10 Tips to Prepare for Mohs Surgery
- Preparing for Mohs Micrographic SurgeryMohs surgery is used to treat skin cancer, including basal cell carcinoma, squamous cell carcinoma, and melanoma. It is usually performed in a doctor’s office or outpatient surgery center and doesn’t require general anesthesia. You’ll be awake (but appropriately numbed) during the procedure. It is a highly effective treatment for skin cancer. Mohs surgery has a 99% cure rate, according to the Skin Cancer Foundation. These practical tips will help you prepare for Mohs surgery on your face, nose, scalp or other area.
- 1. Learn about Mohs surgery.One way to prepare for a medical procedure is to learn how it’s done. During Mohs micrographic surgery, your surgeon will remove all visible skin cancer and a thin surrounding layer of skin. The surgeon will then carefully examine this layer under a microscope, looking for any traces of cancer. If cancer cells are apparent, the surgeon will remove another thin layer of skin. This process is repeated until no cancer remains. In most cases, your doctor completes the entire surgery in one day. Occasionally, patients go home after the initial layer is removed and return the next day. Ask your physician which technique he plans to use.
- 2. Stop smoking as far in advance as possible.Mohs surgery is very safe. However, bleeding and infection are risk factors of any surgery. Cigarette smoking and vaping both interfere with wound healing. Nicotine causes blood vessels to constrict, which reduces blood flow; it also makes the blood more likely to clot. Wounds need a steady, constant supply of blood to heal well, so physicians generally ask patients to stop smoking at least two weeks prior to surgery. It’s best to stay nicotine-free for at least two weeks after surgery as well. (Need help quitting for good? Ask your doctor for suggestions.)
- 3. Talk with your doctor about your other health conditions.Mohs surgery is generally performed by highly trained dermatologists. Make sure your surgeon knows your health history. If you have diabetes or heart disease, or have previously had a reaction to a local anesthetic, your surgeon needs to know. You may need to see your primary care provider before your surgery as well. Some patients who have heart murmurs or artificial joints may need to take an antibiotic before surgery to prevent infection.
- 4. Stop taking aspirin, ibuprofen, and over-the-counter supplements.You want to minimize the risk of bleeding during surgery. Very little blood is usually lost during Mohs surgery, but any steps you can take to decrease the risk of bleeding will be helpful. Aspirin, ibuprofen and naproxen all thin the blood slightly and increase the risk of bleeding, so you should stop taking these medications at least two weeks before surgery. Certain over-the-counter supplements also increase the risk of bleeding. One week before surgery, stop taking fish oil, vitamins E and C, garlic, ginkgo biloba, and ginseng.
- 5. Abstain from alcohol for a few days before your surgery.Alcohol can also increase the risk of bleeding during surgery, so physicians recommend abstaining from beer, wine and cocktails before surgery. Some doctors recommend staying away from alcohol for three days or so before surgery; others say to stop drinking alcoholic beverages at least 24 hours before your scheduled procedure. If you are concerned about your ability to abstain from alcohol, tell your physician. It’s better for you if your doctor is fully informed of all factors that might affect your body’s reaction to surgery.
- 6. Get a good night’s sleep.Sleep has been shown to boost immune system activity. People who get adequate amounts of sleep are less likely to get sick and more likely to heal quickly when injured or ill, especially compared to people who are chronically short on sleep. It’s not always easy to sleep the night before a medical procedure but do your best. Dim the lights nine hours or so before you need to get up. Take a hot bath if it soothes you or read something that’s comforting or entertaining. Aim for eight hours of sleep.
- 7. Skip makeup and moisturizer the day of surgery.The morning of your surgery, bathe or shower as usual. (If you don’t usually bathe in the morning, wash the area to be worked on with soap and water.) If the surgery is on your face, do not apply any sunscreen, moisturizer or makeup. If the surgery is on your scalp, don’t apply any kind of leave-in treatments. Your surgeon wants a clean, lotion- and cream-free surface to work on.
- 8. Eat a good, healthy breakfast.For many surgeries, you’re advised to stop eating or drinking at midnight of the day before. Not so for Mohs. Because Mohs surgery uses local anesthesia instead of general anesthesia, you’re allowed—and encouraged —to eat breakfast the morning of surgery. Want to promote healing? Consider having eggs and orange juice for breakfast. Protein and vitamin C are both crucial to healing, and eggs are high in protein while OJ contains lots of vitamin C.
- 9. Wear comfy clothes.If your surgery is on your face or scalp, access isn’t usually a problem. You can wear whatever you like (you don’t need to wear a hospital gown during the procedure). You’ll probably feel best if you wear something comfortable and familiar. You may want to wear a shirt with a large neck opening or buttons down the front if you’re having surgery on your face. You also may want to dress in layers or bring a light jacket or sweater; it’s often cool in the treatment room. If your surgery is on a part of your body that’s normally covered by clothing, ask your physician what you should wear.
- 10. Pack snacks and diversions.It may take 1 to 2 hours to receive the results of the microscopic examination of each skin layer that is removed. During this time, you’ll basically be sitting around, waiting. To make the time go more quickly (and ease your mind), bring something along to occupy your attention. You can read a book, play on your phone or work (or watch a movie) on a laptop computer or tablet. It’s a good idea to bring a light lunch and some snacks along as well. You’ll be able to eat and drink in between sessions. With preparation, most people will have a good Mohs surgery experience.
10 Tips to Prepare for Mohs Surgery