Skin Cancer

Mohs surgery is a surgical technique for comprehensive skin cancer treatment. The procedure is unique because diagnostic information and curative response happen in real-time. It is an outpatient procedure performed under a local anesthetic. This specialized surgery is performed by medical professionals who have undergone very extensive fellowship training at a Mohs-accredited surgical program.

The curative success of Mohs surgery for skin cancer stems from the removal of every last unhealthy cell. This highly specialized surgical procedure removes single layers of skin tissue for microscopic examination to map the presence of cancer cells. This process continues until reaching a layer that is free from cancerous cells. This methodical technique saves as much healthy skin as possible.

After cancer removal, a wound or gap may be present. This can be addressed with the help of a skin reconstruction procedure, which often involves flap or graft techniques.

Dr. Frederic Mohs pioneered this micrographic surgical technique in the 1930s during his time as a professor of surgery at the University of Wisconsin. This specialized technique is also referred to as micrographic surgery or Mohs micrographic surgery.

Patients commonly feel minimal discomfort, if any, during the procedure. Localized numbing from a tiny injection of anesthetic in the treatment area does an excellent job of keeping patients comfortable and pain-free. Minor discomfort after surgery is well managed with rest, ice, elevation, and ibuprofen or acetaminophen. If prescription-strength pain medication is appropriate for the patient and needed, it will be prescribed.

Each skin tissue layer removed is considered a stage, with stage one being the raised portion and the lesion’s first underlying layer and surrounding margins. For most patients, one or two additional stages are needed. In some cases, cancerous lesions can have extensions or roots not visible at the surface, so the Mohs surgeon will continue the process until the examination confirms 100% cancer-free margins.

After Mohs surgery, patients are encouraged to rest. Specific instructions for aftercare are reviewed with patients before they leave their surgical appointment.

Ice packs applied for 20 minutes once an hour until bedtime will relieve discomfort and help reduce swelling. To minimize the duration or occurrence of minor bleeding, bruising, or the opening of the wound, keep the treatment area elevated. Strenuous activity and lifting must be avoided for one to two weeks.