[Reduced recurrence risk with Dual Laser] Flat Wart Removal

How to Utilize Dual Laser Treatment

Moles are skin lesions that appear when melanin-producing cells overproliferate in the epidermis or dermis.

Unlike what appears on the surface, the removal method can vary depending on the depth and location of the mole.

Erbium YAG laser specializes in precisely ablating the skin surface. This is useful for removing shallow moles in the epidermal layer while minimizing skin irritation.

This procedure can lead to cosmetic improvements while reducing the possibility of scarring, making it a good choice particularly for facial mole removal. Subsequently, using a CO2 laser to thermally refine the root of the mole can help prevent recurrence by treating any melanin cells that may remain deep within. This can reduce the possibility of 'recurrent moles,' which appear to be removed on the surface but recur due to remaining roots.

Consider CO2 laser finishing in the following situations:

- If the mole is slightly raised or feels thick to the touch

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

- If diagnosed with a deep dermal nevus (e.g., blue nevus, slate gray nevus)

Flat warts are viral skin diseases caused by human papillomavirus (HPV) infection. They appear as widespread lesions in the epidermal layer of the skin, presenting to the eye as thin, flat, brownish or flesh-colored small lesions. They are especially prone to appearing when immunity is lowered and can spread to other parts of the body, so early management is crucial.

Erbium YAG laser is effective in uniformly removing the epidermal layer, making it useful for treating widespread flat warts

all at once. This helps to evenly remove lesions while reducing skin irritation. However, due to the nature of viral diseases, removing only the surface lesions may lead to recurrence. In such cases, the finishing process of applying thermal stimulation to the perilesional area with a CO2 laser can clinically help reduce recurrence rates by further refining virally infected cells remaining in the epidermal layer and its surroundings.

CO2 laser finishing may be particularly important in the following situations:

- If the lesion boundaries are unclear, or if it feels flat and spread out to the touch

- If immunity is weakened (due to stress, lack of sleep, etc.), or if multiple recurrences have already been experienced

- If the lesion is located in areas prone to contact and spreading, such as the hands or face

Milia are lesions that appear as small white sacs when keratin protein is trapped within the skin. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are benign lesions unrelated to infection or inflammation.

Erbium YAG laser is one of the effective methods for milia removal. It precisely ablates the skin surface to remove the thin epidermis covering the milium, creating a pathway for the trapped keratin to be smoothly discharged. Subsequently, gently finishing with a CO2 laser can help lower the possibility of residual keratinocytes re-proliferating and prevent milia from recurring in the same area. However, strong thermal damage to the skin can lead to hyperpigmentation, requiring careful energy control.

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

- If milia frequently recur in the same location

- If there has been an experience of lesions reappearing during the recovery process after treatment

- When seeking natural recovery after removing multiple milia

Syringomas are benign skin lesions caused by the excessive proliferation of sweat glands (eccrine glands) in the dermal layer. They are characterized by multiple small, bead-like lesions typically found under the eyes, on the cheeks, and forehead. They often have a genetic component or are commonly observed in women in their 20s and 30s.

Erbium YAG laser can remove the epidermis thinly and precisely, making it suitable for managing syringomas in sensitive areas like around the eyes. It can refine the skin surface and remove the upper part of the sweat gland lesions, with a low risk of scarring or pigmentation during recovery, leading to satisfactory cosmetic results. Subsequently, applying heat with a CO2 laser to

provide subtle stimulation to the deeper parts of the lesion as a finishing method can weaken the activity of dermal sweat glands,

and help prevent syringomas from recurring in the same area. Due to the depth of the lesions, repeated treatments may be necessary.

Combining CO2 laser finishing in the following situations can aid in improvement:

- If there are relatively deep and numerous syringomas located under the eyes or on the cheeks

- If recurrence has been experienced despite multiple previous laser treatments

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

Skin tags are benign lesions caused by the excessive proliferation of fibrous tissue and blood vessels in the dermis. They commonly appear in skin folds such as the neck, armpits, under the breasts, and eyelids, presenting as small, skin-colored protrusions. While painless, they can be irritated by friction. Generally, CO2 lasers are often used for skin tag removal, offering efficient cutting power and hemostatic effects for rapid removal of multiple lesions. However, for small and thin skin tags, delicately removing the lesion first with an Erbium YAG laser, followed by finishing the root of the lesion with a CO2 laser, can contribute to treating the deeper tissues of the skin tag and help reduce recurrence in that area. Thermal stimulation can help regulate fibrous cells and microvessels in the tissue, inhibiting the regenerative environment.

CO2 laser finishing can be considered in the following cases:

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

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

- If the lesion's root is deep or wide, making it likely to leave a mark after removal

Thus, depending on the depth and characteristics of the lesion,

the 'Dual Laser Technique,'

which combines the use of two types of lasers,

is an important approach to enhancing improvement.

Post-Mole Removal Care: How Long to Keep DuoDERM On?

During the process of mole removal, the skin surface may peel, leading to minor damage.

Therefore, proper protection and care of the treated area significantly impact recovery.

In particular, keeping the treated area moisturized can help skin recovery and reduce the likelihood of scar formation.

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

Duoderm helps cell regeneration by keeping the wound area moist. It can slow down scab formation, which helps reduce the likelihood of scarring.

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

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

If you experience difficulty using Duoderm or develop an allergic reaction, you can prevent dryness by frequently applying a regenerating cream or moisturizing gel. Furthermore, it is important to carefully apply sunscreen with SPF 50 or higher and avoid touching the wound area.

Post-mole removal care is an important step that goes beyond simply protecting the wound; it can influence the outcome of the procedure.

Neglecting care can lead to scarring, so continuous attention is required even after the procedure.

At our clinic, we provide detailed explanations of post-procedure care methods to help our patients recover quickly and healthily.

Recommended for

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• 1. Those who have been concerned about moles, seborrheic keratosis, milia, syringomas, or skin tags.
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• 2. Those who are concerned about moles reappearing after previous removal.
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Procedure Steps

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• STEP 01. Personal Cleansing
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• STEP 02. Apply Anesthetic Cream
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• STEP 03. Mole Removal Procedure
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Post-Procedure Precautions

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• ㆍPlease be careful not to let water directly touch the treated area. (It is best to wash your face with Duoderm still attached.)
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• ㆍDuring the skin regeneration period, please consistently change and apply the regenerative tape if possible. (Recommended for approximately 10 days.)
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• ㆍMoles may reappear in the removed area. Re-treatment can usually be considered 4-6 weeks after the initial procedure.
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• ㆍFor moles with deep roots, multiple treatment sessions may be required.
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• ㆍIt is best to avoid UV exposure as much as possible. (Sunscreen must be used, and it is recommended to apply it even over Duoderm.)
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