Skin cancer is the most common type of cancer in the United States, but when detected and treated early, many forms are highly treatable. At Dayton Skin Care, patients receive comprehensive evaluation and treatment for suspicious skin lesions and diagnosed skin cancers, including Mohs micrographic surgery when clinically appropriate.
Mohs surgery is a specialized technique designed to remove skin cancer while preserving as much healthy surrounding tissue as possible. Because the removed tissue is examined systematically during the procedure, Mohs surgery allows the physician to continue removing small amounts of tissue until the examined margins are clear of cancer.
If you have been diagnosed with skin cancer or have noticed a new, changing, bleeding, or non-healing spot on your skin, a dermatologic evaluation is an important next step.
Understanding Skin Cancer
Skin cancer develops when abnormal skin cells grow uncontrollably. Exposure to ultraviolet (UV) radiation from sunlight and tanning devices is an important risk factor, although skin cancer can occur in people with a wide range of skin tones and histories of sun exposure.
The major forms of skin cancer include:
Basal Cell Carcinoma
Basal cell carcinoma (BCC) is the most common form of skin cancer. It typically grows slowly and rarely spreads to distant areas of the body, but untreated BCC can invade surrounding tissues and cause significant local damage.
Possible signs include a pearly or translucent bump, a persistent sore, a pink or red patch, a scar-like area, or a lesion that repeatedly bleeds and heals.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) develops from squamous cells in the outer layers of the skin. Some SCCs can grow aggressively and spread to other areas, making prompt diagnosis and treatment important.
SCC may appear as a firm red bump, scaly patch, crusted growth, tender lesion, or sore that does not heal.
Melanoma
Melanoma is less common than basal and squamous cell carcinoma but has a greater potential to spread to other parts of the body. Early detection is particularly important.
Melanoma can develop within an existing mole or appear as a new pigmented or unusual-looking lesion. Changes in a mole’s size, shape, color, border, or appearance should be evaluated by a qualified medical professional.
What Is Mohs Micrographic Surgery?
Mohs micrographic surgery is a precise surgical technique used to treat certain skin cancers. Instead of removing a predetermined amount of surrounding healthy skin, the surgeon removes the visible cancer along with a thin layer of surrounding tissue.
That tissue is carefully processed, mapped, and examined microscopically. If cancer cells remain at any margin, the surgeon can identify their location and remove another thin layer specifically from that area.
This process is repeated until the examined margins are free of cancer.
The technique provides two important advantages: thorough microscopic margin evaluation and conservation of healthy tissue.
What Types of Skin Cancer May Be Treated With Mohs Surgery?
Mohs surgery is most commonly used for certain basal cell carcinomas and squamous cell carcinomas. Whether Mohs is appropriate depends on several clinical factors rather than the diagnosis alone.
A dermatologist may consider Mohs surgery when a skin cancer:
-
Is located on an area where preserving healthy tissue is especially important
-
Is large or has poorly defined borders
-
Has returned after previous treatment
-
Has aggressive microscopic characteristics
-
Occurs in an area previously treated for skin cancer
-
Has a higher risk of recurrence
-
Requires precise margin control
Mohs is frequently considered for cancers involving cosmetically or functionally sensitive locations, such as the nose, eyelids, lips, ears, scalp, face, hands, feet, and genital areas.
Treatment recommendations are individualized after reviewing the patient’s diagnosis, pathology findings, location of the tumor, medical history, and other relevant factors.
What Happens During Mohs Surgery?
Step 1: Preparing the Treatment Area
The treatment area is identified, cleaned, and typically numbed using local anesthesia. Patients are generally awake during Mohs surgery.
Step 2: Removing the Visible Skin Cancer
The surgeon removes the visible tumor along with a thin layer of surrounding tissue.
Step 3: Mapping and Examining the Tissue
The tissue is mapped so its exact orientation is known. It is then processed and examined microscopically to determine whether cancer cells remain at the margins.
Step 4: Removing Additional Tissue if Necessary
If cancer cells are detected, another thin layer is removed specifically from the area where those cells remain. This targeted approach helps avoid unnecessarily removing healthy tissue.
Step 5: Confirming Clear Margins
The removal and examination process continues until the evaluated margins are clear of cancer.
Step 6: Repairing the Surgical Site
Once the cancer has been removed, the physician determines the most appropriate approach for wound healing or reconstruction. Depending on the size and location of the surgical site, this may include allowing the wound to heal naturally, closing it with stitches, or using another reconstructive technique.
Benefits of Mohs Surgery
One of the defining features of Mohs surgery is the ability to examine the surgical margins during the procedure.
Potential benefits include:
-
Precise removal of cancerous tissue
-
Preservation of surrounding healthy skin
-
Comprehensive microscopic examination of the treated margins
-
High cure rates for appropriately selected basal and squamous cell carcinomas
-
Potentially smaller surgical defects than less targeted approaches
-
Tissue preservation in cosmetically and functionally important areas
No procedure can guarantee that skin cancer will never recur, so continued dermatologic surveillance remains important after treatment.
Other Skin Cancer Treatment Options
Mohs surgery is not necessary for every skin cancer. Depending on the type, size, depth, location, pathology, and individual patient factors, other treatments may be considered.
These can include surgical excision, electrodesiccation and curettage, topical medications, cryotherapy, radiation therapy, or other specialized treatments.
For melanoma and certain higher-risk or advanced cancers, additional surgery, staging, imaging, oncology consultation, or other multidisciplinary care may be necessary.
The goal is to select treatment based on the characteristics of the individual cancer rather than applying the same approach to every patient.
When Should You Have a Skin Lesion Checked?
A dermatologic examination is recommended for lesions that are new, unusual, changing, or persistently symptomatic.
Schedule an evaluation if you notice a spot that:
-
Changes in size, shape, or color
-
Has irregular borders or multiple colors
-
Bleeds without an obvious injury
-
Repeatedly crusts, heals, and returns
-
Does not heal
-
Becomes painful, itchy, or tender
-
Looks noticeably different from your other moles or spots
-
Grows progressively
Skin cancer does not always match a textbook appearance. A professional examination—and a biopsy when indicated—is the appropriate way to determine whether a suspicious lesion is cancerous.
Skin Cancer Diagnosis and Biopsy
When a suspicious lesion is identified, a dermatologist may recommend a skin biopsy. A small sample or the lesion itself is removed and sent for microscopic examination by a pathology laboratory.
The pathology report can identify whether cancer is present and provide information about the specific type and characteristics of the lesion. These findings help guide treatment recommendations.
If Mohs surgery is recommended, the pathology results and clinical examination help the physician plan treatment.
Skin Cancer Prevention and Early Detection
Although not every skin cancer can be prevented, reducing UV exposure can lower risk.
Helpful strategies include using broad-spectrum sunscreen, wearing protective clothing and hats, seeking shade during periods of intense sunlight, avoiding indoor tanning, and periodically examining your own skin.
Regular professional skin examinations may also be appropriate for people with risk factors such as a personal history of skin cancer, numerous or atypical moles, substantial cumulative sun exposure, or a family history of certain skin cancers.
Frequently Asked Questions About Mohs Surgery and Skin Cancer
Is Mohs surgery painful?
Local anesthesia is generally used to numb the treatment area. Patients may notice pressure or movement during the procedure but should not feel sharp pain in the anesthetized area. Some tenderness, swelling, or discomfort can occur afterward.
How long does Mohs surgery take?
The duration varies because tissue must be processed and examined between surgical stages. Some cancers are cleared after the first stage, while others require additional stages. Patients should be prepared for the appointment to take several hours.
Will I have a scar after Mohs surgery?
Any surgery that cuts the skin can produce a scar. Mohs surgery is designed to preserve as much healthy tissue as possible, which can help minimize the size of the surgical defect. The final appearance depends on factors including the cancer’s size and location, the reconstruction required, and individual healing.
Why is Mohs surgery often used on the face?
The face contains areas where preserving healthy tissue is particularly important for appearance and function. Mohs surgery combines precise cancer removal with tissue conservation, making it useful for appropriately selected facial skin cancers.
Can skin cancer return after Mohs surgery?
Yes. Mohs surgery has high cure rates for appropriately selected cancers, but recurrence is still possible. A previous skin cancer also increases the importance of monitoring for additional skin cancers.
Does every basal cell carcinoma require Mohs surgery?
No. Treatment depends on the tumor’s location, size, subtype, borders, recurrence status, and other clinical factors. Some basal cell carcinomas can be treated effectively with other approaches.
Does every squamous cell carcinoma require Mohs surgery?
No. Mohs may be recommended for certain higher-risk SCCs or cancers in locations where tissue preservation and margin assessment are especially important. Other SCCs may be treated with standard excision or another method.
Is Mohs surgery used for melanoma?
Mohs surgery is primarily associated with basal cell and squamous cell carcinoma. Management of melanoma differs and depends on factors including the melanoma subtype, depth, location, and stage. Your dermatologist will recommend an appropriate treatment strategy based on the pathology findings.
Can I drive myself home after Mohs surgery?
Many Mohs procedures are performed with local anesthesia, but whether you should drive depends on the location and extent of surgery, medications used, reconstruction, and your physician’s instructions. Ask the office about transportation recommendations before your procedure.
What should I do after Mohs surgery?
Follow the wound-care instructions provided by your medical team. These may include keeping the area clean and protected, changing dressings, limiting certain activities, and watching for signs of infection or other complications.
Do I still need skin checks after my skin cancer is removed?
Yes. Follow-up skin examinations are an important part of ongoing care because people who have developed one skin cancer can develop additional skin cancers in the future. Your dermatologist can recommend an examination schedule based on your individual risk.
Schedule a Skin Cancer Evaluation at Dayton Skin Care
A suspicious lesion should not be ignored simply because it is small or painless. Early evaluation can help identify skin cancer when treatment may be more straightforward.
Dayton Skin Care provides dermatologic evaluation and treatment for skin cancer, with individualized recommendations based on the type, location, and characteristics of each lesion. If Mohs micrographic surgery is appropriate, your care team can explain the procedure, expected recovery, wound care, and follow-up plan.
Visit daytonskincare.com to learn more or request an appointment.
