Mohs Surgery

Mohs surgery is a procedure that is done to treat skin cancer. It is often used to treat common types of skin cancer, such as basal cell carcinoma and squamous cell carcinoma. In this procedure, cancerous skin cells are carefully cut away layer by layer. The goal is to remove all cancerous tissue and leave healthy skin. This reduces scarring and allows for a better cosmetic outcome.

• Your skin cancer has come back after another type of treatment was done.
• The cancer is likely to return.
• The cancerous area is large.
• The cancerous area has edges that are not clearly defined.
• The cancer is growing rapidly.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any bleeding problems you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures, such as nerves.

What happens before the procedure?

Medicines

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

Surgery safety

• How your surgery site will be marked.
• What steps will be taken to help prevent infection. These steps may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Taking antibiotic medicine.

What happens during the procedure?

• You will be given a medicine to numb the area (local anesthetic).
• A layer of cancerous tissue will be removed with a scalpel. The layer removed will contain a small amount of the healthy tissue surrounding the cancerous tissue.
• The layer of removed tissue will be checked right away under a microscope. The surgeon will note the exact location of the cancerous cells.
• Another layer of tissue may be removed from an area with any remaining cancerous cells. This layer will be checked in the same way.
• More layers of cancerous tissue may be removed, one by one, and checked until no signs of cancer remain.
• Depending on the size and location of the surgical wound, it may be closed with stitches (sutures) or left open to heal on its own. In some cases, a skin flap or skin graft may be needed.
• A bandage (dressing) will be applied to the area.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Return to your normal activities as told by your health care provider.

Summary

• Mohs surgery is a procedure used to treat skin cancer on the face, ears, nose, lips, and genitals. It removes the cancerous cells while leaving as much healthy skin as possible.
• Generally, this is a safe procedure. However, problems may occur, including infection, bleeding, and damage to other structures, such as nerves.
• Follow your health care provider's instructions before the procedure. You may be asked to change or stop certain medicines.
• After the procedure, you may return to your normal activities as told by your health care provider.