MohsSurgery

Mohs surgery treats basal cell and squamous cell carcinoma, the two most common skin cancers, and certain other skin tumors. Rather than removing the cancer together with a wide margin of healthy skin and sending it away for analysis, the surgeon removes one thin layer at a time and examines the entire edge of each layer under the microscope while you wait.

If cancer cells remain, another layer is taken from exactly that spot, and only there. The process repeats until the margins are clear. The result is the highest cure rate of any skin cancer treatment, up to 99 percent for a cancer that has not been treated before, with the smallest possible wound.

Mohs is the treatment of choice when a skin cancer sits somewhere that healthy tissue matters most: the nose, eyelids, lips, ears, scalp, hands, feet and genitals. It is also recommended for cancers that are large, growing quickly, have indistinct borders, have come back after earlier treatment, or arise in people whose immune system is weakened.

Not every skin cancer needs it. Many small, low-risk cancers on the trunk or limbs are treated well by other methods, and some are candidates for non-surgical therapy. If Mohs is the right course, we will explain why, and if it is not, we will say so.

Mohs surgery is performed in the office under local anesthesia, and you are awake and comfortable throughout. After each layer is removed, the tissue is processed and read while you wait, which can take an hour or more, so plan on being with us for a good part of the day and bring something to read.

Once the margins are clear, the wound is repaired, usually the same day: some heal best on their own, most are closed with stitches, and a few call for a small flap or graft. You go home with clear written instructions and a follow-up visit already scheduled.

If a biopsy has shown basal cell or squamous cell carcinoma, particularly on the face or another site where scarring and function matter, Mohs surgery is very likely the recommendation. Your dermatologist may already have suggested it.

Whether the cancer was found here or by another physician, we will review the biopsy, examine the site, and talk you through the options in plain language, in English or in Spanish.