Mole, Raised Mole, Recurrent Mole Removal

Treatment Approach Using Two Lasers

A mole is a skin change caused by an excessive increase in melanin cells in the epidermis or dermis layer of the skin.

Although it may seem like a simple pigmented lesion, the treatment method can vary depending on the depth or location of the mole.

The Erbium YAG laser is used to precisely ablate the skin surface. This allows for the removal of shallow moles in the epidermal layer without significant damage to the surrounding skin.

This laser can help reduce scar formation and enhance cosmetic satisfaction after treatment, making it suitable for facial mole removal. Subsequently, the process of thermally cauterizing the base of the mole with a CO2 laser aims to remove any remaining melanin cells in deeper areas. This can help reduce the likelihood of recurrent moles, where the mole appears to be gone on the surface but its root remains, causing it to reappear.

Specifically, a finishing process using a CO2 laser can be considered in the following cases:

    - If the mole appears slightly raised to the naked eye, or feels thick when touched.

    - If you have a history of a mole reappearing in the same area.

    - If it is determined to be a nevus located deep in the dermis (e.g., blue nevus, nevus of Ota, etc.).

Flat warts (verruca plana) are viral skin diseases caused by human papillomavirus (HPV) infection. They typically appear widely spread in the epidermal layer and are observed as small, thin, and flat brownish or flesh-colored lesions. They are more likely to occur when immunity is weakened, and it is crucial to manage them early as they can spread to other areas through self-contact.

The Erbium YAG laser can be used to uniformly ablate the epidermal layer. It can be a good approach for removing widely spread flat warts

at once. The expected effect is to reduce skin irritation while uniformly clearing the lesions. However, even if only the superficial part of viral lesions is removed, there is a possibility of recurrence. In such cases, a finishing process involving applying heat around the lesion with a CO2 laser can be helpful. This can be a clinically significant treatment to further remove virus-infected cells remaining in the epidermis and surrounding areas, thereby lowering the chances of recurrence.

A CO2 laser finish may be particularly important in the following situations:

    - If the borders of the lesion are indistinct, or it feels widely spread when touched. It is also highly recommended for individuals with weakened immunity due to stress, lack of sleep, etc.

    - If there is a history of flat warts recurring multiple times.

    - If the lesions are in areas frequently touched or easily spread, such as the hands or face.

Milia are small, white, cyst-like lesions formed when keratin (a type of skin protein) becomes trapped beneath the skin. They are commonly observed around the eyes, on the cheeks, and forehead, and unlike sebaceous cysts, they are a cosmetic concern unrelated to inflammation or infection.

The Erbium YAG laser can be effectively used for milia treatment. It precisely ablates the skin surface to open the thin outer layer of the milia, helping to safely remove the trapped keratin inside. A gentle finishing cauterization with a CO2 laser after the procedure can reduce the likelihood of keratinocyte re-proliferation and help prevent milia from recurring in the same location. However, precise intensity control is crucial, as excessive thermal damage to the skin can lead to post-inflammatory hyperpigmentation.

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

    - If milia frequently reappear in the same spot.

    - If you have experienced lesions reappearing during the post-treatment recovery process.

    - If you desire uniform recovery of the treated area after removing multiple milia.

Syringoma are benign lesions caused by excessive proliferation of sweat glands (eccrine glands) in the dermis layer. They typically appear as multiple small, round, palpable skin lesions, predominantly under the eyes, on the cheeks, and forehead. They can be hereditary or are relatively common in women in their 20s and 30s.

The Erbium YAG laser can precisely and delicately remove the epidermis, making it suitable for treating syringoma in sensitive areas like around the eyes. This procedure is used to refine the skin surface and remove the upper part of the sweat gland lesions. It is also a good cosmetic approach as it reduces the possibility of scars or hyperpigmentation during recovery. Subsequently, applying thermal stimulation with a CO2 laser

as a finishing method to give subtle stimulation to the deeper parts of the lesion can contribute to weakening the activity of the dermal sweat glands.

This can be a clinically significant method to prevent syringoma from proliferating again in the same area. However, due to the depth of the lesions, multiple treatment sessions may be required.

In the following cases, incorporating a CO2 laser finish can help improve post-treatment satisfaction:

    - If multiple syringomas are deeply embedded under the eyes or on the cheeks.

    - If you have a history of lesions reappearing despite receiving multiple laser treatments previously.

    - If you hope for an effect that reduces recurrence as much as possible with a single treatment.

Skin tags are benign skin lesions caused by an excessive increase in fibrous tissue and blood vessels in the dermis layer. They typically form in skin folds such as the neck, armpits, under the breasts, and eyelids, appearing as small, skin-colored protrusions. They are usually painless but can cause discomfort due to friction. CO2 laser is commonly used for skin tag removal due to its excellent cutting power and hemostatic properties, allowing for quick removal of multiple lesions. However, for small and thin skin tags, a method of precisely ablating the lesion with an Erbium YAG laser first, followed by cauterizing the base with a CO2 laser, can help manage the root tissue of the skin tag and reduce the likelihood of recurrence in that area. Thermal stimulation contributes to inhibiting regeneration by destroying fibrous cells and microvessels within the tissue.

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

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

    - If there is a history of lesions reappearing in the same spot after skin tag removal.

    - If the root of the lesion is deep or wide, which might leave a noticeable mark on the skin even after removal.

Thus, tailored to the depth and characteristics of the skin lesion,

using two lasers together,

the ‘Dual Laser Technique’

can be an important approach to enhance the completeness of the treatment.

How long should DuoDERM (healing patch) be kept on after mole removal?

Mole removal procedures involve physical stimulation to the skin surface, which can cause damage.

Therefore, it is very important to protect and manage the treated area well after the procedure.

In particular, keeping the treated area moist helps skin recovery and has benefits in reducing the possibility of scar formation.

For this purpose, we recommend using DuoDERM, a hydrocolloid type dressing.

DuoDERM maintains a moist environment around the wound, promoting natural cell regeneration. This can reduce scab formation and alleviate the concern of scarring.

It is recommended to apply DuoDERM immediately after mole removal, replace it every 3-5 days, and manage the area for at least 7 days.

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

If DuoDERM use is difficult or a skin allergic reaction occurs, apply a regenerative cream or moisturizing gel frequently to prevent skin dryness. It is also important to carefully apply sunscreen with SPF 50 or higher and avoid touching the wound directly.

Aftercare following mole removal goes beyond simply protecting the wound; it significantly impacts the procedure's outcome.

If proper care is not provided, scars may remain, so consistent attention after the procedure is necessary.

Our medical facility provides detailed guidance on post-procedure care methods to help patients recover quickly and healthily.

Recommended for

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• 1. Those who have experienced skin concerns such as moles, lentigines, milia, syringomas, or skin tags.
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• 2. Those who previously had moles removed but they reappeared and are considering re-treatment.
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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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• ㆍBe careful not to let water directly touch the treated area. (You can wash your face while the DuoDERM is applied)
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• ㆍDuring the skin regeneration period, if possible, consistently replace and apply the regenerative tape. (Approximately 10 days)
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• ㆍMoles may reappear in the removed area, and in case of recurrence, re-removal treatment is possible after 2-3 months.
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• ㆍFor deep-rooted moles, a single procedure may not completely remove them, and repeated treatments may be necessary.
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• ㆍIt is best to avoid exposure to ultraviolet rays as much as possible. (Always use sunscreen, and applying it over DuoDERM is even better.)
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