Using Mohs Surgery to Treat Skin Cancer

by Min Deng, MD, Director of Mohs Micrographic Surgery
September 8, 2020

It can certainly be frightening to hear the diagnosis: that innocent-looking spot on your face is a skin cancer. And it’s going to require surgery.

But Mohs micrographic surgery can provide peace of mind. This advanced microscopically guided procedure offers a precise, layer-by-layer removal of the cancer that achieves up to a 99% cure rate while sparing normal healthy skin.

During Mohs surgery, a surgeon removes the patient’s cancerous skin lesion and color-codes the margins of the tissue to indicate its exact origin in the skin. The entire sample is then frozen and stained, and the complete surgical margins are analyzed in real-time in the Mohs lab. If cancerous cells remain in any section of the tissue, the surgeon returns to the operating room to remove the cancer from its precise location. The process is repeated until all cancerous cells are removed, allowing the surgeon to map the exact margins of the cancer and excise the entire tumor.

What Are the Benefits of Mohs Surgery?

The primary benefit of Mohs surgery is precision. In traditional surgery for skin cancer removal, the surgeon must estimate how deep and wide the cancer extends, which can result in unnecessary removal of healthy tissue or incomplete removal of cancer cells. By contrast, Mohs surgery allows the surgeon to see the margins of the skin microscopically during the procedure, so all cancerous cells are removed, while ensuring as much healthy tissue as possible is preserved.

It can be a frightening diagnosis: that innocent-looking spot on your face is a skin cancer. But #MohsSurgery can offer peace of mind, says Dr. Min Deng. #SkinCancerRemoval https://bit.ly/3m4yH6K via @MedStarWHC
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This precision makes Mohs surgery an incredibly effective treatment for skin cancer; the procedure has a cure rate of up to 99%. Because this method preserves the maximum amount of healthy tissue, it also results in minimal scarring.

When Is Mohs Surgery Used?

Mohs surgery has traditionally been used to treat basal and squamous cell carcinomas. It is commonly used to remove skin cancer from functionally and cosmetically sensitive body sites, such as the head and neck, hands and fingers, and genitals.

It can also be used in more advanced or complex cases, including tumors that have recurred and large tumors that are greater than 2 cm in diameter. Skin cancer on the nose, eyelids, lips, ears, hands, feet, and genitals are considered particularly high-risk.

In recent years, Mohs surgeons have even adapted this method to treat more complex types of skin cancer, such as melanoma and other skin cancer types.

Recovering From Mohs Surgery

Most patients recover very well from Mohs surgery. For the first 24 hours after surgery, patients may experience mild pain or discomfort around the surgical site, which is easily managed with acetaminophen.

To minimize the risk of bleeding, I always advise my patients to take it easy for the first two days after surgery. Patients with sutures may need to avoid lifting heavy objects or participating in strenuous activity until the sutures are removed (usually within one to two weeks). Depending on how deep the tumor extends, some patients may notice numbness in the affected area, but this usually fades as the nerves regenerate. Since this is a surgical procedure, there will be a scar, however Mohs surgeons are trained to hide these scars and help them blend into the surrounding skin. Within about one year, most people will notice their scar has faded.

Most patients do not require further treatment after undergoing Mohs surgery. However, if you have undergone the procedure, it is important to continue following up with your regular dermatologist. Approximately 60% of people who have had one skin cancer will be diagnosed with a second within 10 years, so continued vigilance is vital.

Choosing a Mohs Surgeon

Mohs surgery is an excellent treatment option for many types of skin cancer, including skin cancers of the head and neck, hands and feet, and genitals, as well as more complex and advanced cancers.

Whether the case is simple or complex, a fellowship-trained Mohs surgeon can provide treatment that is effective both clinically and cosmetically.

At MedStar Washington Hospital Center, we are proud to offer cutting-edge Mohs surgery. A qualified member of our team can help you decide if it’s the right treatment for you.

LISTEN: Dr. Deng discusses Mohs surgery in the Medical Intel podcast.

Ready to explore Mohs surgery?

Connect with our dermatology team.

Request an Appointment or call 202-644-9526

Category: Healthy Living, Medical Intel     Tags: Der-2pmohs surgeryskin cancer treatment