Mohs Micrographic Surgery Overview

Mohs Surgery is used to remove skin cancer that affects the face and other sensitive areas. The doctor removes the cancer layer by layer, examining the tissue under a microscope until only healthy tissue remains.

Basal Cell Carcinoma © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

In the time leading up Mohs Surgery:

• Discuss with your doctor any allergies or medical problems that you have.
• You will most likely be able to continue taking your medicines. Tell your doctor if you are taking any blood thinning medicines.
• Arrange for a ride home and for help at home.
• Eat normally the day of the procedure.

Anesthesia

Local anesthesia will be used. You will not feel pain. You will be awake during the procedure.

Description of Procedure for Mohs Surgery

The area will be cleansed with antiseptic. A local anesthetic will be injected into the area. Using a small scalpel, the doctor will remove the top visible portion of the cancer. Next, the doctor will remove another, deeper layer. The layer will be divided into sections. Each section will be color coded. This will allow the doctor to know exactly where the layer was in the skin.

These sections will be frozen and examined under a microscope for remaining cancer cells. If cancer is found at the edges of the removed layer, the doctor will go back to the precise section. Additional layers will be removed until all areas are cancer free. For larger wound areas, the doctor will close the wound with stitches or a skin graft procedure. Small, shallow wounds may heal without stitches.

How Long Will It Take?

The surgery will go quickly. You will have to wait while the doctor examines the tissue microscopically. In some cases, this procedure can last for several hours.

How Much Will It Hurt?

You should have minimal discomfort during the procedure. There will be some minor pain during recovery. You will be given pain medicine.

Post-procedure Care

At the Care Center

After the Mohs Surgery, you may be given pain medicine and an antibiotic. You will be able to leave the same day.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Keep the area clean, dry, and protected. Follow your doctor’s instructions for caring for the wound.
• Avoid swimming and soaking in tubs until the area has healed.
• For pain relief, take over-the-counter pain medicine, such as Tylenol .
• Be sure to attend any follow-up visits. Your doctor will monitor your condition.
• Keep in mind that it is normal for a scar to form. The appearance may improve over time.
• Take steps to prevent skin cancer:
  • Use sunscreens with a sun protection factor (SPF) of at least 15.
  • Protect your skin from the sun. For example, wear a shirt, wide brimmed hat, and sunglasses.
• Regularly check your skin for changes.

RESOURCES:

American College of Mohs Surgery
http://www.mohscollege.org/

American Society for Mohs Surgery
http://www.mohssurgery.org/

CANADIAN RESOURCES:

Canadian Association of Mohs Surgeons
http://www.mohssurgery.ca/cams.html

Canadian Cancer Society
http://www.cancer.ca/

References:

American Academy of Dermatology website. Available at: http://www.aad.org/ . Accessed February 2, 2010.

American College of Mohs Micrographic Surgery website. Available at: http://www.mohscollege.org/ . Accessed March 26, 2010.

American Society for Mohs Surgery website. Available at: http://www.mohssurgery.org/i4a/pages/index.cfm?pageid=1 . Accessed February 2, 2010.

Narayanan K, Hadid OH, Barnes EA. Mohs micrographic surgery versus surgical excision for periocular basal cell carcinoma. The Cochrane Collaboration website. Available at: http://www.cochrane.org/reviews/en/ab007041.html . Published April 15, 2009. Accessed February 2, 2010.