Dermatologist examining patient’s skin

Skin cancer is one of the most common forms of cancer, but it’s also one of the most treatable types. Mohs surgery is frequently performed by a dermatologist in San Diego, CA, because it’s extremely effective and usually eliminates the need for further treatments to kill the cancer. If dermatology specialists have recently diagnosed you with skin cancer and have recommended Mohs surgery, here’s what you need to know about the procedure.

Why Mohs Is the Preferred Treatment

Mohs surgery is named after a doctor from the 1930s who used a special surgical technique that other surgeons adopted for dermatological uses in the ‘60s and ‘70s. It uses micrographic techniques to remove cancerous tissue while still sparing the healthy tissue around it. It’s very effective on nonmetastatic cancers, such as basal cell and squamous cell carcinomas, which are the two most common types of skin cancer. The procedure requires only local anesthesia, it can be done on an outpatient basis, and the labs are done on-site as well. There is an extremely high cure rate and only a small scar results. Here are the basic steps of the Mohs procedure.

Surgical Procedure

The procedure begins with the doctor marking the surgical area and creating a sterile environment around the site, although patients can often wear their street clothes. The area is injected with local anesthesia and the surgeon removes a thin layer of cancerous tissue. The wound is temporarily bandaged so that the next step can begin. 

Lab Analysis

The first layer removed is cut into sections and color coded with dyes, so a map of the surgical site can be drawn. A technician in the on-site lab cuts very thin slices of the tissue so that they can be placed on slides for the microscopic examination step.

Examination via Microscope

The surgeon then looks at all the areas of the tissue on slides to see if any cancerous cells remain. If there are still cancerous cells, they’re marked on the map. This examination helps determine whether any additional tissue needs to be removed.

Examining skin cells with microscope

Additional Tissue Removal

If the cancer goes deeper into the skin than suspected, the surgeon will return to the operating area and possibly administer more local anesthesia. Another thin layer of skin will be removed from the area marked on the map. Then, the lab and microscopic procedure is repeated. This process repeats as many times as it takes to make sure there are no more remaining cancer cells. 

Repair and Recovery

Once all the cancerous cells have been removed, the surgeon will close up the wound with stitches, if necessary. Some surgical wounds are small enough that they can be left open to heal on their own. The location is a factor in determining how the wound is closed. The wound size also determines whether stitches are sufficient, or if a skin flap needs to be moved from a neighboring area and then grafted into the surgical site for better healing. The recovery isn’t intense for most patients since they don’t receive general anesthesia. The process can take a few hours, depending on how many times the process is repeated, but once the wound is closed, you’ll simply need to follow the doctor’s instructions for wound and scar care.

Cosmetic Results

Fortunately, most Mohs scars are very small and inconspicuous, so the procedure is great for the face and often used in dermatology in San Diego, CA. To learn more about this procedure and to learn if it’s right for you, contact Academic & Aesthetic Dermatology Consultants today.