Indication
Benign skin lesions
Benign skin lesions such as xanthelasma, syringomas, warts and seborrhoeic keratoses are harmless, but patients often want them removed. With the Zoom handpiece, which comes as standard with the eCO2 3D, the CO₂ laser vaporises tissue layer by layer, so you can match the depth to the lesion and spare the surrounding skin.
eCO2 3D
Benign skin lesions are common and represent a frequent indication in aesthetic and dermatological practice. They include seborrhoeic keratoses, verrucae seborrhoicae, syringomas, xanthelasma, fibromas and other benign epidermal or superficial dermal lesions. Moles (naevi) do not belong on this list: laser treatment destroys the tissue needed for histological examination.
Successful treatment calls for careful consideration of the type of lesion, its depth, its anatomical location, the patient's skin type and the desired cosmetic outcome. The objective is removal that is as complete as possible, with minimal thermal damage to surrounding tissue and the smallest possible risk of scarring or pigment change.
Technologies for benign skin lesions
For most benign skin lesions, ablative lasers are the gold standard. Systems such as the eCO2 3D and Erbium:YAG make it possible to vaporise tissue layer by layer under precise control. That precision lets the practitioner match the depth of ablation closely to the lesion, sparing as much healthy surrounding skin as possible and allowing excellent cosmetic results.
The choice between a CO₂ laser, Erbium:YAG or the UltraClear depends on the indication, the degree of thermal effect wanted and the practitioner's preference. Where some lesions benefit from more coagulation, others call for maximum precision with minimal heat diffusion.
The alexandrite laser of the Clarity II is also used for pigmented seborrhoeic keratoses: the pigment in the lesion absorbs the laser light, after which the lesion crusts and comes away. This approach does not work on non-pigmented lesions; an ablative laser is used for those.
In practice
Treating benign skin lesions is among the most rewarding indications in laser practice. Results are often immediately visible, treatments can be carried out efficiently, and patient satisfaction is generally high.
Having several ablative technologies available, complemented by the distinctive capabilities of the alexandrite laser, means a suitable treatment strategy can be chosen for virtually any benign skin lesion. This gives practitioners the flexibility to pursue the optimal result, both functionally and cosmetically.
Medi-Invest supports practitioners with clinical training, practice-oriented treatment protocols and technical guidance, so that every technology can be deployed safely and effectively in the treatment of benign skin lesions.
Technologies for this indication
CO₂ laser (10,600 nm)
A CO₂ laser vaporises tissue with little bleeding, because the heat seals small vessels [1]. This makes it possible to remove raised benign lesions. Syringomas around the eyes improved after two fractional treatments in most of 35 patients [2]. A lesion can also be removed in its entirety with a non-fractionated CO₂ beam. In xanthelasma, all lesions in 23 patients disappeared this way after one treatment; after ten months they had returned in three patients, and there were temporary pigment changes [3]. Vaporised tissue can no longer be examined histologically. Laser ablation is therefore only an option when the diagnosis is certain.
Erbium
Full-surface Er:YAG removes superficial lesions layer by layer [4]. In a series of more than three thousand patients, these included seborrhoeic keratoses, flat warts and xanthelasma, with a short recovery time [5]. In deeper lesions, bleeding can hinder treatment, and the authors saw scarring after healing [4]. Acclaro also lists UltraClear for benign keratoses, in a fractional mode. Vaporised tissue can no longer be examined histologically. Laser ablation is therefore only an option once the diagnosis is certain.
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References
- Omi T, Numano K. The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology. Laser Ther. 2014;23(1):49–60. doi:10.5978/islsm.14-re-01
- Cho SB, Kim HJ, Noh S, Lee SJ, Kim YK, Lee JH. Treatment of Syringoma Using an Ablative 10,600-nm Carbon Dioxide Fractional Laser: A Prospective Analysis of 35 Patients. Dermatol Surg. 2011;37(4):433–438. doi:10.1111/j.1524-4725.2011.01915.x
- Raulin C, Schoenermark MP, Werner S, Greve B. Xanthelasma palpebrarum: Treatment with the ultrapulsed CO2 laser. Lasers Surg Med. 1999;24(2):122–127. doi:10.1002/(sici)1096-9101(1999)24:2<122::aid-lsm7>3.0.co;2-6
- Kaufmann R, Hibst R. Pulsed Erbium:YAG laser ablation in cutaneous surgery. Lasers Surg Med. 1996;19(3):324–330. doi:10.1002/(SICI)1096-9101(1996)19:3<324::AID-LSM7>3.0.CO;2-U
- Nisticò SP, Cannarozzo G, Campolmi P, Dragoni F, Moretti S, Patruno C, Bennardo L. Erbium laser for skin surgery: a single-center twenty-five years' experience. Medicines (Basel). 2021;8(12):74. doi:10.3390/medicines8120074
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