[Skin Protrusion Lesion Laser] Skin Tags, Milia, Seborrheic Keratosis, Warts, etc.

Utilizing Dual Laser Technique

Moles are lesions that occur when melanin pigment accumulates excessively and proliferates in the epidermis or dermis.

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

The Er:YAG laser is advantageous for precisely ablating the skin surface. It is used to remove superficial moles in the epidermis while minimizing damage to the surrounding skin.

This procedure is suitable for facial mole removal as it reduces scars and can lead to natural cosmetic improvement. Subsequently, the process of thermocoagulating the root of the mole with a CO2 laser can help destroy melanin cells remaining in deeper areas, thereby lowering the possibility of mole recurrence. This reduces the risk of 'recurrent moles' that can reappear even if the superficial part has been removed but the root remains.

CO2 laser finishing may be considered, especially in the following situations:

- When the mole is slightly raised or feels voluminous to the touch.

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

- When diagnosed with deep dermal nevi, such as blue moles or grayish-brown moles.

Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They tend to spread widely within the epidermal layer and appear as thin, flattened, brownish or flesh-colored small lesions to the eye. They frequently occur when immunity is low and can spread through self-contact, so early treatment is recommended.

The Er:YAG laser is effective in uniformly removing the epidermal layer. It helps to efficiently address widely spread flat warts.

It helps in efficiently managing them at once. It is a method that minimizes skin damage and evenly removes lesions. However, viral lesions carry a risk of recurrence even if only the surface is removed. In such cases, applying thermal energy around the lesion with a CO2 laser can additionally remove virus-infected cells that may remain in and around the epidermal layer, which can have a clinically positive impact on reducing the recurrence rate.

In the following cases, combining CO2 laser finishing is particularly recommended:

- When the lesion's border is not clear, or it feels flat and spread out to the touch.

- Individuals with weakened immunity due to stress, lack of sleep, etc.

- When there is a history of flat warts recurring multiple times.

- When lesions appear on frequently touched or easily spreadable areas like hands or face.

Milia are small, white, cystic lesions formed when keratin, a skin protein, becomes trapped beneath the skin. They typically appear around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are a cosmetic issue unrelated to infection or inflammation.

The Er:YAG laser is effectively used for milia removal. It precisely ablates the skin surface to open the thin epidermal layer of the milia and safely expels the trapped keratin. Subsequently, a light finishing cauterization with a CO2 laser can lower the possibility of residual keratin cells re-proliferating and help reduce the repetitive occurrence of milia in the same area. However, excessive heat damage to the skin can cause hyperpigmentation, so precise intensity control is necessary.

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

- When milia continuously reappear in the same location.

- When there is a history of lesions reappearing during the regeneration process after treatment.

- When expecting a more uniform skin condition during the regeneration process after removing multiple milia.

Syringomas are benign lesions that occur due to the excessive proliferation of sweat gland tissue in the dermis. They typically appear as multiple small, bead-like lesions, primarily under the eyes, on the cheeks, and forehead. They can be influenced by genetics or commonly found in women in their 20s and 30s.

The Er:YAG laser can precisely and delicately remove the epidermis, making it suitable for managing syringomas in sensitive areas like around the eyes. By refining the skin surface, it removes the upper part of the sweat gland lesions and can lead to cosmetic improvement by reducing the possibility of scars or hyperpigmentation during the recovery process. Subsequently, applying thermal energy with a CO2 laser

A finishing method that applies subtle thermal damage to the deeper part of the lesion helps weaken the activity of sweat glands within the dermis.

This can play a clinically positive role in preventing syringomas from reappearing in the same location. However, due to the depth of the lesions, multiple treatment sessions may be required.

In the following cases, combining CO2 laser finishing can lead to even more effective results:

- When there are multiple syringomas located relatively deep under the eyes, on the cheeks, etc.

- When lesions reappeared despite receiving multiple laser treatments previously.

- When you wish to pay more attention to recurrence prevention with a single treatment.

Skin tags are benign lesions that appear due to 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 are observed as small, skin-colored protrusions. They are painless but can be irritated by friction. Generally, the CO2 laser is suitable for skin tag removal, as its excellent cutting ability and hemostatic effect allow for quick treatment of multiple lesions. However, for small and thin skin tags, precisely removing the lesion first with an Er:YAG laser, followed by finishing cauterization of the root with a CO2 laser, can help treat the underlying tissue of the skin tag and reduce the likelihood of recurrence in that area. Thermal stimulation contributes to weakening fibrous cells and microvessels within the tissue, thereby inhibiting regeneration.

Cases where CO2 laser finishing is beneficial to consider are as follows:

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

- When there is a history of skin tags recurring in the same area after removal.

- When the root of the lesion is deep or wide, potentially leaving a thick mark even after removal.

Thus, considering the depth and characteristics of each lesion,

the combined use of two types of lasers,

the 'Dual Laser Technique',

can contribute to increasing treatment satisfaction.

How long should I keep DuoDERM (regenerative band) on after mole removal?

Mole removal is a procedure that subtly exfoliates the skin's surface. This process causes a slight physical irritation to the skin.

Therefore, it is paramount to protect and manage the treated area well after the procedure.

In particular, keeping the treated area moist can help ensure smooth recovery and reduce the formation of scars.

For this type of care, we recommend using DuoDERM, a hydrocolloid dressing.

DuoDERM helps skin cells regenerate well by keeping the treated area moist. It can also delay scab formation, which may reduce the likelihood of scarring.

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

Generally, a total care period of about 10 days is recommended.

If using DuoDERM is uncomfortable or causes an allergic reaction, please frequently apply a regenerative cream or moisturizing gel to prevent skin dryness. Additionally, it is advisable to carefully apply sunscreen with SPF 50 or higher and manage the treated area carefully, avoiding touching it.

Post-mole removal care is more than just protecting the wound; it is a crucial step that significantly impacts the outcome of the procedure.

If proper care is not maintained, there is a possibility of scarring, so continuous attention is required even after the procedure.

At our medical facility, we provide detailed guidance on post-procedure care methods to help patients achieve a fast and healthy recovery.

We recommend this procedure for those who:

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• 1. Have had skin concerns such as moles, age spots, milia, syringomas, or skin tags.
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• 2. Have had moles reappear after removal and wish for improvement.
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The procedure process is as follows:

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• STEP 01. Perform self-cleansing.
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• STEP 02. Apply anesthetic cream.
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• STEP 03. Perform the mole removal procedure.
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Points to Note After the Procedure

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• ㆍCare should be taken to prevent direct contact of water with the treated area. (It is advisable to wash your face with DuoDERM attached.)
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• ㆍDuring skin regeneration, it is best to consistently replace and apply the regenerative tape for about 10 days, if possible.
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• ㆍMoles may reappear in the removed area, and re-treatment can be considered after 4-6 weeks if necessary.
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• ㆍDeep-rooted moles are difficult to remove completely in a single session and may require multiple treatments.
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• ㆍIt is important to avoid exposure to ultraviolet light as much as possible. (Sunscreen use is essential, and applying it over DuoDERM is also recommended.)
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