely refine the skin surface. It can be carefully applied for treating syringomas in sensitive areas like around the eyes. Gently removing the upper part of the lesion can positively impact reducing concerns about scarring or pigmentation during recovery. Subsequently, when a CO2 laser is used to apply heat,

the finishing step of providing micro-stimulation to the deeper parts of the lesion can calm sweat gland activity within the dermis,

and help reduce the likelihood of syringomas reappearing in the same area. However, since lesions are often located deep in the skin, multiple treatment sessions may be considered.

In the following cases, combining CO2 laser treatment can be even more beneficial:

- When syringomas are deeply formed in multiple areas, such as under the eyes or on the cheeks

- If syringomas have recurred despite multiple laser treatments in the past

- When aiming to minimize the possibility of recurrence with a single treatment

*Skin tags are benign skin lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermis. They primarily occur in areas where skin folds, such as the neck, armpits, under the breasts, and eyelids, and appear as small, flesh-colored protuberances. They are not painful but can be irritated by friction. CO2 laser is generally used for skin tag removal because it is effective for excising lesions and achieving hemostasis. However, for small and thin skin tags, one can consider precisely refining the lesion surface with an Erbium-YAG laser, followed by cauterizing the root of the skin tag with a CO2 laser. This can help reduce the possibility of recurrence in that area by removing the root tissue. Thermal stimulation can positively impact reducing the regrowth of skin tags by inhibiting the activity of fibroblasts and microvessels within the tissue.

Situations where applying a finishing treatment with CO2 laser together can be even more beneficial are as follows:

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

- If you have a history of skin tags recurring in the same area after removal treatment

- When the root of the lesion is deep or wide, and there is concern about potential residual marks after treatment

Thus, tailored to the characteristics of skin lesions, namely their depth and type,

utilizing two lasers in combination,

'Dual Laser Treatment'

is a method that can contribute to increasing satisfaction with treatment results.

For how long should DuoDerm (sticker) be typically worn after mole removal?

Mole removal is a process that subtly exposes the skin's surface, so a temporary physical reaction may occur on the skin.

After such a procedure, meticulous protection and care are needed to ensure the treated area recovers stably.

In particular, keeping the treated area moist can help accelerate skin regeneration and reduce the likelihood of scarring.

Therefore, we recommend using Duoderm, a hydrocolloid dressing.

Duoderm keeps the treated area moist, aiding in smooth skin cell regeneration. It also helps prevent the formation of unnecessary scabs, reducing the risk of scarring.

It is advisable to apply Duoderm immediately after mole removal, replacing it every 3-5 days, and maintaining care for at least one week.

Generally, about 10 days of care is recommended.

If you experience discomfort or an allergic reaction from using Duoderm, you should use a regenerating cream or moisturizing gel to prevent dryness. At this time, it is important to apply sunscreen with SPF 50 or higher thoroughly and avoid directly touching the treated area.

Aftercare following mole removal is more than just protecting the treated area; it is a crucial process that affects the final outcome of the procedure.

Insufficient care can lead to scarring, so it is advisable to continue paying attention to the treated area even after the procedure.

At our medical facility, we provide detailed guidance on post-procedure care to help patients recover quickly and healthily.

You might consider the procedure if any of the following apply:

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• 1. Those who have experienced aesthetic discomfort due to moles, lentigines, milia, syringomas, skin tags, etc.
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• 2. Those who are considering another procedure because a mole has recurred in the same area after a previous mole removal treatment.
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Procedure Steps

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• STEP 01. Personal Cleansing
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• STEP 02. Anesthetic Ointment Application
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• STEP 03. Mole Removal Procedure
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Post-Procedure Precautions

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• ㆍ Avoid direct water contact with the treated area. Washing your face with DuoDERM attached is recommended.
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• ㆍ During skin regeneration, regularly replace and reapply the regeneration dressing for approximately 10 days.
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• ㆍ Moles may reappear in the treated area. If another procedure is needed, it can generally be considered after 2–3 months.
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• ㆍ Deep-rooted moles may be difficult to remove completely in one session and may require several sessions.
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• ㆍ Minimize exposure of the treated area to ultraviolet light. Sunscreen is essential, and applying it over DuoDERM is also recommended.
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