What You Need to Know About Mohs Surgery: From Prep to Recovery

Skin cancer is one of the most common types of cancer, and while it can be hard to hear the word “cancer,” it’s important to know there are many treatments for skin cancer. 

Here at Orange Coast Dermatology, our team offers many types of skin cancer treatments, including curettage and electrodesiccation, cryosurgery, light and laser therapy, and Mohs surgery.

Mohs surgery is often recommended to treat basal cell carcinoma and squamous cell carcinoma, but it can also be used for early stages of melanoma.  

If you’re scheduled for an upcoming Mohs surgery, you may be curious about the procedure. Here’s everything you need to know about Mohs surgery from your preparation to your recovery.

Preparing for Mohs surgery

As with any surgery, it’s important to prepare mentally for Mohs surgery. It’s normal to feel anything from anxiety to excitement (at the prospect of removing the cancerous lesion from your body). That being said, you can prepare for surgery by taking time to center your mind, focus on all of the things within your control, and practice deep breathing. 

In addition to preparing mentally for surgery, you can also prepare your medicine cabinet with a few wound care essentials, such as ointment (or petroleum jelly), bandages, non-stick pads, and paper tape. Depending on your specific surgical site (and if you need any sutures or skin grafts), our team provides a list of other essentials you may need at home. Having all of these items prepared ahead of time can make your surgery day go smoother.

You may also need to stop taking any non-prescription blood-thinning medications at least 10-14 days before your scheduled Mohs surgery. Bring a list of your medications (including all supplements) to your consultation, and remember to never stop or adjust prescription medications unless specifically instructed to do so.

What to expect during Mohs surgery

Jeffrey Lander, MD, PhD is our  board-certified dermatologist and Mohs surgeon here at Orange Coast Dermatology. He performs Mohs surgery as an outpatient procedure in a series of steps. 

The first step is preparing the surgical site. After he examines your skin, he injects a local anesthetic and marks the surgical site. Depending on where the lesion is located, you may need to change into a gown. 

Once you’re numb and the area is marked, Dr. Lander removes the top layer of the cancerous lesion with a scalpel. He examines this first sample of tissue under a microscope to determine if (and where) any cancerous roots are located. Once he identifies the roots, he carefully removes the next layer of skin. He also examines this sample thoroughly under a microscope. He repeats the process until the microscopic examinations reveal that all of the margins are clear.

You can expect that this process will take several hours, but the end result is the confidence you feel knowing the process is meticulous and thorough. When the doctor removes the final layer of tissue, he closes the wound, but you may not know what type of closure you have until you're in the surgery. In some cases, you won’t even need stitches, if you had just a few layers removed. On the other hand, we’re prepared to stitch the wound closed, or, if needed, perform a skin graft using a flap of adjacent skin.

Recovering from Mohs surgery

Your recovery from Mohs surgery varies depending on several factors: the location of your skin cancer lesion, the size of the lesion, how many layers of skin were removed, and if you had stitches or a skin graft. Regardless, redness, swelling, and tenderness are common and to be expected. Because your unique recovery can vary, our team provides customized aftercare instructions. Don’t hesitate to ask questions before heading home. We’re always happy to answer questions, especially when it comes to aftercare.

While your own post-op instructions may vary, here are some general guidelines that help you make the most of your recovery:

• Modify activities, especially if you have sutures in highly mobile areas
• Keep your surgical site clean and dry
• Monitor for any signs of infection 
• Eat nourishing meals to help your body heal
• Avoid smoking (which can delay wound healing)
• Apply a cold compress during the first 24 hours to reduce pain and swelling

Before you head home from  your surgery, we’ll schedule a follow-up appointment and/or a suture removal appointment.

For questions or to schedule an appointment, call the location of your choice 一 Orange, Rancho Santa Margarita, and Mission Viejo, California 一 or book online today.