Mohs Surgery

An Advanced Skin Cancer Treatment

Overview
Mohs surgery is an advanced procedure primarily used to treat squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs). It combines medical precision with cosmetic considerations to effectively remove cancerous cells while preserving healthy tissue. This technique is especially beneficial for facial skin cancers with ill-defined margins, larger tumors (over 2 cm in diameter), or aggressive histological types. Mohs surgery boasts a high success rate, achieving 95% for recurrent cancers and 99% for new ones.

Alternate Name

Mohs Micrographic Surgery

Body Location

Facial skin and areas such as around the lips, eyes, ears, nose, fingers, toes, and genitals.

Procedure Type

Minimally invasive.

Preparation for Mohs Surgery

Clothing: Wear comfortable, breathable clothes to allow easy access to the treatment area.
Positioning: Patients may need to sit or lie down for the procedure, depending on the area being treated.
Minimal Preparation: No extensive preparation is needed. The process is staged, requiring the patient to wait between steps for laboratory evaluation of tissue margins.

How Mohs Surgery Is Performed

Marking the Tumor: The surgeon marks the tumor margins.
Local Anesthesia: Administered to numb the area.
Tissue Removal: A thin layer of tissue (0.5 mm–2 mm) is excised, and an electric current is applied to stop capillary bleeding.
Lab Analysis: The excised tissue is color-coded, processed, and examined under a microscope to identify cancer cells.
Re-excision (if needed): If cancer cells are still detected, additional layers are removed until the margins are cancer-free.
Wound Closure: After ensuring all cancer is removed, the wound may be left to heal naturally, closed with sutures, or reconstructed using skin grafts or flaps.

Follow-up Care

Keep the pressure dressing on for at least 24 hours post-surgery.
Clean the wound gently with mild soap and water and reapply antimicrobial ointment.
Avoid makeup, harsh chemicals, or excessive sun exposure on the treated area.
Keep the area elevated during rest and take prescribed antibiotics to prevent infection.
Attend follow-up appointments to monitor healing.

Risks of Mohs Surgery

Medication Reactions: Some patients may experience sensitivity to anesthesia or other medications.
Inflammation: Swelling or bruising may occur post-surgery.
Infection: Though rare, infections can lead to scarring or delayed healing.
Delayed Healing: Healing time may vary depending on wound size and patient health.

Recovery

Small sutured wounds typically heal in 1–2 weeks, while larger or naturally healing wounds may take 3–4 weeks.
Avoid heavy lifting, strenuous activities, and smoking during recovery.
Protect the treated area from excessive sun exposure.

FAQs

What makes Mohs surgery so effective?
Mohs surgery allows immediate examination of removed tissue, ensuring complete cancer removal while sparing healthy tissue.
Can Mohs surgery be performed on any part of the body?
Yes, it is suitable for sensitive areas or those with limited tissue, such as the face and genitals.
Can Mohs surgery be combined with other treatments?
Yes, it can be followed by reconstructive surgery or combined with radiation therapy for comprehensive care.
Will Mohs surgery leave scars?
While efforts are made to minimize scarring, the extent depends on factors such as wound size, location, and individual healing.
What is the success rate?
Cure rates are typically 95% for recurrent cancers and 99% for new cancers, making it one of the most effective treatments for skin cancer.
Why is Mohs surgery performed by dermatologists?
Dermatologists specialize in skin conditions and are trained in the precise techniques required for Mohs surgery, ensuring optimal results.

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