Most people have moles or small skin growths that remain unchanged for years. But when a mole or lesion begins to look different, becomes symptomatic, or raises concern, it may be time to seek a professional evaluation. Some changing lesions can signal skin cancer, and when treatment is needed, Mohs surgery is often the most precise and effective approach.
What Is Mohs Surgery and What Does It Treat?
Mohs micrographic surgery is a specialized, highly effective technique used to remove certain types of skin cancer while preserving as much healthy tissue as possible. It is performed by dermatologists who have advanced training in this procedure.
A Mohs surgeon typically becomes involved when your regular dermatologist refers you after locating and diagnosing a type of skin cancer that responds well to Mohs surgery.
Mohs surgery is most commonly used to treat:
- Basal cell carcinoma (BCC)
- Squamous cell carcinoma (SCC)
- Some early melanomas, depending on location and subtype
- Recurrent skin cancers that have returned after previous treatment
- Cancers in cosmetically sensitive areas, such as the nose, eyelids, lips, ears, or scalp
The goal of Mohs surgery is complete cancer removal with the smallest possible scar. The technique achieves the highest cure rates for BCC and SCC by examining every layer of tissue removed in real time.
Changing Moles and Skin Lesions: When to Get Checked
Your regular dermatologist should evaluate any mole or skin lesion that changes in appearance. Not all changes indicate cancer, but early assessment helps ensure timely diagnosis and treatment when needed.
Signs you should have a mole or lesion checked include:
- Asymmetry: One half looks different from the other.
- Border irregularity: Edges appear jagged, notched, or uneven.
- Color changes: Darkening, lightening, or multiple colors within one spot.
- Diameter increases: Growth larger than a pencil eraser.
- Evolution: Any noticeable change in size, shape, color, or symptoms.
- Itching, bleeding, or crusting that persists.
- A sore that doesn’t heal, or heals and returns.
- A firm, growing bump that wasn’t there before.
While melanoma often begins with color or structural changes, non-melanoma skin cancers may look like a red patch, pearly bump, scaly area, or non-healing wound.
When a dermatology professional evaluates the lesion, they may perform a biopsy to determine the diagnosis and whether Mohs surgery is the most appropriate treatment. If the biopsy shows areas of concern and your type of skin cancer is appropriate for this treatment, you will be referred to a Mohs surgeon.
What Happens During Mohs Surgery?
Mohs surgery is performed in stages on the same day as the diagnosis confirmation. It is done under local anesthesia in a comfortable outpatient setting.
The procedure typically involves:
- Removing a thin layer of visible cancerous tissue.
- Examining the tissue under a microscope. A specialist checks the margins to see if any cancer cells remain.
- Mapping the precise location of any remaining cancer cells.
- Removing another thin layer only in the area where cancer persists.
- Repeating the process until all margins are clear.
Between stages, patients can rest comfortably while the tissue is examined. Once the cancer is fully removed, the dermatologist closes the wound using the method that best supports healing and cosmetic outcome. This may include stitches, a layered closure, a skin flap, or allowing the area to heal naturally.
How Long Is the Recovery After Mohs Surgery?
Recovery varies depending on the size and location of the treated area, but most people experience a fairly smooth healing process.
Typical recovery expectations include:
- Mild swelling or tenderness for several days
- Stitches removed within 5–14 days, depending on the area
- Detailed wound care instructions to support healing and reduce scarring
- Full healing over several weeks to months, depending on the repair type
Most individuals return to work and light activities a day or two after the procedure, though strenuous exercise may be restricted temporarily. You may have other restrictions depending on the location of your surgery. Follow-up visits help ensure the site is healing well and that no new concerning lesions have developed.
Why Choosing the Right Mohs Surgeon Matters
Mohs surgery is a complex, highly technical procedure that requires specialized training. Choosing a dermatologist with expertise in Mohs surgery ensures:
- Accurate cancer detection during tissue examination
- Precise removal of cancerous cells while preserving healthy skin
- Optimal cosmetic and functional outcomes
- Lower recurrence rates compared to other skin cancer treatments
- Experience managing complex or recurrent cancers
If you notice a changing mole or persistent skin lesion, your dermatology professional can determine whether a biopsy or Mohs surgery is needed. Early evaluation leads to better outcomes, greater peace of mind, and the most effective treatment when required.
If you are referred to a Mohs surgeon, feel free to ask questions about what to expect from your procedure so you can understand what to expect.
Take the Next Step
If you have further questions about Mohs surgery for moles and skin lesions, we encourage you to schedule a consultation at Krauss Dermatology. Call us at (781) 247-5593 or fill out our online contact form. We look forward to taking care of you.