[From small moles to raised moles, and recurrent moles] Mole Removal

Dual Laser Technique

Moles are one type of skin lesion that appears when melanin-rich cells excessively accumulate and proliferate in the epidermis or dermis of the skin.

Although moles may appear similar on the surface, their location and depth within the skin vary, leading to differences in treatment approaches.

The Erbium YAG laser can be used to precisely refine the superficial layers of the skin. This allows for the removal of moles close to the epidermis while minimizing stress on the surrounding skin.

This laser can be carefully applied, especially for facial mole removal, as it reduces recovery burden and offers cosmetic improvement. Next, a CO2 laser is used to gently cauterize the deeper parts of the mole with thermal energy. This process helps to clear melanin cells that may remain deep within the skin, reducing the possibility of the mole recurring.

Especially in the following cases, a finishing process using a CO2 laser can be considered.

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

-If you have a history of the mole recurring in the same location

-When a deep dermal nevus (e.g., blue mole, greyish-brown mole) located deep in the dermal layer of the skin is suspected

Flat warts are a skin condition caused by human papillomavirus (HPV) infection. They typically spread widely in the epidermal layer and are characterized by thin, flat, small, brownish or flesh-colored lesions visible to the naked eye. They are particularly likely to appear when immunity is weakened and can spread to other areas, requiring prompt attention.

The Erbium YAG laser can be used to uniformly refine the epidermal layer of the skin. Therefore, its application can be considered for widely distributed flat wart lesions.

It is used to evenly remove lesions while minimizing stress on the skin surface. However, since flat warts are a viral disease, there is a possibility of recurrence if only the superficial part of the lesion is removed. Therefore, a finishing process that involves applying fine thermal stimulation to the periphery of the lesion using a CO2 laser can help to further clear potentially remaining virus-infected cells in and around the epidermal layer, reducing the likelihood of recurrence.

In the following situations, combining a finishing treatment with a CO2 laser may be considered more carefully.

-When the borders of the lesion are not clear, or when it feels flat and spread out to the touch. This may also be considered for individuals with weakened immunity due to stress, lack of sleep, etc.

-If you have a history of the lesion recurring multiple times

-When the lesion is located in an area frequently touched, such as hands or face, or an area prone to spreading to other parts of the body

Milia are small, white, cyst-like lesions that occur when keratin (a type of skin protein) accumulates within the skin. They are often observed around the eyes, cheeks, and forehead, and unlike sebaceous cysts, they are considered a cosmetic concern with little relation to inflammation or infection.

The Erbium YAG laser can be delicately used to treat milia. It precisely refines the skin surface to remove the thin outer layer of the milia, opening a pathway for the trapped keratin inside to be smoothly discharged. After lesion removal, a finishing process involving gentle cauterization with a CO2 laser can help reduce the possibility of remaining keratinocytes proliferating again, thus preventing milia from recurring in the same spot. However, excessive thermal stimulation to the skin can cause hyperpigmentation, requiring precise energy control.

The following situations may benefit from considering CO2 laser finishing:

-When milia frequently and repeatedly occur in the same location

-If you have a history of lesions recurring during the recovery process after treatment

-If you desire a smooth and even skin surface after recovery from the removal of multiple milia

Syringomas are benign skin lesions that occur due to the excessive proliferation of sweat glands (eccrine glands) in the dermal layer of the skin. They typically appear as multiple small, firm, bead-like lesions under the eyes, on the cheeks, and forehead. They tend to be influenced by genetic factors or are relatively common in women in their 20s and 30s.

The Erbium YAG laser can be used to delicately refine the skin epidermis, allowing for a careful approach to managing syringomas in sensitive areas like around the eyes. This method involves carefully removing the upper part of the sweat gland lesion while tidying the skin surface. During the recovery process, there is less risk of scarring or hyperpigmentation, offering potential cosmetic improvement. Following this, thermal energy is applied with a CO2 laser to

a finishing process can follow, which applies fine thermal stimulation to the deeper parts of the lesion. This aims to regulate the activity of the sweat glands within the dermis, and

can help manage the recurrence of syringomas in the same area. However, because syringomas are deep lesions, multiple treatment sessions may be required.

In the following situations, a more cautious approach, considering CO2 laser finishing, may be necessary:

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

-If you have a history of lesions recurring despite having received multiple laser treatments previously

-When aiming to increase the likelihood of recurrence management with a single treatment session

Skin tags (acrochordons) are benign skin lesions that appear due to the excessive proliferation of fibrous tissue and blood vessels in the dermal layer of the skin. They are typically found in areas where skin folds, such as the neck, armpits, under the breasts, and on the eyelids, and are observed as small, skin-colored protrusions. They are usually painless but can be irritated by friction. For skin tag removal, a CO2 laser is generally preferred because its tissue cutting ability and hemostatic effect can help swiftly treat multiple lesions. However, for small and thin skin tags, an approach that involves first precisely refining the lesion surface with an Erbium YAG laser, followed by gently cauterizing the root of the lesion with thermal energy using a CO2 laser, can be considered. This approach can help manage the underlying tissue of the skin tag and reduce the likelihood of it recurring in that area. Thermal stimulation can affect fibrous cells and microvessels within the tissue, potentially suppressing the environment for recurrence.

The following situations require a more cautious approach when considering CO2 laser finishing:

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

-If you have a history of skin tags recurring in the same area despite having undergone removal procedures in the past

-When the lesion has deep and widely spread roots (a type where a raised trace may still be felt even after treatment)

Thus, by matching the depth and nature of the skin lesion,

applying two types of laser treatments together,

the so-called ‘Dual Laser Technique’

is an approach that can help increase treatment satisfaction.

After mole removal, how long should I keep the DuoDerm (regenerative patch) on?

Mole removal procedures are performed by gently stimulating the skin surface, and during this process, temporary physical changes may occur in the skin.

Therefore, properly protecting and managing the treated area is a crucial step for recovery.

In particular, maintaining a moist environment to prevent the treated area from drying out can aid in faster recovery and reduce the likelihood of scarring.

For this management, applying a hydrocolloid dressing like Duoderm is sometimes recommended as one method.

Duoderm can help maintain a moist state in the wound area, aiding cell regeneration, slowing scab formation, and thus contributing to reducing the risk of scarring.

After applying Duoderm immediately after mole removal, replacing it every 3-5 days and consistently managing it for at least 7 days can help ensure effective recovery.

Generally, we recommend considering a total management period of about 10 days.

If you experience discomfort using Duoderm or develop an allergic reaction, you should frequently apply a regenerative cream or moisturizing gel to prevent the skin from drying out. Additionally, it is necessary to apply sunscreen with SPF 50 or higher thoroughly and manage the area by avoiding direct contact with the treated site.

Proper care after mole removal is a crucial process that goes beyond simply protecting the wound, potentially having a positive impact on the final outcome of the procedure.

Negligent care can leave unwanted marks, so it is advisable to continue to pay attention and be careful even after the procedure.

We provide detailed explanations of post-procedure care methods to help our patients recover quickly and healthily.

Who Can Consider the Procedure

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• 1. The procedure may be considered for individuals who have had skin concerns due to moles, lentigines, milia, syringomas, skin tags, etc.
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• 2. Even if moles were previously removed but have reappeared, the suitability for the procedure can be determined through consultation.
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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 Precautions

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• ㆍIt is advisable to avoid direct contact with water on the treated area. (In some cases, facial cleansing is done after applying Duoderm.)
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• ㆍDuring the skin regeneration period, it is recommended to consistently replace and apply regenerative tape for approximately 10 days.
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• ㆍThere is a possibility that moles may reappear in the removed area, and if considering re-treatment, we recommend doing so after approximately 2-3 months.
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• ㆍFor deep-rooted moles, complete removal with a single procedure can be difficult, and repeated treatments may be necessary.
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• ㆍAfter the procedure, sun exposure should be avoided as much as possible. Sunscreen is essential, and applying it over Duoderm can also be helpful.
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