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Mohs Surgery for Skin Cancer

Surgery Overview

Mohs surgery removes a skin cancer one layer at a time. The doctor checks each layer for cancer cells until no more cancer is found.

This method lets the doctor save as much healthy tissue as possible.

This surgery is mostly used for areas of skin you can see or where scarring is a bigger concern, such as on the ears, nose, or eyelids.

It is also used for skin cancer that is likely to return, is growing fast, or has a high risk of spreading.

What To Expect

You will have a scar that fades with time. If your wound is large, your doctor may need to take a thin sheet of healthy skin from another part of your body. This sheet of skin can be used to cover the area where the cancer was removed. The doctor will try to use healthy skin from an area that is usually covered by clothes or is not easily seen.

You should be able to return to your normal routine on the same day or the day after the surgery. But your doctor may ask you to limit activity until your follow-up appointment in 1 to 2 weeks. Some soreness, swelling, or bruising is normal.

Your doctor may recommend over-the-counter or prescription medicines to help with pain. Most wounds take 1 to 3 weeks to heal.

You may have stitches that will be removed in a week or two. If you have the type of stitches that dissolve, they don't have to be removed. They will disappear on their own.

Why It Is Done

Mohs surgery may be used for removal of skin cancer that:

  • Is likely to return. Mohs surgery works well for getting cancer-free margins for cancers that have irregular borders and a history of removal and recurrence.
  • Is located in visible areas or areas where skin tissue should be preserved, such as on the ears, nose, or eyelids.
  • Is growing quickly.
  • Has a high risk of spreading to other parts of the body, such as in some squamous cell carcinomas.
  • Occurs in children.

How Well It Works

Mohs surgery can be an effective treatment for skin cancer. This technique preserves as much nearby healthy skin as possible. It is recommended for squamous cell carcinoma when the highest cure rate is desired while sparing as much healthy tissue as possible.footnote 1 And for basal cell carcinoma, Mohs surgery is the best treatment for sparing healthy tissue and preventing the cancer from coming back.footnote 2

Risks

Risks of surgery include:

  • Infection of the wound.
  • Scarring.
  • Discomfort or pain.
  • Bleeding.

References

Citations

  1. Grossman D, Leffell DJ (2012). Squamous cell carcinoma. In LA Goldman et al., eds., Fitzpatrick's Dermatology in General Medicine, 8th ed., vol. 1, pp. 1283–1294. New York: McGraw-Hill.
  2. Carucci JA, et al. (2012). Basal cell carcinoma. In LA Goldman et al., eds., Fitzpatrick's Dermatology in General Medicine, 8th ed., vol. 1, pp. 1294–1303. New York: McGraw-Hill.

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