What you need to know about Mohs skin cancer surgery

by Heidi Anderson, M.D.

While new technological advancements for skin care garner national attention, a technique that was developed in the 1930s and popularized in the 60s and 70s remains the standard of care for eradicating the most common skin cancers in the U.S.

Mohs Microscopic surgery targets basal cell and squamous cell carcinomas, cancers that typically appear on areas of the body frequently exposed to the sun. These cancers are primarily from cumulative excessive ultraviolet (UV) radiation exposure.

Mohs surgery is used to remove skin cancers that are invasive, large or in areas at risk for recurrence, while sparing healthy cells. This technique is highly effective, with a success rate of 97-99 percent, and has been proven to be the most effective, accurate way to eradicate these cancers. Read on to learn more about this tissue-sparing, highly effective skin cancer surgery.

How does it work?

The tumor and surrounding area are anesthetized and the tumor is surgically removed. The removed tissue is marked with colored dyes to map the tissue compared to the excision site, and then processed and examined under the microscope. If any cancer is still present on the outer edge of the areas, additional layers where the cancer cells exist are precisely removed. The process is carefully repeated until only cancer-free tissue is left. Unlike routine excisions, the lab work is processed immediately to ensure all impacted cells are removed.

How long does the process take?

The whole process is usually completed in one day. Total removal of a skin cancer spot may involve several surgical stages and, therefore, tissue processing. The length of each session will depend on tumor location, size and extent of closure. Once the cancer is removed, the surgeon determines the best repair technique. This may be a simple line, a flap (rearranging tissue) or even a graft (using tissue from another site).

Are follow-up appointments necessary?

A period of observation is necessary by your dermatologist to examine for recurrence. Follow-up appointments will be determined by how well your skin is healing. Studies have shown that once you have skin cancer, there is a possibility that you will develop additional cancerous spots in the years ahead. Regular self-examinations are encouraged, as well as routine check-ins with your dermatologist.

How should I prepare?

Try to get a good night’s rest and eat a full breakfast. You can take your usual medication, unless we direct otherwise. It’s a good idea to bring a book or magazine with you on the day of surgery. The procedure may take a full day and there is time to relax while the tissue specimens are processed and reviewed.

Call us today if you see any suspicious spots (here’s what to look for). We’re here to help you lead a healthy, active life!

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