Skin cancer is the most common form of cancer, affecting around 3.5 million Americans annually. The two most prevalent forms of skin cancer are basal cell carcinoma and squamous cell carcinoma. If you have had a recent diagnosis with either of these conditions, Mohs Surgery may be your best option for the removal of the tumor.
How Mohs Surgery Works
Mohs procedure is a highly specialized form of dermatologic surgery. It is often used in the treatment of basal cell carcinomas, squamous cell carcinoma (the second most common form of skin cancer) as well as in a modified version for certain kinds of superficial melanoma (“slow Mohs”, and other rarer forms of skin cancers. The Mohs surgeon will remove layers of cancerous skin and tissue, examining all margins under the microscope, until the area is completely clear of cancer.
How Long Does Mohs Surgery Take?
The entire process, from examination to treatment, takes two hours or more, if additional tissue removal is found to be necessary after microscopic exam. If cancer is detected at the edge of a layer of skin or tissue, the surgeon will take another sample for analysis before continuing with surgery. This “staged” approach allows for precise removal of the tumor while preserving enough normal tissue around it to ensure continued function and healthy appearance following treatment as well as minimizing scarring.
Am I a Good Candidate For The Mohs Procedure?
Certain requirements must be satisfied for the Mohs procedure to be covered by insurance. These include locations where excess skin is not plentiful, such as face, scalp, lower leg, back of hands. Other qualifications include larger size, aggressive subtype of Basal or Squamous cell cancer or immunosuppressive conditions (such as organ transplant or certain medications).
What is Mohs Surgery Like?
Prior to the procedure, you will meet with our dedicated Mohs Surgeon, Suzanne Mosher, to discuss your skin cancer, what to expect during treatment, and post surgery course. The surgery takes place in our state-of-the-art facility. During the Mohs process, your skin will be numbed with lidocaine anesthetic to prevent discomfort.
After the area is prepped with antiseptic and local anesthesia, a small section of skin approximately 1/16th inch in diameter will be removed using a scalpel under magnification. Dr. Mosher then examines the sample to make sure she has completely removed the cancer. She may take an additional layer of skin to remove cancer cells surrounding the edge of the incision. Typically, it takes 1-3 rounds to remove all of the cancerous tissue. Dr. Mosher will then use her surgical expertise to reconstruct the area to achieve the best cosmetic result possible.
Is There Any Recovery Time After Mohs Surgery?
Some recovery time is necessary. Dr. Mosher will give you instructions for what to do at home following your procedure, typically including:
- Keeping the wound clean and covered with a dressing
- Staying out of direct sunlight
- Applying ice packs to reduce bruising and swelling
- Taking pain medications as needed.
What Results Can I Expect After Mohs Surgery?
After your Mohs procedure, you can expect to notice changes in the wound over the next several weeks to months. The areas around the original wound may appear darker or slightly raised from your normal skin tone; however, this should resolve over time. Even after it has healed completely, you will likely have some subtle scarring where your procedure was performed.. The latter can take between 6-12 months to fully mature.
“I really like coming here – specifically to see Dr. Norden (worth the drive). She’s very thorough, a good listener and detail oriented. I really appreciate that Dr. Norden doesn’t dismiss any question or concern – no matter how small or minor you may think it is – and she always explains very thoroughly why she’s recommending a particular course of action or treatment plan (I appreciate her clear communication). Dr. Norden is the best dermatologist that I have ever had – and she doesn’t hesitate to test anything that looks suspicious or that she wants confirmation about. My prior dermatologist waited over 18 months to test a suspicious spot on my nose and it turned out to be Basal Cell Carcinoma, requiring painful MOHs surgery and a skin graft. I feel like Dr. Norden is proactive, thorough and wouldn’t hesitate to test something sketchy. One other little thing that I LOVE about this doctor…I had some weird rough patch on my elbow that I had for years that I mentioned in passing during one of our appts. and the doctor gave me a couple of small free samples of this cream that cleared it right up in no time (like miraculously)…I later found out from my pharmacy that this miracle cream typically costs hundreds (literally hundreds) of dollars and most insurance companies don’t cover it. This one small gesture from the doctor saved me a ton of $. However, (more importantly) Dr. Norden saw a way she could solve a relatively minor problem, acted proactively and didn’t try to write me out a costly prescription when she had some samples readily available to help me. That’s how Dr. Norden rolls. Can’t beat that.”*
Take The Next Step
If you have further questions on Mohs surgery or are wondering how much it may cost you, we encourage you to schedule a consultation at Krauss Dermatology. Call us at 781-416-3500 or fill out our online contact form. We look forward to meeting you!