How Does Mohs Surgery Treat Skin Cancer?

Mohs surgery, also known as Mohs micrographic surgery, is a technique used by dermatologists to remove cancerous skin cells. This surgery was originally developed in the 1930s but has been refined since then. Today, the Mohs technique has a success rate of over 98 percent for basal cell carcinomas and squamous cell carcinomas, which is much higher than for the traditional methods of skin cancer surgery.

What is Mohs Surgery?

Mohs surgery involved removing layers of the carcinoma, rather than the traditional excision method which involved removing the entire carcinoma in addition to a small amount of healthy tissue surrounding the carcinoma. During Mohs surgery, the dermatologist removes a layer of the carcinoma, then examines it under a microscope to determine how much of the cancer has been removed and to determine how much cancerous tissue remains. In this manner, the physician can avoid removing too much healthy tissue yet ensure that they have removed all of the cancerous cells. The fact that the dermatologist can verify that all of the cancer has been removed accounts for the exceptionally high success rate of the surgery.

Reasons for Treatment

Mohs surgery is particularly successful for the two most common types of skin cancer: basal cell carcinomas and squamous cell carcinomas. However, Mohs surgery is also often used to treat some types of melanoma and other skin cancers.

Physicians use Mohs surgery on skin cancers that have recurred or have a higher than average risk of recurring, are located in noticeable or sensitive areas, have indistinct borders, or that are large in size or fast growing.

What to Expect During Surgery

Mohs surgery is an outpatient procedure that is typically performed with a local anesthetic. The dermatologist typically covers the resulting wound with a bandage. The wound heals in one to two weeks, with minimal scarring.

Risks

The surgery may cause bleeding from the wound, hematoma, pain or sensitivity around the wound, as well as a risk of infection. Less common risks include a loss of feeling at the surgical site, muscle weakness near the surgical area, itching during healing, pain, or keloid scarring.

Finding a Dermatologist

Not every dermatologist is qualified to perform Mohs surgery. Although no special certification is required for the dermatologist to perform Mohs surgery, a physician that is specially trained to perform the surgery has a greater chance for completing the surgery successfully and with a lower risk of complications.

Following Up

Although the risk of recurring skin cancer is relatively small after the procedure, it is important to follow up to make sure that the cancer has not recurred. Patients who have been diagnosed with skin cancer have a greater risk of developing skin cancer again. Your dermatologist may request that you have a follow up appointment each year.

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Peter Wendt makes his living writing and researching from his home office in Austin, TX. He recently discovered he has skin cancer from spending too much time in the sun as a child. In his quest to find the right dermatologist for treating his condition, he found Vanguard Dermatology in New York.