Mohs Surgery Procedure – Healthnile.com

Overview

Mohs micrographic surgery is a specialized method for removing skin cancer. The surgeon carefully cuts away thin layers of skin from the affected area. After removing each layer, the surgeon checks it under a microscope to look for cancer cells. This examination continues with each new layer until the surgeon confirms that all cancer cells are gone.

Key Points About Mohs Surgery:

The surgeon aims to take out all the cancer while saving as much healthy skin as possible.
The medical team uses a local anesthetic to numb the area, making the procedure more comfortable.
The procedure typically takes place in a clinic or doctor’s office, and patients usually return home the same day.
By minimizing the removal of healthy tissue, this surgery is useful for treating skin cancer in sensitive or visible areas.

Benefit	Detail
Precise removal	Ensures only cancerous tissue is removed.
Lower recurrence rate	Reduces the chance of cancer returning.
Outpatient procedure	No overnight hospital stay needed.

Reasons for Performing the Procedure

Mohs surgery removes certain types of skin cancer, especially when it is important to save as much healthy skin as possible. Surgeons use this method for cancers like basal cell carcinoma, squamous cell carcinoma, melanoma, and other less-common types. Situations where Mohs surgery is often chosen include:

Skin cancers that are likely to return or that have already come back.
Growths located on the face, hands, feet, or other sensitive areas where conserving healthy skin is critical.
Tumors with unclear borders.
Large or fast-growing cancer cells.

Possible Complications

Mohs surgery can cause a few risks. Patients may have bleeding and discomfort in the treated spots. Some people experience infections during wound healing. Less often, patients may feel numbness or weakness if nerves or muscles near the site are affected. Other possible issues:

Shooting pain
Noticeable scarring
Problems with skin regrowth

Most side effects are mild, but some can last longer, especially if nerve damage occurs. Extra care supports the healing process.

How to Get Ready

Before the procedure, patients should talk with their dermatologist about all medications and supplements they are taking. This includes blood thinners, prescription drugs, and herbal supplements. Some items—like aspirin or certain herbs—can increase bleeding, so patients should inform the dermatologist about everything they take regularly.

Only stop taking prescribed medications if the doctor gives specific instructions. Planning for the day is important. Because Mohs surgery timing can vary, patients should set aside the whole day in case the procedure takes longer than expected. Most surgeries last less than four hours, but delays can happen.

Patients should wear comfortable clothes, preferably in layers to adjust for room temperature. Eating a regular meal before heading to the dermatologist is usually allowed, unless the health team gives other instructions. To make waiting times easier, patients can bring a book, magazine, or another quiet activity. The steps below can help:

Step	Details
List all medications.	Include all prescriptions and supplements.
Discuss with a dermatologist.	Ask questions and clarify concerns.
Dress comfortably.	Wear loose, layered clothing.
Prepare for a long visit.	Keep the entire day open.
Eat before coming.	Have a meal unless told otherwise.
Bring activities.	Engage in reading or participate in activities to make the most of your waiting time.

What You Can Expect

What Happens While You Are Getting Treated

The Mohs procedure usually takes place in a clinic or outpatient surgery center. Patients often do not need to change into a hospital gown unless the treated area is on a part of the body where normal clothes would get in the way. Before starting, the medical team cleans and marks the skin around the spot with a special pen.

A local anesthetic is injected to numb the area, helping to make the procedure comfortable. The injection may sting for a moment, but then the skin becomes numb, so no pain is felt during the operation. The surgeon uses a scalpel to remove the part of the skin with visible cancer, as well as a slim layer of tissue from underneath and around it.

This step is quick and takes only a few minutes. The team places a temporary bandage over the wound. The removed tissue goes to a nearby lab, often located very close to the procedure room to speed up the process. The tissue is carefully cut into small pieces and checked under a microscope.

The surgeon also draws a map to show exactly where each piece of skin came from, helping to find any remaining cancer cells. While the tissue is being checked, patients wait in a nearby room. The wait may take about an hour. Patients can have a snack, use the restroom, or relax, but must remain at the medical center until everything is finished.

If the surgeon sees cancer in the tissue, another thin layer is removed from the exact area where the cancer remains. If more numbing medicine is needed, the provider gives another injection. The surgeon continues removing as little healthy skin as possible while ensuring all cancer is gone.

The waiting and checking steps repeat until tests show there are no more cancer cells left. This step-by-step approach can take a few hours but may sometimes last much of the day, depending on how much tissue needs to be examined and removed.

Mohs Procedure Steps Table

Step	What Happens	Purpose
Cleaning and marking	Marks the area for surgery	Helps guide precise removal
Local anesthesia	Numbs the skin	Keeps patients comfortable
First layer removed	Cuts out visible cancer	Begins cancer removal
Lab analysis	Checks for cancer cells	Finds any remaining cancer
Additional removal (if needed)	Removes more thin layers	Gets rid of leftover cancer while saving healthy tissue
Repeat analysis/removal	Until all cancer is gone	Ensures the area is cancer-free

What Happens After You Are Finished

Once the surgeon confirms the last sample is free of cancer, the wound needs care. Several options help the skin heal:

Letting the wound heal by itself (natural healing).
Closing the area with stitches (sutures).
Relocating adjacent skin to create a flap that covers the affected area.
Taking skin from another area, like behind the ear (skin graft).

Most wounds from the Mohs procedure are repaired right after the skin cancer is removed. For larger or more complicated wounds, the doctor might temporarily cover them and schedule another surgery. This is not common.

After surgery, patients usually have some soreness, bruising, or mild pain in the surgical area. Over-the-counter pain medication and rest often relieve this discomfort. Severe pain is rare, but patients should call their health provider right away if it occurs.

A bandage will likely need to be worn over the wound for at least a week. The length of time depends on the wound size and the repair method. Healthcare providers give written instructions on how to keep the wound clean, replace the dressing, and recognize signs that the wound might not be healing well.

Wound Care Tips

Follow the surgeon’s instructions for cleaning and changing the bandage.
Keep the wound dry as directed.
Avoid activities that stretch or stress the area.
Watch for redness, swelling, or drainage.

Most people can return to daily routines fairly quickly, though any activity that could stress the healing spot should be avoided until fully recovered. Regular wound checks and follow-up appointments may be suggested to make sure healing is on track.

Results

Most patients learn the outcome of Mohs surgery before leaving the clinic. This procedure removes all visible skin cancer in one visit, and surgeons achieve a high cure rate of up to 99%. Cosmetic outcome is an important part of recovery, and many people have follow-up visits to check the wound and reduce visible scarring.

Key Points

Cure Rate: Up to 99% for newly treated cases.
Cosmetic Outcome: Follow-up care supports better healing and appearance.