Receiving a skin cancer diagnosis can be scary. When patients receive a cancer diagnosis at one of our offices, a dermatologist explains which type of skin cancer they have as well as the available treatment options. Sometimes Mohs surgery is recommended. At Pariser Dermatology, we have two physicians who are fellowship-trained in Mohs surgery and reconstruction, Dr. James Bota and Dr. Lawrence Chang.
What is Mohs Surgery?
Mohs surgery is a type of procedure used for the treatment of certain skin cancers. During the surgical technique, cancerous layers of skin tissue are removed. Then, the Mohs surgeon examines the skin under a microscope to ensure the cancer is totally removed. Mohs surgery is the “gold standard” treatment for many types of basal cell carcinomas and squamous cell carcinomas of the skin.
“Basal cell carcinoma (BCC) is the most common type of skin cancer,” said Molly Smith, MD, dermatopathologist at Pariser Dermatology. “Most BCCs are very treatable. It’s important to see a dermatologist early before the cancer has a chance to grow deep, making treatment more difficult.”
How Does Mohs Surgery Work?
Mohs surgery works by removing incremental portions of the skin around a skin cancer with the smallest possible margin (referred to as “layers”) until only healthy skin remains. As each “layer” is removed, it is carefully analyzed by the Mohs surgeon performing the procedure who determines when only healthy skin remains at the cancer site. This technique is often completed in just one day, and is completed under local anesthesia without the need for sedation. The procedure is essentially painless and is highly effective.
Mohs surgery success rates from The Skin Cancer Foundation are as follows:
- Up to 99% for a skin cancer that has not been treated before
- Up to 94% for a skin cancer that has recurred after previous treatment
At Pariser Dermatology, our Mohs surgeons, Dr. Lawrence Chang and Dr. James Bota, perform an average of 8,000 Mohs surgeries each year. “Our primary goal during the procedure is to keep our patients as comfortable as possible”, said Dr. Bota.
Tips to Prepare for Mohs Surgery
Our team will explain what will happen before, during and after the procedure so you know exactly what to expect. Here are a few helpful tips to consider before the procedure:
- Make your doctor aware of all medications and supplements that you’re currently taking. Specifically, blood thinning medications and over-the-counter pain medicines may affect the way your blood clots after surgery. Be sure to continue taking all prescription medications as instructed unless you’re instructed otherwise by our team members.
- Show up in comfortable clothing.Your comfort is our primary concern during a Mohs surgery. Consider wearing loose clothing that won’t rub against the area being treated.
- Be prepared. Your Mohs surgery may take several hours to perform given the time needed for tissue processing. Bring snacks and activities, like books or tablet devices.
- Avoid alcohol for two to three days prior to surgery. Alcohol can thin your blood and complicate your procedure unnecessarily.
- Reduce or eliminate tobacco. Your skin depends on tiny capillaries after surgery, and smoking impairs the healing process. This can result in much worse scarring.
- Get a good night’s sleep. A skin cancer diagnosis can be stressful, and experiencing nerves the day of your Mohs surgery is normal. Try to go to bed early to set yourself up to be as well rested as possible.
- Clear your schedule. Make sure to allow for ample time the day of your surgery in case things go for longer than expected. Minimize other appointments or events the day of surgery, and plan for your Mohs surgeon to discuss postoperative limitations (avoiding exercise, sports, etc. for an amount of time).
What Happens After Mohs?
Once your Mohs surgeon has determined that all the cancer has been removed, they will suggest the best method for allowing the area to heal. Depending on the extent of the cancer defect, this may include:
- Allowing the area to heal on its own
- Using stitches or staples to close the wound
- Performing a skin flap or skin graft for the area
- Consulting with a plastic surgeon if necessary
It’s possible you will have a follow-up appointment with your doctor to ensure the area is healing properly and to ensure there is no additional skin cancer.
Make an Appointment Today
If you have questions about Mohs surgery, or concerns about skin cancer in general, please contact our team today for additional information at 757-622-6315.