What to Expect During Mohs Surgery

September 24, 2020

Woman discusses Mohs Surgery with doctor

Skin cancer treatments are among the most important services offered by the U.S. Dermatology Partners team. While many skin conditions carry the risk of causing long-lasting and potentially serious effects without appropriate treatment, skin cancers are especially concerning. According to Dr. Aaron Joseph of U.S. Dermatology Partners in Pasadena, Texas, “Most people don’t think of dermatologists as lifesaving doctors. But, for patients at a higher risk for developing skin cancer such as those with fair skin, light-colored eyes, blond or red hair, prior skin cancers, or those who are immunosuppressed, regular screenings with a dermatologist could definitely save your life! Additionally, early diagnosis and treatment of skin cancer can prevent this disease from spreading to surrounding areas and causing severe, irreversible damage. We have many ways to combat the serious health effects of skin cancer, but Mohs surgery is one of the most effective options for addressing non-melanoma skin cancer.” Keep reading to learn more about Mohs surgery and other important information about skin cancer diagnosis and treatment from Dr. Joseph.

What You Should Know About Mohs Surgery

Mohs surgery, originally called chemosurgery, was developed in the 1930s to treat skin cancers and is named for Dr. Frederic Mohs who first performed the surgery. Mohs surgery is used in the treatment of non-melanoma and superficial melanoma skin cancers, and it has one of the highest cure rates compared with other treatments for skin cancer. In fact, Mohs surgery has a 99% percent cure rate in treating squamous cell and basal cell carcinomas, two of the most common types of skin cancer. The surgery technique requires the dermatologist to carefully remove all of the skin cancer cells and a small margin area of surrounding healthy skin tissue layer by layer. Then, the tissue is examined microscopically to ensure that all cancer cells have been removed. This careful, unique approach to skin cancer treatment allows for the total removal of cancerous cells while minimizing the amount of healthy skin tissue that needs to be removed.

Unless Mohs surgery is completed in conjunction with more invasive procedures, it is typically performed on an outpatient (no hospitalization required) basis under local anesthesia (numbing). Mohs surgery treatment is almost always completed in a single visit unless there is a very large tumor or numerous tumors that need to be treated. The treatment process itself involves precisely removing the cancerous skin cells layer by layer. Then, each layer is carefully analyzed to determine whether or not cancerous cells are still present before removing the next layer. This process will continue until the removed skin layer is cancer-free.

What’s the Difference Between Mohs Surgery & Other Skin Cancer Treatments?

According to Dr. Joseph, “When caught early, most skin cancers can usually be removed with minor surgery under local anesthesia, especially when compared to the more invasive treatments necessary for cancers that originate within the body’s internal organs and systems. The traditional scalpel and suture approach to surgery that is used for treating other types of cancer can be a little excessive for most skin cancers. When this type of approach is used, larger areas of healthy skin may need to be excised to ensure that all cancer has been removed. The benefit of Mohs surgery is that it allows us to look at layers of skin microscopically and precisely remove just the damaged cells and a very small amount of healthy tissue. And, the surgery can usually be completed in one morning without additional delays for the pathology associated with traditional excisional surgery.”

In addition to Mohs surgery and traditional surgical excision, there are a number of other minimally invasive skin cancer treatments available, including:

  • Cryosurgery – use of cold to destroy cancerous skin cells
  • Curettage – use of a special instrument called a curette to remove damaged skin cells followed by a cauterizing tool to minimize bleeding and improve healing
  • Laser treatment – use of highly concentrated light beams to target and remove cancerous skin cells

What Kinds of Skin Cancers can be Treated with Mohs Surgery?

Mohs surgery is most often recommended for treating non-melanoma skin cancers, including squamous cell and basal cell carcinomas. Individuals who have recurring skin cancers may especially benefit from Mohs surgery as this treatment allows dermatologists to accurately remove the cancerous cells at all levels. Skin cancer cases that are considered good candidates for Mohs surgery include:

  • Recurring (tumors that regrow after treatment) non-melanoma skin cancers (specifically basal and squamous cell carcinomas)
  • Skin cancer in locations where minimizing scarring and tissue loss may be most important (the face, neck, hands)
  • Large or changing tumors
  • Tumors with poorly defined borders
  • Skin cancer treatment in patients with immune compromising health issues or those in poor general health who may not be eligible for more invasive procedures

What Should I Expect After Mohs Surgery?

Dr. Joseph says, “After your Mohs surgery, the dermatologist will place a compression dressing. This dressing puts pressure on the surgical site to minimize swelling and reduce the risk of scarring. You will also be provided with specific care directions to minimize infection risk and ensure you heal quickly and comfortably. Be sure to follow your dermatologist’s instructions and use the compression dressing as directed.”

Mohs surgery is very comfortable, and most people experience only a few, very minor side effects, Specifically, you may notice the following common effects:

  • Bleeding from the wound or around the surgical site
  • Pain, swelling, and tenderness around the treatment area
  • Some numbness or loss of sensation may also occur over the surgical site

The common side effects of Mohs surgery are usually managed with over the counter pain medications and will resolve on their own after a few days. If you develop signs of an infection (surgical site feels warm to the touch, severe swelling, fever, nausea), you should contact us right away. If you follow cleaning and care instructions, infection risk is minimal, but infection needs to be treated as soon as possible.

Schedule a Skin Cancer Treatment Consultation at U.S. Dermatology Partners

To reduce your risk of developing skin cancer, we recommend performing monthly self-examinations and scheduling annual full-body comprehensive skin cancer examinations with a dermatologist. According to Dr. Joseph, “These yearly professional exams give us the opportunity to carefully examine your skin for the early warning signs of all forms of skin cancer. The earlier we can diagnose and begin treating skin cancer – the better! If you notice changes during your monthly self-exam, don’t wait to contact your dermatologist. Give us a call right away.”

If you need to schedule your annual skin cancer exam, we would love to see you. It’s easy to set up your in-person visit using our scheduling request form. Once we hear from you, one of our team members will be in touch to answer your questions, verify details, and set the specific date and time for your appointment.

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