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The effect, pain and safety of removing moles, warts and blemishes with a carbon dioxide laser

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The effect, pain and safety of removing moles, warts and blemishes with a carbon dioxide laser

A carbon dioxide laser is a particularly effective laser for the treatment of moles, warts and age spots .

The carbon dioxide laser can sharpen the skin shallowly or dig deep by reacting with the water inside the cells to generate heat energy, and pinpointly removes target moles, warts, and raised spots. I can do it.

Since the blood vessels around the area irradiated with the carbon dioxide laser are instantly solidified by the heat coagulation action, there is less bleeding than excision with a scalpel, and it is a treatment method that leaves less scars after excision.

It is said that downtime is shorter than the method of surgical excision using a scalpel because there is less damage to surrounding tissues other than the target.

The carbon dioxide laser is suitable for removing moles and warts on the face within 5 mm in diameter and improving spots . Surgery with a scalpel is recommended over laser surgery because treatment of moles and warts on large objects with a diameter of 5 mm or more or on the body may cause noticeable scars, white discoloration, and even recurrence. ..

Before undergoing a procedure, it is important to know whether your worries can be improved with a carbon dioxide laser and the types of moles, warts, and spots that a carbon dioxide laser can handle .

In addition, it is safe to receive treatment after understanding the mechanism of carbon dioxide laser, the required number of treatments, downtime, cost, etc.

Carbon dioxide laser that crushes the cause of skin troubles with little damage

Laser features and mechanisms to improve skin problems

A laser is an artificial light created by extracting a specific wavelength from light containing multiple wavelengths and amplifying it.

Light has the property of a waveform that repeats peaks and valleys, and the length of the waveform from peak to peak (or valley to valley) is called the wavelength. Wavelengths are expressed in units of nanometers (nm), which is one billionth of a meter.

The wavelength of light or laser has the property of being absorbed by a specific substance, and heat energy is generated when the wavelength is absorbed by a specific substance .

Laser treatment by aesthetic medicine uses a laser with a wavelength that is absorbed by the black pigment of melanin, which causes spots and moles, and the red pigment of hemoglobin, which causes reddish face, to make spots, freckles, bruises, reddish faces, etc. By destroying the causes of various skin problems with heat energy, it leads to improvement.

The type of laser differs depending on the specific wavelength taken out, and they are called by names such as "carbon dioxide laser", "ruby laser", and "Alexandr laser", respectively.

The three main points of laser treatment are wavelength, irradiation time, and irradiation energy.

Depth of action with different wavelengths depending on the type of laser

The shorter the wavelength, the shallower the skin, and the longer the wavelength, the deeper the skin . For example, a short wavelength of about 500 nm is effective for spots on the skin surface.

The shorter the pulse width, the stronger the instantaneous energy.

As a general rule, when irradiating a laser in cosmetology, instead of continuously irradiating the laser beam, a method called pulse irradiation is used, in which the laser beam is radiated at intervals as if the button was pressed repeatedly.

The irradiation time of one shot when pulse irradiation is performed is called the pulse width, and the shorter the pulse width , the stronger the instantaneous energy for the irradiated substance . The unit of pulse width is expressed in milliseconds (ms), microseconds (μs), nanoseconds (ns), and picoseconds (ps) in descending order.

Irradiation energy that represents the power of the laser

The higher the irradiation energy (output), the stronger the heat action on the target substance, but the stronger the stimulation, the easier it is to feel pain . The less the irradiation energy, the less irritation and pain, but the effect is mild. The unit of output is J (joule) / ㎠.

List of laser types and substances to be absorbed
Main types of laser wavelength Absorbed skin substances
hemoglobin melanin moisture
Carbon dioxide laser 10,600nm
Er: YAG laser 2,940nm
Nd: YAG (neodymium yag) laser 1,064nm
Diode laser Around 810nm to 1,450nm ○ at 1,450 nm
KTP laser 532nm
Die laser Around 585nm-595nm
Red laser 660nm
Ruby laser 694nm
Alexandrite laser 755nm

Features of carbon dioxide laser and mechanism to remove moles, warts and stains

A carbon dioxide laser is a laser with a wavelength of 10,600 nm that is easily absorbed by moisture. By reacting with the water inside the cells to generate heat energy, the tissues of moles, warts, and stains are burned with heat to evaporate (vaporize) and remove them.

If melanin pigment remains on the surface of the skin after removing the swollen moles and warts, the remaining melanin pigment can be thinly scraped off by the heat energy of a carbon dioxide laser.

When removing moles and warts by surgery, it is necessary to cut them after the incision and then suture and remove the threads. On the other hand, in the case of a carbon dioxide laser, the heat energy causes the blood to clot and there is almost no bleeding, so there is no need to suture . It has the characteristics that the wound heals quickly and the scar is hard to remain.

Many moles, warts and blemishes can be removed at one time, but if the melanin that causes moles and blemishes is in the deep layers of the skin, it cannot be removed at once. If you try to force it in one treatment, you may end up with a deep scar, so it is recommended to treat it in two treatments.

Mechanism of carbon dioxide laser used in a wide range of applications

A carbon dioxide laser is called a "gas laser" that oscillates a wavelength using a mixed gas composed of carbon dioxide (CO2), nitrogen, and helium as a medium. In beauty treatments that aim to remove hokuro and warts, Dedicated machines developed by each medical device manufacturer are used.

The structure of a carbon dioxide laser machine is usually equipped with a device (oscillation tube) filled with a mixed gas containing carbon dioxide, and when an electric current is passed through this device, the molecules of the mixed gas vibrate with each other. It is a mechanism that oscillates and irradiates a wavelength of 10,600 nm (carbon dioxide laser) by causing energy transfer (excitation) between each molecule.

The wavelength of 10,600 nm for carbon dioxide lasers is infrared rays that are invisible to the human eye, and is the longest wavelength of any laser. In addition to cosmetic dermatology and plastic surgery , which mainly aim to remove moles and warts, dentistry, ophthalmology, otolaryngology, and those with increased laser output are used in a wide range of fields such as industry . ..

  • Dermatology / Plastic Surgery including Cosmetology: Removal of moles, warts / scars (scars), incision treatment, etc.
  • Dentistry: Treatment of tooth decay that reaches nerves (root canal treatment), etc.
  • Ophthalmology: Incision treatment for ptosis, etc.
  • Otorhinolaryngology: Treatment of nasal congestion and hay fever (allergic rhinitis), etc.
  • Industry: Welding and processing of materials such as metals and resins

Three irradiation modes of carbon dioxide laser

1) Continuous mode

Continuous mode is a function that can irradiate continuous waves. Continuous wave means to continue to irradiate the laser light. Continuous waves are used in the industrial field when processing metals, and in the medical field as scalpels that make incisions while controlling bleeding.

In continuous mode, you can evaporate the tissue of moles, warts, and spots, and cut off and excise the bulging part like a laser scalpel .

When irradiating using the continuous mode, the heat of the laser instantly solidifies the surrounding blood vessels due to the heat coagulation action, so bleeding can be stopped.

2) Short pulse mode to improve skin quality for beauty purposes

The short pulse mode is a function that can output a short pulse width that can be irradiated between nanoseconds and microseconds. The shorter the pulse width, the higher the peak power can be obtained, and since there is less heat damage to the target moles, warts, and surrounding tissues of spots when irradiated, there is an advantage that pain and post-inflammatory hyperpigmentation can be suppressed. there is.

In short pulse mode, it is possible to evaporate and remove moles, warts, and spots with shallow roots of melanin pigment .

3) Fractional irradiation is possible with the scanner function

The scanner function is a function that can irradiate the surface of the skin with a thin and even laser. By attaching a scanner that controls the laser beam, it is possible to perform irradiation called fractional irradiation, which is like stamping in dots.

The skin consists of two layers, the epidermis layer and the dermis layer, from the outside. Fractional irradiation of the dermis layer, which contains "collagen," "elastin," and "hyaluronic acid," which are components that maintain the elasticity of the skin, can promote the production of collagen and elastin. It can be expected to improve the firmness and elasticity of the skin, make pores less noticeable, and improve spots, fine wrinkles, uneven crater-like acne scars, and post-inflammatory hyperpigmentation .

Carbon dioxide laser irradiation method

There are two methods of irradiating a carbon dioxide laser: a focused beam and a defocused beam. Depending on the subject, the irradiation method is adjusted and treatment is performed.

Focused beam is an irradiation method that focuses on the image of bringing the tip of the handpiece closer to the treatment area. The shorter the focal length of the laser, the smaller the focusing diameter of the laser beam and the higher the energy, so it is often used when excising deep tissue .

Defocused beam is an irradiation method in which the tip of the handpiece is placed at a certain distance from the irradiation site and the focus is blurred. As the focusing diameter of the laser beam increases, the energy concentrated at one point weakens, but it can irradiate a large area. The defocus beam is an irradiation method used to evaporate the tissues of moles, warts, and spots .

Carbon dioxide laser safety

The carbon dioxide laser is a laser that has been used for a long time, and the year when the carbon dioxide laser instrument was first marketed was 1966. Since then, through repeated development, in the 1990s, a short pulse mode was developed to improve skin quality for the purpose of beauty, promoting skin regeneration without damaging the epidermis layer and surrounding tissues, and producing collagen in the dermis layer. It has also been used to treat acne scars, pore openings and wrinkles.

Carbon dioxide laser instruments have a long history among laser instruments, and are characterized by safety, output stability, and ease of operation . It is smaller than other laser instruments, compact and inexpensive, and is often used in industrial fields and as a medical laser scalpel.

Symptoms suitable for carbon dioxide laser treatment

Removal of benign moles

Mole is called melanocytic nevus (nevus cell nevus) in medical terms, and is a type of benign tumor caused by the proliferation of "mole cells (bohansaibo)" in which melanocytes, which are cells that produce melanin pigment, have changed. ..

They range in size from a few 5 mm to a few centimeters, with not only benign moles but also malignant moles.

The characteristics of malignant moles are often deformed, suddenly swelling, or increasing in size, but if malignant moles are suspected, examine the properties of the moles by ultrasonography or CT examination. I can.

A carbon dioxide laser is suitable for treating benign moles up to about 5 mm on the face . If the size is 5 mm or more, carbon dioxide laser can be used for treatment, but the recurrence rate tends to be higher than surgical excision.

A carbon dioxide laser irradiates a mole, which is basically benign, and burns the mole cells with heat to evaporate (vaporize) the water inside the cells, scraping the tissue and removing the moles.

If it is small, it is possible to clean a large number of moles with one treatment without anesthesia, but depending on the size and the depth of the root of the melanin pigment, it is divided into 2 to 3 times after anesthesia. May be treated.

Removal of raised spots (seborrheic keratosis) and warts

To treat swelling spots and warts, use local anesthesia , remove the swelling part with a carbon dioxide laser scalpel, and vaporize (transpiration) to scrape off .

The raised spots are called seborrheic keratosis in medical terms. Warts that look like raised spots on the face, neck, and scalp. The cause is thought to be ultraviolet rays, and the color varies from light brown to black. With age, small bumps and swelling spots increase. They come in a variety of shapes, especially in the elderly.

Seborrheic keratosis can also be treated by cryocoagulation with liquid nitrogen, which is covered by insurance, but it may cause pigmentation, pain after the procedure, and scarring in some people.

Other treatments may need to be considered if freezing and coagulation with liquid nitrogen does not completely improve.

Removal of soft fibroma (a type of wart)

Soft fibroma (skin tag, acrocordon) is a benign tumor and a type of wart. It is easy to form on soft skin such as the neck and sides, and the color is flesh-colored and features soft warts of about 2 mm to 3 mm.

When it begins to occur, it is often a relatively flat ridge, but it gradually swells like a wart and becomes like hanging on the skin.

Removal of soft fibroma is said to be painful enough to tolerate without anesthesia. Since a carbon dioxide laser can irradiate high energy pinpointly in a short time, it cauterizes small warts and evaporates (vaporizes) the water inside the cells to excise them. It is said that the damage to the skin is very small and pigmentation after treatment is unlikely to occur.

Improvement of senile pigment spots (so-called spots)

There are various types of spots such as "senile pigment spots," "chloasma," and "freckles." Carbon dioxide lasers are only effective in treating senile pigment spots (so-called normal spots caused by UV rays) .

Treatment of freckles and chloasma caused by constitution, heredity, female hormones, etc. is not recommended because it is difficult to improve with carbon dioxide laser and post-inflammatory hyperpigmentation may worsen.

Liver spots begin to appear in the 20s, and are spots that appear mainly on exposed areas such as the face and back of the hands, regardless of gender. Most of the colors are light brown and brown, and the boundary between normal skin colors is clearly visible, and it is characterized by no pain or itching. The color tends to darken and the number of spots tends to increase due to exposure to ultraviolet rays and a decrease in turnover, which is the metabolism of the skin.

Treatment of senile pigment spots with a carbon dioxide laser is performed with a defocus beam.

Improves acne and pore opening

By irradiating a carbon dioxide laser in very fine dots with fractional irradiation and intentionally damaging the skin, it is possible to promote skin regeneration by the action of wound healing.

Fibroblasts, which have the function of producing elastic components of the skin, are activated, and the production of elastic components such as collagen, elastin, and hyaluronic acid is promoted, and the skin regains its elasticity and elasticity, resulting in uneven acne marks and pores. You can expect the effect of improving the opening .

Treatment site to which carbon dioxide laser treatment is applicable

It is said that the thickness of the skin of the human body varies depending on the part. Carbon dioxide lasers are suitable for treating moles, warts and age spots on the face.

Since the wounds on areas other than the face heal slowly after treatment and the scars are often noticeable, surgery or treatment using a Q-switched laser is recommended rather than carbon dioxide laser .

Removal of moles and warts with a carbon dioxide laser provides local anesthesia to relieve pain. Local anesthesia is performed by injection, but for areas where pain is strongly felt during injection (such as moles and warts on the palm and sole of the foot), a method of freezing with liquid nitrogen or a treatment method such as a patch rather than carbon dioxide laser treatment Is suitable.

Comparison of mole and spot treatment

Part type Carbon dioxide laser
face deep color
Uplift type
Thin type
neck deep color
Uplift type
Thin type
body deep color
Uplift type
Thin type

◎: Optimal 〇: Suitable △: Depending on the case

Number and frequency of treatments recommended by carbon dioxide laser

Small moles, warts, and raised spots can be removed in one go, but moles and warts larger than 5 mm in diameter cannot be completely removed, so wait 4 to 6 weeks or more for the second treatment. To do.

If the melanin pigment is in the deep layers of the skin, it may recur. If it recurs, check the condition and treat with additional laser irradiation or surgery.

Pain during treatment, downtime, and guideline for progress after treatment

Pain during carbon dioxide laser treatment

Since the carbon dioxide laser treatment uses anesthesia, it is said that you will hardly feel any pain during the treatment . There are methods such as applying cream anesthesia to the treatment site and injecting local anesthesia with a fine needle. In the case of local anesthesia, there is a tingling sensation when injecting the anesthesia.

If you have had a redness, rash, or allergic reaction when you were anesthetized in the past, please inform your medical institution in advance.

Carbon dioxide laser downtime

Immediately after irradiation, the irradiated area may feel tingling, but it is said that it will subside in about a week . The affected skin may become dented, but it will gradually recover in about 2 weeks .

For moles and large warts , tape the irradiated area for 1-2 weeks after treatment. You may feel itching as the damaged skin regenerates due to its natural healing power.

In the case of multiple warts, a small black scab will form on the irradiated area, but please wait for it to come off naturally in about 1 to 2 weeks.

Even after the scab has peeled off , redness or darkening may appear on the treated area. It depends on the treatment site, but it is said that it disappears spontaneously in about 3 months . Larger ones may last for half a year to a year, but it is said that they will become less noticeable over time.

Risks and side effects of carbon dioxide laser

If the wound is deep after removing the moles and warts, it can cause bleeding , scarring, and pigmentation . In rare cases, bacterial infection may occur after the wound. The risk of hypertrophic scars (swelling scars) and keloids increases when the treatment target is large or when the keloid constitution is large .

When irradiating thin skin areas such as near the eyes, there is a risk of burns, so it is important to select a medical institution with a doctor who has extensive experience in treating moles and warts with a carbon dioxide laser.

What you need to know before undergoing a carbon dioxide laser procedure

Precautions before carbon dioxide laser treatment

If you get sunburned after the treatment, pigmentation is likely to occur, so it is safe to take measures against UV rays such as hats and sunglasses .

Eye protection is required during the procedure due to the diffuse reflection of the laser light. Insertion type eye guards and contact shells may be used, so those who use contact lenses should change to eyeglasses for treatment.

Remove makeup and sunscreen before carbon dioxide laser treatment as laser treatment will be less effective.

Precautions after carbon dioxide laser treatment

Two to three hours after the procedure, you may experience a tingling sensation and redness such as sunburn, but it gradually subsides.

Burning, itching, or tingling may occur during the healing process, which can be reduced by cooling . When cooling with an ice pack, wrap it in a towel and then apply it to your skin so that it does not come into direct contact with your skin.

You can wash your face and make up from the day after the treatment, but since it is easily affected by UV rays, you need to apply UV protection tape to the affected area for about 2 weeks after the treatment .

If the wound is dried, dents are likely to occur after the wound, so be sure to keep it moisturized .

Those who cannot receive carbon dioxide laser treatment

  • Those who are pregnant, may become pregnant, or breastfeeding
  • Those who have an infection or severe skin disease at the treatment site
  • Those with light allergies
  • Those with allergies or atopic dermatitis
  • Those with keloid constitution
  • Those who have or suspect a malignant tumor on the skin
  • Those who have gold thread in the irradiated area
  • Those who are tanned
  • Those with heart disease
  • Those who have problems with wound healing such as diabetes

Carbon dioxide laser treatment flow and treatment time / price

Flow of carbon dioxide laser treatment

1) Counseling / examination

Diagnose the condition of moles and warts to see if they can be treated with a carbon dioxide laser. After receiving an explanation about the treatment period and aftercare, proceed to the treatment.

2) Face washing / cleansing

Makes up, stains and sebum are thoroughly removed to clean the treatment area.

3) Anesthesia

Select local anesthesia, anesthetic tape, anesthetic cream, etc. according to the size of the treatment site and the depth of treatment. Please check that some medical institutions charge an additional fee for anesthesia.

4) Treatment

Irradiate the affected area such as moles and spots with a carbon dioxide laser.

5) Treatment

Apply ointment to the treatment area and apply protective tape to finish.

6) Re-examination

According to the doctor's instructions, the patient will be revisited about 1 to 2 weeks after the treatment to confirm the healing condition of the affected area. Please follow the doctor's instructions as the presence and timing of return visits will vary depending on the treatment site.

Carbon dioxide laser treatment time

The treatment time for one small mole takes about 10 to 15 seconds , but if it exceeds 1 cm, it takes about 5 minutes . In the case of small moles and warts, it is common to take 5 to 10 places in one treatment, but in that case the treatment time is about 10 to 15 minutes.

Carbon dioxide laser price

Flat moles and spots are covered by free medical care (out-of-insurance medical care), and raised moles, warts and spots are covered by insurance .

It depends on the size and condition, but the market price is about 3,000 to 10,000 yen for free medical treatment .

In the case of removal of moles and warts covered by insurance, the market price per time is about 2,000 to 3,000 yen for diameters less than 1 mm, about 5,000 yen for diameters less than 3 mm, and about 8,000 yen for diameters 3 mm to less than 5 mm .

Treatment of acne and open pores is a free practice . The approximate price is about 30,000 yen for all faces, about 20,000 yen for nose + cheeks, and about 15,000 yen for nose only .

Types of carbon dioxide lasers for sale

The conventional carbon dioxide laser has only a continuous wave function that cuts an object like a scalpel, but the current carbon dioxide laser has evolved with repeated development, has high energy efficiency, and has a super pulse function that does not easily damage surrounding tissues. Has been developed.

Carbon dioxide laser equipment has new functions such as a small machine that does not take up space, fine adjustment of output during treatment, single function that can irradiate only once, repeat function that can irradiate repeatedly, focus beam that can control transpiration. Has been added, and it is now possible to safely treat the affected area such as moles, warts, and spots .

Comparison table of carbon dioxide laser treatment equipment

Product name Medical device approval number Variable output range Body weight action mode wavelength Functions / effects Manufacturing company
Bell Laser S 21700BZZ00348000 0.5w ~ 15w 28kg Continuous / super pulse mode 10,600nm Incision, hemostasis, coagulation, transpiration of living tissue Takara Belmont Co., Ltd.
Neek Laser Lee 15Zμ 22500BZX00187000 0.5w ~ 15w 34kg Continuous / single / repeat 10,600nm Incision, hemostasis, coagulation, transpiration of living tissue Japan Luminous Co., Ltd.
AcuPulse 30AES-RST 22200BZX00655000 1w-30w 49kg Continuous / super pulse mode 10,600nm Incision, hemostasis, coagulation, transpiration of living tissue Japan Luminous Co., Ltd.
CO2 laser system UAL3000DP 22700BZX00123000 1w-30w 25kg Continuous / single pulse / super pulse mode 10,600nm Incision, hemostasis, coagulation, transpiration of living tissue Medical U & A Co., Ltd.

Q-switched laser (YAG laser) that is effective when used in combination with a carbon dioxide laser

A carbon dioxide laser can treat moles, warts, and blemishes with little damage to the surrounding normal skin, but if the roots of the melanin pigment are deep, it may be scraped too much, slowing recovery or slowing recovery. The scars may be noticeable.

On the other hand, treatment with a Q-switched laser requires irradiation time and frequency, so by using a carbon dioxide laser and a Q-switched laser together, downtime can be shortened and treatment can be performed efficiently .

The procedure is to first inject a local anesthesia, irradiate the target raised mole or wart with a carbon dioxide laser to remove the bulge, and then switch to the Q-switched laser to irradiate the flat mole or stain. Revisit one month later and re-irradiate the Q-switched laser if melanin pigment still remains.

In order not to fail or regret the carbon dioxide laser treatment

The treatment of moles, warts, and age spots using a carbon dioxide laser is basically performed by scraping, cutting, and digging the skin, but the satisfaction level of the treatment depends on the experience and skill of the doctor.

When irradiating thin skin areas such as near the eyes, there is a risk of burns, so delicate techniques are required for laser irradiation settings and operations. It is important to choose a medical institution that has a doctor with a wealth of knowledge and experience in carbon dioxide laser machines .

It is safe if the medical institution can actually receive counseling and explain the treatment policy, the required number of treatments, possible risks, etc.

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