What is Mohs surgery?
Mohs surgery, also called Mohs micrographic surgery, is a specialized procedure for the treatment of certain skin cancers. The technique was developed by Dr. Frederic Mohs in the mid 1900s and thus its name. The procedure entails removal of cancerous tissue followed by microscopic examination of that tissue in a way that ensures all the skin cancer cells have been removed while leaving behind the healthy tissue. Mohs is often referred to as a “tissue-sparing technique” because of the ability to leave the healthy tissue intact.
In simpler terms, abnormal skin is removed so that the margins (normal skin surrounding the skin cancer) can be assessed. If cancer is seen on the margins during microscopic examination then another piece (called a layer) will need to be taken. This process repeats itself until the cancer is removed entirely and then the wound can be repaired with sutures or left to heal on its own.
When is Mohs surgery recommended?
In our office, only non-melanoma skin cancers are treated with Mohs surgery. The most common types of these being basal cell carcinoma and squamous cell carcinoma. Additionally, Mohs surgery is reserved for cosmetically sensitive areas of the head and neck as well as hands and feet. Large or aggressive cancers that occur on other parts of the body may also be treated with Mohs surgery if deemed necessary by your primary dermatologist.
What to expect at your Mohs surgery appointment?
Mohs surgery is performed in an outpatient setting in our office. Only local anesthetics are required to numb the surgical area which is safer and has shorter recovery times compared to general anesthesia. Once the skin has been numbed, the visible skin cancer and biopsy scar are removed with a scalpel. You will receive a temporary bandage while your tissue is taken to the lab to be processed for microscopic examination. If cancer is found at any of the edges (margins) of the removed tissue, then another thin layer of skin will need to be excised and examined under the microscope. This process is repeated until the skin cancer is removed. Once the cancer is gone, the resultant wound will need to be addressed. We will have a discussion on how to best approach the healing process to minimize downtime and scarring. Typically, the wounds are repaired with sutures that will remain for 1-2 weeks before coming back to our office for removal.
To learn more about Mohs surgery, visit aad.org/mohs.