Flat Wart Dual Laser Precision Removal

Kkeuthan Clinic's Dual Laser Approach

Moles are lesions that appear when melanin pigment cells excessively proliferate in the epidermal or dermal layers of the skin.

While they may seem like simple hyperpigmentation, the treatment method can actually vary depending on the depth and location of the lesion.

The Erbium-YAG laser is highly precise and effective for shallow peeling procedures. It can be used to remove superficial moles in the epidermis, reducing damage to surrounding skin and allowing for natural shaving.

When minimizing scars and considering cosmetic satisfaction, it can be an excellent option, especially for mole removal on the face. Subsequently, thermally cauterizing the base of the mole with a CO2 laser can help remove melanin cells that may remain deep within, reducing the possibility of mole recurrence. This contributes to reducing ‘recurrent moles’ that appear to be gone from the surface but grow back from remaining roots.

CO2 laser finishing can be actively considered, especially in the following situations:

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

-If there is a history of moles recurring in the same area

-When determined to be a nevus located deep within the dermis (e.g., blue nevus, grayish-brown nevus)

*Flat warts are viral skin lesions caused by human papillomavirus (HPV) infection. They appear to spread widely within the epidermal layer and are often observed as thin, widespread, small brown or flesh-colored lesions. They are prone to occur during periods of weakened immunity and can spread to other areas through self-contact, thus requiring early and appropriate management.

The Erbium-YAG laser is useful for evenly peeling the epidermal layer, making it effective for widely spread flat warts.

It can be efficient for treating widely spread flat warts in one go. It minimizes skin irritation and allows for uniform removal of the affected area. However, due to the nature of viral lesions, there's a risk of recurrence if only the surface lesion is removed. In such cases, using a CO2 laser to apply thermal stimulation to the periphery of the lesion for finishing can clinically help reduce the recurrence rate by additionally cauterizing any virus-infected cells that may remain in the epidermis and its surroundings.

In the following situations, CO2 finishing can be considered an particularly important factor:

-When the lesion's border is unclear, or it feels widely spread to the touch, or for individuals with weakened immunity (due to stress, lack of sleep, etc.)

-If there is a history of multiple recurrences

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

*Milia are small, white, cyst-like lesions formed when keratin protein gets trapped under the skin. They typically appear around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are cosmetic concerns not directly associated with infection or inflammation.

The Erbium-YAG laser can be efficiently applied for milia removal. It precisely peels the skin surface to remove the thin epidermal layer of milia, creating a channel for the safe expulsion of keratin trapped inside. After removal, a light finishing cauterization with a CO2 laser can help lower the possibility of remaining keratinocytes re-proliferating and reduce the recurrence of milia 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 occur in the same location

-If there is a history of lesions protruding again during the recovery process after previous treatments

-When aiming for an even skin texture after removing multiple milia

*Syringomas are benign lesions formed by the excessive proliferation of sweat glands (eccrine glands) within the dermis. They are characterized by multiple small, bead-like skin lesions appearing under the eyes, on the cheeks, and forehead. They are especially common in individuals with genetic factors or 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. By refining the skin surface and eliminating the upper portion of the sweat gland lesions, it can reduce the risk of scars or hyperpigmentation during recovery, contributing to increased cosmetic satisfaction. Subsequently, applying thermal stimulation with a CO2 laser

the finishing method, which creates micro-damage in the deeper parts of the lesion, can mitigate the activity of sweat glands within the dermis and,

can provide clinically significant help in preventing syringomas from proliferating again in the same area. However, as lesions are often deep, repeated treatments may sometimes be necessary.

In the following cases, combining CO2 finishing can be expected to improve treatment outcomes:

-When multiple syringomas are relatively deep-seated, such as under the eyes or on the cheeks

-If there is a history of recurrence despite receiving multiple laser treatments previously

-When aiming for maximum recurrence prevention with a single treatment

*Skin tags are benign lesions formed by the overgrowth 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, appearing as small, skin-colored protrusions. They are typically painless but can become irritated by friction. While CO2 lasers are generally used for skin tag excision, effectively removing numerous lesions quickly with excellent cutting and hemostatic capabilities, for small and thin skin tags, first delicately peeling the lesion with an Erbium-YAG laser, followed by finishing cauterization of the lesion's base with a CO2 laser, can help remove the root tissue of the skin tag, reducing the likelihood of recurrence in that area. Thermal stimulation helps manage the regenerative environment by regulating fibrous cells and micro-blood vessels within the tissue.

It is advisable to consider CO2 finishing in conjunction in the following cases:

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

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

-When the lesion's root is deep and wide (a type where a raised trace might remain even after excision)

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

using two types of lasers together,

the ‘Dual Laser Technique’ is

an approach that contributes to enhancing the completeness of treatment.

DuoDerm (sticker) after mole removal, how long should it be applied?

Mole removal is a procedure that alters the skin's surface, causing a physical impact on the skin.

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

In particular, keeping the treated area moist can significantly impact skin recovery and scar prevention.

For this purpose, applying a hydrocolloid dressing like Duoderm is often recommended.

Duoderm maintains a moist environment for the wound, promoting cell regeneration and reducing scab formation, thereby lowering the likelihood of scarring.

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

We recommend a total management period of approximately 10 days.

If Duoderm use is difficult or an allergic reaction occurs, frequently apply a regenerating cream or moisturizing gel to prevent skin dryness. Additionally, carefully use sunscreen with SPF 50 or higher, and manage the area without directly touching the wound.

Post-mole removal care is more than just protecting the wound; it's a crucial stage that can significantly impact the procedure's outcome.

Negligent care can lead to scarring, so continuous attention is necessary even after the procedure.

We provide detailed guidance on post-procedure care to help our patients recover healthily.

Recommended for

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• 1. Those who have had skin concerns due to moles, seborrheic keratosis, milia, syringomas, skin tags, etc.
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• 2. Those who have previously undergone mole removal but are considering re-treatment due to recurrence.
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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 directly touch the treated area. (Cleansing is possible while Duoderm is applied)
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• ㆍDuring the skin regeneration phase, it is recommended to consistently replace and apply regenerative tape (such as Duoderm). (Approximately 10 days recommended)
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• ㆍOccasionally, moles may reappear in the treated area, and re-treatment is usually possible after 4-6 weeks.
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• ㆍDeep-rooted moles may be difficult to remove completely in a single session, and repeated treatments may be necessary.
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• ㆍMinimize exposure to UV rays. (Sunscreen is essential, and applying it over Duoderm can also be helpful.)
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