Mole, Raised Mole, Recurrent Mole Removal

Two Laser Treatment Techniques

Moles are lesions that appear due to the excessive proliferation of melanin cells in the epidermis or dermis.

While they may appear as simple pigmentation, the treatment method can vary depending on the location and depth of the mole.

The Erbium-YAG laser is used for precise ablation of the superficial epidermis. This allows for the removal of moles in the epidermal layer while minimizing damage to surrounding tissue by precisely shaving off the lesion.

This procedure can help reduce the risk of scarring while offering cosmetic improvement, making it particularly useful for facial mole removal. Following this, the process of thermally cauterizing the base of the mole with a CO2 laser can help destroy melanin cells remaining in deeper layers, thereby lowering the recurrence rate of moles. This reduces the likelihood of 'recurrent moles,' which are moles that reappear because their roots remain even after the surface has been removed.

A CO2 laser finishing treatment may also be considered in the following specific cases:

- If the mole is visibly raised or feels slightly thick when pressed.

- If there is a history of mole recurrence in the same area.

- If it is identified as a deep dermal nevus (e.g., blue nevus, grey-brown nevus).

*Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They tend to spread within the epidermal layer and can appear as small, thin, widespread brown or flesh-colored lesions to the naked eye. They are particularly common when immunity is weakened and can spread to other areas through self-contact, making early management crucial.

The Erbium-YAG laser is useful for uniformly ablating the epidermal layer. It can be used for the management of widespread flat wart lesions.

This laser can be used to uniformly remove lesions while minimizing skin damage. However, viral lesions carry a risk of recurrence if only the surface is removed. In such cases, a finishing treatment using a CO2 laser to apply thermal damage to the periphery of the lesion can clinically help reduce the recurrence rate by additionally cauterizing residual virus-infected cells in and around the epidermal layer.

CO2 laser finishing may be particularly beneficial in the following cases:

- If the lesion's borders are unclear or it feels widely spread when touched. For individuals with weakened immunity (e.g., due to stress, lack of sleep, etc.).

- If there is a history of the lesion recurring multiple times.

- If the lesion appears on areas prone to frequent contact or easy spread, such as hands or face.

*Milia are small, white, cyst-like lesions formed when keratin (a type of skin protein) becomes trapped within the skin. They are commonly observed around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are classified as cosmetic lesions unrelated to infection or inflammation.

The Erbium-YAG laser can be used for milia removal. It can precisely ablate the skin surface to remove the thin epidermal layer of the milium, opening a pathway for the trapped keratin to be easily expelled. Following the procedure, a gentle finishing cauterization with a CO2 laser can help reduce the possibility of residual keratinocytes proliferating and prevent milia from recurring in the same area. However, if strong thermal damage is applied to the skin, hyperpigmentation may occur, requiring precise intensity control during the procedure.

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

- If milia repeatedly appear in the same location.

- If there is a history of the lesion becoming prominent again during the regeneration process after treatment.

- If, after removing multiple milia, a more even skin texture is desired during the recovery process.

*Syringomas are benign lesions caused by the excessive proliferation of sweat glands (eccrine glands) within the dermis. They are characterized by multiple small, bead-like skin lesions primarily appearing under the eyes, on the cheeks, and forehead. They can have a genetic component and are particularly common in women in their 20s and 30s.

The Erbium-YAG laser can precisely and delicately remove the epidermis, making it suitable for managing syringomas in sensitive areas like around the eyes. It can address the upper portion of the sweat gland lesions on the skin surface, reducing the risk of scarring or pigmentation during recovery, and offering cosmetic improvement. Subsequently, a CO2 laser can be used to apply heat.

A finishing treatment that delivers subtle thermal damage to the deeper parts of the lesion can help weaken the activity of sweat glands within the dermis.

This can have clinical significance in reducing the recurrence of syringomas in the same area. However, as lesions often run deep, repeated treatments may be necessary.

Combining a CO2 laser finishing treatment can lead to even more positive treatment outcomes in the following cases:

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

- If there is a history of lesions recurring despite multiple previous laser treatments.

- If you're looking to maximize recurrence prevention even with a single treatment.

*Skin tags are benign 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, often appearing as small, skin-colored protrusions. While painless, they can become irritated by friction. CO2 lasers are typically used for skin tag excision, and their excellent cutting and hemostatic effects help remove multiple lesions quickly. However, for small and thin skin tags, precisely ablating the lesion with an Erbium-YAG laser followed by a finishing cauterization of the base with a CO2 laser can help remove the root tissue of the skin tag, thereby contributing to lowering the recurrence rate in that area. This thermal stimulation can affect fibrous cells and microvessels within the tissue, potentially inhibiting the regenerative environment.

Combining a CO2 laser finishing treatment can be beneficial in the following cases:

- If skin tags are located in high-friction areas like the neck or armpits.

- If there is a history of skin tag recurrence in the same area after excision.

- If the lesion's root is deep and wide, potentially leaving a raised mark even after treatment.

Thus, considering the depth and characteristics of the lesion,

utilizing two types of lasers together,

the ‘Dual Laser Treatment Technique’

is an important approach that can contribute to increasing treatment satisfaction.

After mole removal, how long should I keep a Duoderm (healing patch) on?

Mole removal procedures involve precisely treating the superficial layer of the skin, and this process can cause minor damage to the skin.

Therefore, it is crucial to systematically protect and manage the treated wound area after the procedure.

Keeping the treated area moist can help skin regeneration and reduce the likelihood of scarring.

For this, we recommend using Duoderm, a hydrocolloid dressing.

Duoderm helps maintain an appropriately moist environment for the wound, promoting cell regeneration and reducing scab formation due to dryness, thereby lowering the risk of scarring.

It is recommended to apply Duoderm immediately after mole removal, change it every 3-5 days, and continue management for at least 7 days.

We recommend a total management period of approximately 10 days.

If using Duoderm is difficult or an allergic reaction occurs, it is advisable to consistently apply a regenerative cream or moisturizing gel to prevent skin dryness, and to diligently use sunscreen with an SPF of 50 or higher. Furthermore, be careful not to unnecessarily touch the treated area.

Post-mole removal care is an important process that goes beyond simple wound protection and affects the outcome of the procedure.

Neglecting aftercare can lead to scarring, so it is advisable to consistently pay attention to the treated area even after the procedure.

For healthy and rapid recovery, we provide detailed explanations on post-procedure care methods.

Recommended for

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• 1. Individuals concerned about skin issues such as moles, lentigines, milia, syringomas, or skin tags.
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• 2. Individuals who have had moles removed but they have reappeared and are considering re-treatment.
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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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Post-Procedure Instructions

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• ㆍCare should be taken to prevent water from directly contacting the treated area. (Washing your face is possible with Duoderm attached.)
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• ㆍDuring the skin regeneration period, it is recommended to consistently change and apply regenerative tape for approximately 10 days.
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• ㆍMoles may reappear in the treated area, and re-treatment can be considered after 2-3 months.
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• ㆍFor moles with deep roots, multiple procedures may be necessary.
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• ㆍIt is best to minimize sun exposure. (Always use sunscreen, and it is recommended to apply it over Duoderm as well.)
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