Mohs Surgery

New treatments for skin cancer continue to appear and evolve today.  However, Mohs surgery is the most effective and advanced treatment, today, for treating skin cancer.  Mohs Surgery offers the highest potential for cure, even if the skin cancer has been previously treated by another method.  Developed by Dr. Fredrick Mohs in the 1930s, Mohs micrographic surgery has, with few refinements, come to be embraced over the past decade by dermatologists for treating a variety of skin cancers.  Mohs surgery is one of the most effective treatments for most types of skin cancer and is an extremely intricate procedure that requires time and patience for rewarding results.

What is Mohs Surgery?
The Mohs procedure involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached.  Mohs surgery is unique and effective because of the way the removed tissue is microscopically examined, evaluating 100% of the surgical margins.  Some advantages of Mohs surgery include:

  • Ensuring complete cancer removal during surgery, virtually eliminating the chance of cancer growing back
  • Minimizing the amount of healthy tissue lost
  • Maximizing the functional and cosmetic outcome resulting from surgery
  • Repairing the site of cancer the same day the cancer is removed, in most cases
  • Curing skin cancer when other methods have failed

Typically, Mohs surgery is performed as an outpatient procedure in your dermatologist’s office.  Surgery will generally begin in the morning and is completed that same day, depending on the extent of the tumor and the amount of reconstruction that is necessary.  Local anesthesia is often administered around the area of the tumor as the patient is awake during the entire procedure.

Why It’s Done

Common skin cancers, basal cell carcinoma, squamous cell carcinoma, some kinds of melanoma and other more unusual forms of skin cancers can be treated with Mohs Surgery.  This treatment is especially useful for skin cancers that have a high risk of recurrence or that have recurred after previous treatment has been completed. 

Mohs surgery is also appropriate for skin cancers that are located in areas where you want to preserve as much healthy tissue as possible.  This would include the eyes, ears, nose, mouth, hairline, hands, feet and genitals.  Skin cancers with borders that are hard to define and are large or aggressive, can also be successfully treated with Mohs Surgery.

Mohs surgery differs from other techniques, and allows your dermatologist to remove all of the cancer cells while sparing as much normal tissue as possible.  Skin cancer rates continue to skyrocket, which is why treatment is vital in protection and saving your life.  Mohs surgery continues to play an important role in the treatment of most skin cancers in patients today.

The Mohs Procedure

Step 1

Skin cancers often extend beyond their visible borders. It is these extensions that cause the tumors to recur if not completely removed.

Step 2

Like other surgical procedures, Mohs surgery first removes the visible tumor.

Step 3

A thin layer of normal tissue is removed, mapped and evaluated by the surgeon with a microscope.

Step 4

Additional layers may then be taken precisely in the areas of remaining cancer until the tumor is completely removed.

Step 5

Mohs surgery is the only method that ensures all of the tumor is removed while preserving the maximum amount of healthy tissue and therefore minimizing scars and cancer recurrence.

Merritt BG, Lee NY, Brodland DG, Zitelli JA, Cook J. The safety of Mohs surgery: A prospective multicenter cohort study. J Am Acad Dermatol 2012 Aug 11. [Epub ahead of print]

Patients can Learn More About Mohs Surgery, including what the Mohs Procedure is, see the Mohs step-by-step process, and get answers to the most-asked questions about the procedure.