What to Expect from Mohs Surgery for Skin Cancer

Learning you have cancer is never easy, especially when it involves skin cancer.

In the United States, nearly 9,500 people receive a skin cancer diagnosis each day. Statistics also show that an estimated one in five people will end up with the disease at some point in their lifetime.

But despite these frightening numbers, there’s good news too. This disease also has a remarkably high cure rate when detected early and treated correctly.

Our team at Dermatology Associates of Central NJ, with offices in Old Bridge, Freehold, and Union, New Jersey, has advanced training in preventing, diagnosing, and treating skin cancer. Whether you need a regular skin cancer screening or expert cancer removal, we can provide the care you need.

While there are different skin cancer solutions, the leading treatment involves Mohs surgery. This minimally invasive approach yields success rates up to 99%, making it the gold standard, especially with high-risk or aggressive skin cancers.

How Mohs surgery works

This procedure isn’t new. Instead, it was first developed in the 1930s by general surgeon Frederic Mohs. 

What sets Mohs apart from other cancer treatments is that it removes thin layers of tissue, one at a time. Each layer gets examined under a microscope to see if cancer cells remain. If they do, another layer of skin is removed. The process is repeated until no cancer cells remain in the sample.

This allows our team to remove all of the cancer cells while sparing your healthy tissue. It’s even an option for skin cancers that spread inward, similar to tree roots, or have irregular borders. 

And, as you might imagine, this approach is especially valuable in sensitive or visible areas where you would like to minimize as much damage as possible, from your face and eyelids to your fingers, toes, and genitalia.

Preparing for Mohs surgery

We perform Mohs surgery as an outpatient procedure, so you can go home the same day. However, there are steps you need to take in advance to ensure the best outcomes:

At least two weeks out

First, talk with your primary care physician. They can help determine if you should take a course of preoperative antibiotics. This precautionary measure is often beneficial for patients who’ve recently undergone other surgeries, like joint replacement or heart surgery. 

Similarly, your doctor might want to adjust any medications you’re already taking. For example, they might suggest stopping blood thinners for 1-2 weeks. But this varies from person to person, so it’s crucial to speak with your primary care doctor.

In addition to prescription medications, you should also stop taking over-the-counter options like ibuprofen, aspirin, and naproxen, which can increase your risk of excessive bleeding. 

Finally, it’s also a good time to stop using any form of tobacco, whether you smoke, chew, or vape. Tobacco interferes with wound healing, so quitting now can help keep your recovery on track. 

One week out

Now it’s time to avoid anything that can raise your blood pressure and risk of excessive bleeding. These types of substances include alcoholic beverages and certain supplements, such as:

• Vitamin C
• Vitamin E
• Fish oil
• Garlic

You should also stop using certain herbal supplements, like ginkgo biloba and ginseng.

The day of your procedure

When the big day arrives, we know you’ll be nervous. But try to eat a normal breakfast and take your prescribed medications as directed. Simply bathe or shower as usual, taking expert care around your treatment site. However, don’t apply any perfume, lotion, or cosmetics to the area. Just put on comfortable, loose-fitting clothing.

Because of the precise nature of Mohs surgery, the entire process can take several hours or even most of the day. So bring some things to pass the time, like a book or electronic device, along with some snacks and any medication you may need to take later in the day. 

What happens during your surgery

It’s no secret cancer surgery is stressful. However, most people end up pleasantly surprised that the most challenging aspect of the Mohs procedure is typically the amount of time it can take — often the entire day.

It starts with an anesthetic injection in your treatment area to numb the site and ensure your comfort. Then, we remove the visible skin cancer with a thin layer of surrounding tissue that we mark for reference. Your sample gets put on a glass slide and examined under a microscope.

Up to 50% of skin cancer cases get eliminated by Mohs in a single stage, which means the first layer of surrounding skin tissue is clear of cancer cells. However, if the tissue isn’t clear of abnormal cells, we administer another numbing injection and remove another thin layer of your skin that contains cancer cells. 

The time-consuming aspect of Mohs surgery lies with the analysis. Removing the tissue sample only takes a few minutes, but it can take up to an hour to analyze it properly. We continue removing and analyzing your skin until we no longer detect any cancer, a process that typically takes 1-3 rounds of surgery. 

Finally, we either close your wound with stitches or let it heal naturally, depending on the location and severity of your procedure. Some Mohs procedures require reconstruction as well, but we can often do this immediately.

Do you have skin cancer? Schedule an appointment online or over the phone at the Dermatology Associates of Central NJ office nearest you today.