Mole, Raised Mole, Recurrent Mole Removal

Kkeuthan Clinic's Dual Laser Technique

*Moles are lesions caused by the excessive proliferation of melanocytes in the epidermis or dermis.

While they may appear to be simple pigmentation on the surface, the treatment approach varies depending on their location and depth.

The Er:YAG laser is specialized for precise and superficial ablation, allowing for the natural removal of shallow moles located in the epidermis without skin damage.

Additionally, it minimizes scarring and provides aesthetic 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:

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

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

-When it is judged to be a deep dermal nevus (e.g., blue nevus, grayish-brown nevus, etc.).

*Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They spread within the epidermal layer and appear as thin, widely spread, small brown or flesh-colored lesions. They are especially common when immunity is lowered and can spread through self-contact, making early treatment important.

The Er:YAG laser is effective for uniformly ablating the epidermal layer, making it useful for widespread flat warts.

It is useful for clearing them all at once. It can uniformly remove lesions while minimizing skin damage. However, due to the nature of viral lesions, there is a risk of recurrence if only the surface lesions are removed. In this case, the finishing process of applying thermal damage to the periphery of the lesion with a CO2 laser can be a clinically significant treatment to reduce the recurrence rate by additionally cauterizing virus-infected cells that may remain in the epidermis and its surroundings.

CO2 finishing is particularly important in the following cases:

-When the lesion's border is indistinct, or it feels flat and spread out to the touch, especially for individuals with weakened immunity (due to stress, sleep deprivation, etc.).

-When there is a history of multiple recurrences.

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

*Milia are lesions that appear as small, white cysts when keratin (a horny 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.

The Er:YAG laser is highly suitable for milia removal. It precisely ablates the skin surface to remove the thin epidermal layer of the milium, creating an opening for the safe expulsion of keratin inside. A light finishing cauterization with a CO2 laser after removal helps reduce the possibility of remaining keratinocytes proliferating 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 post-inflammatory hyperpigmentation.

CO2 finishing is particularly helpful in the following cases:

-When milia repeatedly appear in the same location.

-When there is a history of lesions reappearing during regeneration after surgery.

-When desiring uniform results during the regeneration process after removing multiple milia.

*Syringomas are benign lesions formed by the overgrowth of sweat glands (eccrine glands) within the dermis, characterized by multiple small, bead-like skin lesions primarily appearing under the eyes, on the cheeks, and forehead. They are especially common with genetic factors or in women in their 20s and 30s.

The Er:YAG laser is suitable for treating syringomas in sensitive areas like around the eyes because it can precisely and thinly remove the epidermis. It refines the skin surface and removes the upper part of the sweat gland lesions, resulting in minimal scarring or pigmentation during recovery, which is excellent from an aesthetic perspective. Subsequently, applying heat with a CO2 laser

The finishing method of inflicting micro-damage on the deeper parts of the lesion weakens the activity of sweat glands within the dermis and

is clinically significant in preventing syringomas from proliferating again in the same area. However, as the lesions are deep, repeated treatments are often necessary.

Combining CO2 finishing in the following cases enhances treatment efficacy:

-When numerous syringomas are relatively deeply embedded under the eyes, on the cheeks, etc.

-When recurrence has been experienced despite multiple previous laser treatments.

-When aiming for the maximum recurrence prevention effect with a single treatment.

*Skin tags are benign lesions caused by the overgrowth of fibrous tissue and blood vessels in the dermal layer. They commonly appear in skin folds such as the neck, armpits, under the breasts, and on the eyelids, presenting as small, protruding lesions similar in color to the skin. While painless, they can be irritated by friction. Generally, CO2 lasers are more suitable for skin tag excision, offering excellent cutting and hemostatic effects to quickly remove multiple lesions. However, for small and thin skin tags, precisely ablating the lesion first with an Er:YAG laser, followed by finishing cauterization of the lesion's base with a CO2 laser, helps remove the root tissue of the skin tag and reduces the likelihood of recurrence in that area. Thermal stimulation has the effect of destroying fibrous cells and microvessels within the tissue, thereby inhibiting the regenerative environment.

It is highly recommended to combine CO2 finishing in the following cases:

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

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

-When the lesion has a deep and wide root (a type where a raised mark remains even after excision).

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

combining two lasers,

the 'Dual Laser Technique' is

a key strategy to enhance the completeness of treatment.

After mole removal, how long should I keep the DuoDERM (sticker) on?

Mole removal procedures involve exfoliating the skin's surface, which leaves physical damage to the skin.

Therefore, it is very important to properly protect and manage the wound area.

Keeping the treated area moisturized is particularly crucial for recovery speed and scar prevention.

For this, attaching a hydrocolloid dressing like DuoDERM is recommended.

DuoDERM keeps the wound moist, promoting cell regeneration and slowing down scab formation, thereby reducing the possibility of scarring.

Ideally, DuoDERM should be applied immediately after mole removal, changed every 3-5 days, and managed for at least 7 days.

A total management period of about 10 days is recommended.

If DuoDERM use is difficult or an allergic reaction occurs, you should manage the area by frequently applying a regenerating cream or moisturizing gel to prevent dryness, meticulously using sunscreen with SPF 50 or higher, and avoiding touching the wound.

Post-mole removal care is not just about protecting the wound; it's a crucial process that determines the final outcome.

Neglecting aftercare can lead to scars, so consistent attention is required even after the procedure.

Kkeut Korean Medicine Clinic carefully guides patients on post-procedure care methods for their quick and healthy recovery.

Recommended for

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• 1. Those who have been concerned about moles, lentigines, milia, syringomas, or skin tags
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• 2. Those who have experienced mole recurrence after removal
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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
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Post-Procedure Precautions

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• ㆍBe careful not to let water touch the treated area. (Please wash your face while the DuoDERM is attached.)
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• ㆍDuring the skin regeneration phase, please continue to change and apply the regenerating tape if possible. (Approx. 10 days)
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• ㆍMoles in the removed area may recur and can be re-removed after 2-3 months.
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• ㆍMoles with deep roots may require repeated procedures.
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• ㆍAvoid sun exposure as much as possible. (Sunscreen is essential, and apply it over DuoDERM if possible.)
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