Managing Treatments

What Is Mohs Surgery for Skin Cancer?

Mohs micrographic surgery offers a high cure rate for some types of skin cancers.

If you’ve been diagnosed with skin cancer, you’ve probably discussed your treatment options with your physician. In many cases, doctors recommend Mohs surgery, also called Mohs micrographic surgery, as an effective method for managing these types of cancers.

But what is Mohs surgery? What happens during the procedure, and what are the benefits and risks? While your cancer treatment plan is specific to your personal needs, Mohs surgery may offer you the best chance at a full recovery from certain types of skin cancers.

What Is Mohs Surgery?

According to the Skin Care Foundation, Mohs surgery was first developed in the 1930s as a way to treat skin cancer. Doctors recommend Mohs surgery for many types of basal cell carcinomas (BCCs), as well as squamous cell carcinomas (SCCs). This gold standard in treatment is often performed on functionally and cosmetically important areas of the body, such as the eyes, face, scalp or fingers.

Doctors also recommend Mohs surgery for BCCs and SCCs that are big, growing rapidly or have indistinct edges. In some cases, Mohs surgery has been used to successfully manage melanomas.

How Is Mohs Surgery Performed?

The entire Mohs surgical procedure takes place in an outpatient setting. Your surgery is completed all in one visit, but it may take several hours.

First, your doctor positions you so the cancer is most easily accessed — this may mean you sit or lie down for the procedure. Your doctor cleans your skin and uses a local anesthetic to numb the surgical site completely. You stay awake during the procedure.

Your doctor uses a scalpel to remove a thin layer of visible cancerous tissue from the surgery site. This sample is cut into sections and color coded with special dyes. Color coding allows your doctor to create a map of the surgical site. The sample is sent to an on-site laboratory for analysis.

In the lab, technicians freeze the sample and cut it into thin slices. Your doctor examines the sample under a microscope to see if any cancer cells remain. If they do, your doctor marks their location on the map of your surgical site.

Depending on whether any cancerous cells remain, you may need one or several more layers of tissue removed. Each time your doctor removes tissue, it is analyzed under a microscope the same way the first sample was. This process continues until no more cancer cells are present. Then, your doctor dresses your wound.

Why Choose Mohs Surgery?

Many people choose Mohs surgery because of its convenience and high cure rates. This procedure is performed in a single visit and spares healthy tissue that surrounds the tumor. Because tissue is removed one layer at a time, Mohs surgery leaves the smallest scar possible.

More importantly, Mohs surgery effectively cures many types of skin cancers. The Skin Care Foundation reports that this procedure cures up to 99 percent of skin cancers never previously treated. It also cures up to 94 percent of skin cancers that have come back after previous treatment.

What Are the Risks of Mohs Surgery?

Like any surgical procedure, Mohs surgery does have some risk involved. According to the University of Virginia Health System, the risks of Mohs surgery include:

  • Bleeding
  • Damage to nerve endings
  • Infection
  • Pain
  • Reaction to the local anesthetic
  • Scarring

If you’re concerned about complications, your doctor can help you weigh the benefits of the procedure versus the risks. Determining whether this surgery is right for you is a personal decision, but it may be the best chance at the most successful recovery possible.

Your doctor can help answer any questions you may have about Mohs surgery, and can help you decide whether it's the right option for you.

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Sarah Handzel, BSN, RN