Skin cancer is one of the most frequently diagnosed cancers in the United States. Treatment depends on several factors, including the type of cancer, its size, and where it appears on the body. One technique that doctors may recommend is Mohs surgery. This procedure removes cancerous tissue in thin layers, and the surgeon examines each layer under a microscope before deciding whether more tissue needs to be removed.
What Is Mohs Surgery?
Mohs surgery is a precise technique for removing certain skin cancers. Rather than cutting away a large section of skin at once, the surgeon removes one thin layer of tissue at a time. Each layer is examined in an on-site laboratory while the patient waits. This layered approach is designed to preserve as much healthy skin as possible. The tissue is reviewed during the same visit, so patients can receive information about their margins the same day rather than waiting several days for outside lab results.
What Does It Treat?
Mohs surgery is most often used for basal cell carcinoma and squamous cell carcinoma; these are the two most common forms of skin cancer. Not every skin cancer calls for Mohs surgery. A doctor may recommend it based on certain factors, such as:
- Location: Cancers on the face, ears, nose, lips, eyelids, hands, feet, or genitals, where preserving tissue matters for appearance and function
- Borders: Tumors with edges that are difficult to see or define
- Size and Growth: Larger tumors or those that appear to be growing quickly
- Recurrence: Cancers that have returned after earlier treatment
For other skin cancers, a doctor may suggest alternatives such as standard excision or topical medications. The right approach depends on each person’s diagnosis and health history.
What Should You Expect?
Mohs surgery is typically performed in an outpatient setting; this means you can usually return home the same day. Your care team may provide instructions about medications, eating, and what to wear before the procedure. On the day of surgery, the process generally includes these steps:
- Numbing the Area: The surgeon applies a local anesthetic, so you remain awake, but the treatment site is numb.
- Removing the First Layer: The surgeon removes the visible portion of the tumor along with a thin layer of surrounding tissue, then places a temporary bandage.
- Reviewing the Layer: The tissue is processed and examined under a microscope.
- Removing Additional Layers: If cancer cells remain, the surgeon removes another layer from the affected area only.
- Repairing the Wound: Once the margins appear clear, the surgeon decides how to close the wound.
The number of layers removed varies, so the full appointment may last several hours. Patients can bring reading material or another quiet activity to pass the time between stages. After surgery, some swelling, bruising, or tenderness near the site is common. Your care team will provide wound care instructions and may schedule a follow-up visit to check healing.
Confer With a Specialist
People who have had one skin cancer also face a higher chance of developing another, so ongoing skin checks are a common part of long-term care. It helps to watch for new growths, sores that do not heal, or spots that change in size, shape, or color. If you have noticed a suspicious spot or have received a skin cancer diagnosis, speak with a dermatologist to learn whether Mohs surgery or another treatment may be appropriate for your situation.
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