Kkeut Clinic's Dual Laser Technique

Moles are lesions caused by the excessive proliferation of melanocytes in the epidermis or dermis. Although they may appear as simple pigmentation, the treatment approach varies depending on their location and depth. Er:YAG laser specializes in precise, shallow ablation, allowing for natural removal of superficial moles located in the epidermis without damaging the skin. Furthermore, it minimizes scarring and offers excellent cosmetic results, making it particularly effective for facial mole removal. The subsequent process of using a CO2 laser to thermally cauterize the base of the mole helps reduce the recurrence rate by destroying melanocytes that may remain in deeper layers. This diminishes the possibility of 'recurrent moles' where the surface is removed but the root remains and regenerates. CO2 finishing is strongly considered in the following cases:

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

- If there's a history of mole recurrence in the same area

- If it's determined to be a deep dermal nevus (e.g., blue moles, grayish-brown moles, etc.)

Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They spread within the epidermal layer and appear visually as thin, widely spread, small brown or flesh-colored lesions. They often develop when immunity is compromised and can spread through self-contact, making early treatment important. Er:YAG laser is effective for uniformly ablating the epidermal layer, making it useful for clearing extensive flat warts in one go. It can uniformly remove lesions while minimizing skin damage. However, due to the nature of viral lesions, removing only the surface lesions carries a risk of recurrence. In such cases, the finishing process of applying thermal damage around the lesion with a CO2 laser can be a clinically significant treatment to reduce recurrence rates by additionally cauterizing virus-infected cells that may remain in the epidermis and its surroundings. CO2 finishing is particularly important in the following cases:

- If the lesion's border is unclear or feels flat and spread out when touched, or for individuals with weakened immunity (due to stress, lack of sleep, etc.)

- If you have experienced recurrence multiple times

- If the lesion is located in areas frequently touched or easily spread, such as hands or face

Milia are lesions that appear as small, white cysts when keratin (a type of skin protein) becomes trapped within the skin. They primarily occur around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are cosmetic lesions unrelated to infection or inflammation. Er:YAG laser is highly suitable for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer of the milia and creates a pathway for the safe discharge of internal keratin. Lightly cauterizing with a CO2 laser afterwards helps reduce the possibility of remaining keratinocytes proliferating again and prevents milia from recurring in the same area. However, precise intensity control is necessary, as excessive thermal damage to the skin can lead to hyperpigmentation. CO2 finishing is particularly beneficial in the following cases:

- If milia repeatedly appear in the same location

- If the lesion has re-protruded during regeneration after previous treatment

- When aiming for uniform results during the regeneration process after removing multiple milia

Syringomas are benign lesions formed by the overgrowth of sweat glands (eccrine glands) in the dermal layer, characterized by multiple small, bead-like skin lesions primarily appearing under the eyes, on the cheeks, and forehead. They are particularly common in women in their 20s and 30s or those with genetic predisposition. Er:YAG laser is suitable for treating syringomas in sensitive areas like around the eyes because it can remove the epidermis thinly and precisely. It refines the skin surface, removes the upper part of the sweat gland lesions, and results in minimal scarring or pigmentation during recovery, offering excellent cosmetic outcomes. Subsequently, the finishing method of applying heat with a CO2 laser to cause micro-damage to the deeper parts of the lesion is clinically significant in weakening the activity of dermal sweat glands and preventing syringomas from re-proliferating in the same area. However, since the lesions are deep, repeated treatments are often necessary. The treatment effect is enhanced when CO2 finishing is combined in the following cases:

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

- When recurrence has been experienced despite multiple previous laser treatments

- When desiring the maximum recurrence prevention effect with a single treatment

Skin tags are benign lesions formed by the overgrowth of fibrous tissue and blood vessels in the dermis. They commonly appear in skin folds like the neck, armpits, under the breasts, and on eyelids, presenting as small, flesh-colored raised lesions. They are usually painless but can become irritated by friction. Generally, a CO2 laser is more suitable for skin tag excision due to its excellent cutting and hemostatic effects, allowing for rapid removal of multiple lesions. However, for small and thin skin tags, precisely ablating the lesion with an Er:YAG laser first, followed by CO2 laser cauterization of the lesion's base, helps remove the root tissue of the skin tag and reduces the likelihood of recurrence in that area. Thermal stimulation effectively inhibits the regenerative environment by destroying fibrous cells and microvessels within the tissue. Combining CO2 finishing is particularly beneficial in the following cases:

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

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

- If the lesion has deep and wide roots (the type that leaves a raised mark even after excision)

Thus, the 'Dual Laser Technique,' which combines two lasers depending on the depth and nature of the lesion, is a key strategy for enhancing the completeness of treatment.

How long should I keep a DuoDerm (sticker) on after mole removal?

Mole removal procedure involves ablating the skin surface, leaving physical damage to the skin. Therefore, it is crucial to properly protect and manage the wound area. Keeping the treated area moist significantly impacts healing speed and scar prevention. For this purpose, applying DuoDerm, a hydrocolloid dressing, is recommended. DuoDerm keeps the wound moist to promote cell regeneration and delays scab formation, reducing the likelihood of scarring. It is ideal to apply DuoDerm immediately after mole removal and replace it every 3-5 days, managing the area for at least 7 days. A total management period of about 10 days is recommended. If DuoDerm use is difficult or causes allergies, you should frequently apply a regenerative cream or moist gel to prevent dryness, rigorously use SPF 50+ sunscreen, and avoid touching the wound. Post-mole removal care is not just about protecting the wound but is a crucial process that determines the outcome. Neglecting care can lead to scarring, so consistent attention is required after the procedure. Kkeut Clinic meticulously guides patients on post-procedure care methods for their quick and healthy recovery.

Recommended for:

1. Those who were concerned about moles, lentigines, milia, syringomas, or skin tags

2. Those who experienced recurrence after mole removal

Procedure Steps:

STEP 01. Self-cleansing

STEP 02. Anesthetic cream application

STEP 03. Mole removal

Post-Procedure Precautions:

ㆍBe careful not to let water touch the treated area. (Please wash your face with DuoDerm attached.)

ㆍDuring the skin regeneration phase, if possible, keep replacing and attaching the regenerative tape. (For about 10 days)

ㆍMoles in the removed area may recur and can be removed again after 4-6 weeks.

ㆍDeep-rooted moles may require repeated procedures.

ㆍAvoid sun exposure as much as possible. (Sunscreen is essential, and apply it over DuoDerm if possible.)