8 Things to Know About Mohs Surgery

Medically Reviewed By William C. Lloyd III, MD, FACS

Written By Megan Freedman on May 6, 2021

• 

  Removing Skin Cancer Layer-by-Layer

  Mohs surgery (also called Mohs microsurgery) is a type of surgery for skin cancer. Dermatologists use Mohs surgery to treat different skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma. The doctor removes the affected skin layer-by-layer until cancer cells are gone. Before you make the decision to have Mohs, consider these important facts, from how well it works to the post-surgery instructions.
• 

  1. Mohs surgery preserves healthy tissue—and your appearance.

  During Mohs surgery, your doctor removes a thin layer of affected skin and looks at it under a microscope for cancer cells. If cancer cells are present, the doctor repeats the process with a deeper skin layer, then another, until the cancer is fully removed. Instead of estimating how much cancer is present and removing a larger amount of tissue into even deeper layers of skin, Mohs surgery allows a doctor to target the exact—and smallest—area of affected tissue. And the less tissue surgery removes, the smaller the scar later.
• 

  2. Mohs surgery is established and effective.

  Mohs surgery was invented in the 1930s by Dr. Frederick Mohs. Doctors have researched and refined the skin cancer treatment technique for decades. Mohs surgery is currently the most effective skin cancer treatment method. It has a 98 to 99% success rate in curing skin cancer. If you’re interested in having Mohs surgery, make sure your dermatologist has additional training and experience performing this special type of surgery.
• 

  3. Mohs surgery is not for all types of skin cancer.

  Mohs surgery typically takes longer and costs more than some other types of skin cancer removal procedures. Your dermatologist will likely only recommend Mohs surgery for skin cancer on a very visible or functional part of your body, such as your nose, ears, hands, feet and genitals. Dermatologists also may recommend Mohs surgery for skin cancer that tends to return more frequently.
• 

  4. Mohs surgery takes time.

  In a typical skin removal procedure, your doctor numbs the skin, cuts out the affected tissue, closes the wound, and finishes within minutes. With Mohs surgery, your doctor numbs the area, takes a small slice of skin and carries out a number of steps in order to see the cancer cells under the microscope. Your doctor repeats these steps several times with deeper skin slices. Due to the nature of the process, Mohs surgery can take a few hours or even most of a day.
• 

  5. There are different closure techniques.

  Once your doctor has removed all cancerous cells, it’s time to close the Mohs surgery wound. Your doctor will talk with you about the best method for the wound’s size and location. Your wound may close on its own with a bandage, or may require a few stitches. Some wounds require a skin graft. This means cutting a section of skin from another part of your body to cover your wound.
• 

  6. You may have a plastic surgeon during surgery.

  If your skin cancer is located in a very visible place on your body like your face or hands, or if the affected area is relatively large, your dermatologist may invite a plastic surgeon to help reconstruct the wound. The plastic surgeon will close the wound using advanced techniques for preserving appearance and function. If you need surgery to remove skin cancer in a noticeable area, ask your dermatologist about involving a plastic surgeon. This applies to Mohs as well as other types of skin cancer surgery.
• 

  7. It’s important to follow post-surgery instructions.

  As with all procedures, it’s important to follow the instructions your care team will give you after Mohs surgery. Mohs surgery is generally safe, but there may be complications, including bleeding, infection, and nerve damage. Taking good care of your wound will help prevent complications, keep scarring minimal, and give you the best chance of a good outcome and an appealing post-surgical appearance.
• 

  8. Skin cancer can return after Mohs surgery.

  Mohs surgery is an effective treatment for skin cancer. But it’s important to know skin cancer can come back in the same spot or somewhere else. Even after successful Mohs surgery, take steps to reduce your chances of getting skin cancer again. Stay out of the sun as much as possible, apply sunscreen on both sunny and cloudy days, wear protective hats and clothing when you’re in the sun, don’t use tanning beds, and see a dermatologist at least once a year for skin checks.

8 Things to Know About Mohs Surgery

Was this helpful?

27