MOHS SURGERY: WHAT TO KNOW
If you’ve been diagnosed with certain types of skin cancer, your doctor may recommend Mohs surgery. This highly precise procedure removes cancer in thin layers, examining each under a microscope until only healthy tissue remains.
The goal is to eliminate all cancer cells while preserving as much healthy skin as possible. This approach offers the highest cure rates, minimizes scarring, and usually avoids the need for additional treatments—making it ideal for delicate or highly visible areas like the face, ears, and hands.
I recently underwent Mohs surgery for a growth on my cheek and was in and out of the clinic in under two hours. If you ever need this treatment, it helps to know what to expect. Here’s a quick overview, taken from a recent Mayo Clinic article titled simply, Mohs surgery.
Why it’s done
Mohs surgery is used to treat skin cancer. This includes common types of skin cancer, such as basal cell carcinoma and squamous cell carcinoma. It also includes melanoma and other less-common skin cancers.
Mohs surgery is most useful for skin cancers that:
- Have a high risk of coming back or that have returned after previous treatment.
- Are in areas where you want to keep as much healthy tissue as possible. This includes areas around the eyes, ears, nose, mouth, hands, feet and genitals.
- Have edges that are hard to define.
- Are large or grow quickly.
What you can expect
You typically go to an outpatient surgery center or doctor’s office for Mohs surgery. The procedure is done in an operating room or procedure room. The room has a lab nearby.
Most of the time, the procedure takes less than four hours. But it can be hard to tell how large a skin cancer is just by looking at it, so health care providers often recommend planning for the procedure to take the whole day.
You probably won’t have to wear a surgical gown unless the location of the cancer requires it. The area of skin to be operated on is cleaned and then outlined with a special pen. After that, you are given a shot in the area with a local anesthetic.
During the procedure
After the anesthetic takes effect, the surgeon uses a scalpel to remove the visible portion of the cancer. The surgeon also takes a thin layer of tissue underneath and around the cancer. This takes only a few minutes.
The tissue is then taken to the lab for analysis. This part of the procedure usually takes the longest time.
You’ll wait about an hour in a waiting room. It may help to bring a book or magazine to pass the time. You can use the restroom or have a snack if you need to. But you won’t be able to leave until the procedure is done.
The surgeon or a technician cuts the tissue sample into sections and looks at them with a microscope. The surgeon makes a map to keep track of the exact spot where each piece of tissue was removed. So if a small area of cancer is found in one piece of tissue, the surgeon knows where to continue with the operation.
If there is more cancer, your Mohs surgery continues. The surgeon removes an additional layer of tissue from the affected area. The surgeon takes care to remove tissue that contains cancer and leave as much healthy tissue as possible. Again, you’ll wait while the surgeon looks at the tissue in the lab.
This process continues until the last tissue sample removed is cancer-free. You may get another shot of local anesthetic if necessary.
After the procedure
You may have some mild pain and soreness after your surgery. Pain medicines you can buy without a prescription may help. Severe pain after surgery is not common.
Expect to wear a bandage over the wound for a week or longer. Though exactly how long you’ll need a bandage depends on your situation. Your provider will give you instructions on how to take care of the wound. You may be asked to change the bandage every day.
Results
One of the advantages of Mohs surgery is that you know your results right away. You usually don’t leave your appointment until all of the skin cancer has been removed. You may have another visit with your surgeon or primary care provider to make sure your wound is healing correctly.