Mohs surgery is considered to be the most effective technique for treating basal cell carcinomas and squamous cell carcinomas, the two most common forms of skin cancer. It also offers the highest cure rate while sparing as much healthy tissue as possible. Mohs skin cancer surgery is done in stages.
What is Mohs Surgery?
Skin cancer is the most common form of cancer and affects many people around the world. While skin cancer can usually be prevented by limiting time in the sun, it can also occur due to other factors. There are three common types of skin cancer: Squamous cell, Basal cell, and Melanoma. Mohs Surgery is an effective treatment option for basal cell and squamous cell carcinoma.
Basal cell skin cancer is the most common form of skin cancer and is also the easiest to cure. It begins in the basal layer of the skin and is frequently found in areas that are commonly exposed to the sun. Individuals with fair skin tones have a higher risk of developing basal cell skin cancer, though any skin type may develop it. Although rare, this type of skin cancer may spread to other areas of the body.
Squamous cell skin cancer is a common type of skin cancer. It is caused by UV exposure over the course of a lifetime, and most commonly occurs in areas that are frequently exposed to the sun. This form of cancer may spread to other areas of the body, though it is rare.
Melanoma is the most aggressive form of skin cancer and is caused by overexposure to UV rays. It can occur in any area of the body but is most commonly found on the back, chest, neck, and face. Melanoma can easily spread to other areas of the body it if is not treated.
Candidates for Mohs Surgery
Mohs surgery is a treatment option for many patients with squamous cell carcinoma or basal cell carcinoma. Mohs surgery is particularly useful for skin cancers that have a high risk of recurrence, are aggressive or large, have borders that are difficult to define, or are located on highly visible areas such as the face or hands.
The Mohs Surgery Procedure
Mohs skin cancer surgery is performed in layers. Layers of the skin will be removed with a scalpel and each layer will be examined under a microscope. To start removing layers, a local anesthetic will be injected, and a scalpel will be used to remove a thin layer of visible cancerous tissue. This tissue will then be sent to an onsite lab to be analyzed to determine the extent of the skin cancer. Your surgeon will then let you know whether another layer of tissue needs to be removed. This entire process is repeated until there are no more cancer cells present.
Once the site is cleared of all cancer cells, the wound may be closed with stitches, depending on its size and location. In the case that a large wound is present, our dermatologists may work with other specialists such as a plastic surgeon, oculoplastic surgeon, or hand surgeon to repair the wound.
After Mohs Surgery
Following Mohs skin cancer surgery, your dermatologist will provide you with post-op instructions to help ensure a quick and easy recovery. Recovery will vary, depending on the site and how much skin was removed. In some cases, in which the incision is large, a skin graft or flap may be required. Reconstructive surgery may also be needed if the excision surgery creates a large scar. Strenuous activity should be avoided for at least 24-48 hours.
How do I know if I need Mohs surgery?
Your dermatologist may recommend Mohs surgery after performing a skin biopsy to determine if your growth is cancerous. There are many different skin cancer treatments available, so your dermatologist can recommend whether Mohs surgery is the right fit for you.
How can I prepare for Mohs surgery?
Mohs surgery requires significant waiting time, so the best way to prepare is by bringing your book or show in order to pass time. Make sure to also avoid alcohol or smoking ahead of your surgery and get a good night’s rest beforehand.
Who will perform my Mohs surgery?
Mohs surgery should only be performed by a board-certified dermatologist with specialization in surgical techniques. It’s best to search for a specified Mohs surgeon when looking at your options.
Will I be put under anesthesia for Mohs surgery?
Mohs surgery does not require you to be put to sleep. In fact, it’s performed using local anesthetic, so you’ll be awake and alert throughout.
What is recovery like from Mohs surgery?
Most patients require about 2 weeks of avoiding heavy activity or exercise. However, you’ll likely be able to return to work the next day (depending on the nature of your job).
How long does it take for a wound to heal after Mohs surgery?
Every patient is different, but wounds typically heal in a month. However, sutures are usually removed in 7 days.
How soon can I shower after Mohs surgery?
You can shower 24 hours after surgery but should take care to keep the wound and bandages completely dry. Our team can give you tips on how to properly shower after your surgery.
How long does it take for Mohs scar to flatten?
This can depend on many different factors like your body’s rate of healing and whether you’re prone to scarring. It can take about six months to one year for the scar to fully settle into its final appearance, after which you can undergo a scar revision treatment as needed.
Do Mohs wounds heal faster covered or uncovered?
Covered wounds heal best. Uncovered wounds can become dry and scab, which ultimately causes a scar. Make sure to keep your wound covered and moisturized with Vaseline.
Will Mohs surgery leave a scar?
Yes, Mohs surgery will leave a scar once the skin cancer has been removed, but your surgeon will preserve as much healthy tissue as possible. There are scar treatments that are available that can be discussed with your surgeon after the scar is fully healed.
Is Mohs surgery the best treatment option for all skin cancers?
Mohs surgery is the best treatment option for skin cancers on the face, scalp and neck. Mohs is also performed on the hands, feet and lower legs, depending on the size of the cancer. Mohs surgery isn’t typically performed on the body unless the cancer has recurred.
What should you not do after Mohs surgery?
You should avoid strenuous activity (heavy lifting, exercising, straining, etc.) for at least one week after surgery since these activities can increase blood pressure and increase the risk of post-operative bleeding or sutures opening.
Does Mohs surgery leave a hole?
Most of the time, the wound is closed with sutures but in some cases the wound is left open to heal on its own. Your surgeon will discuss your options with you during your consultation.
What should I do to prepare for Mohs Surgery?
Before Mohs surgery, you may be asked to stop certain medications. You should wear comfortable clothing, bring something to pass the time, and eat before your surgery so that you can be as relaxed as possible during the procedure.
How long does the Mohs procedure take?
The duration of your Mohs surgery can vary significantly depending on the size of the cancerous lesion. We ask all patients to plan to be in the office all day.
Can you drink alcohol after Mohs surgery?
You should avoid drinking alcohol for three days after Mohs surgery. Alcohol dilates the blood vessels and can cause excessive bleeding.
Can you shower after Mohs surgery?
You should wait 24-72 hours to shower after Mohs surgery since you do not want to get your bandage or wound wet during this initial healing period.