Mohs Micrographic Surgery
Mohs Micrographic Surgery is a safe and effective treatment for skin cancer that thoroughly excises the tumor while only mildly disturbing surrounding tissue. It is the only skin cancer treatment available that targets only cancerous tissue through comprehensive microscopic examination of the affected area.
Designed by Frederic E. Mohs, M.D., in the 1930s, Mohs Surgery excises not only the visible tumor but also any “roots” that may have extended beneath the surface of the skin. Five-year cure rates have been demonstrated up to 99 percent for first-treatment cancers and 95 percent for recurring cancers.
This procedure is most commonly used for the treatment of basal and squamous cell carcinomas, the two most common types of skin cancer, although it can also be used to treat melanoma and other types of cancer. Mohs surgery is often recommended for recurring cancer because its results are so thorough. It is also ideal for treating cancer in cosmetically and functionally prominent areas such as the nose, eyelids, lips, hairline, hands, feet and genitals.
Mohs Surgery Procedure
Mohs surgery is performed on an outpatient basis in your doctor’s office. It may be performed by a team of highly trained specialists who each focus on different parts of treatment, or one experienced Mohs surgeon well-equipped to perform the entire procedure. During the Mohs surgery procedure, the affected area is numbed with a local anesthetic. Small layers of skin are removed and then the area is closely examined to see if the cancer has been thoroughly eradicated. This process significantly reduces damage to surrounding tissue while effectively removing all traces of cancer.
Most Mohs procedures can be performed in three or less stages, which usually takes less than four hours to perform. Some cases may take longer, as there is no way of predicting the extent of cancer growth before treatment begins. Patients should arrange for someone to take them home following surgery.
Recovery and Results from Mohs Surgery
After Mohs surgery, patients may experience mild discomfort, bruising and swelling around the treated area. Prescription pain medication is available for patients if needed, although most only require Tylenol for pain relief.
There will be scarring after Mohs surgery once the area is healed, although the scars from this procedure are often smaller than those from other excision procedures. For patients concerned with the appearance of their skin after treatment, reconstructive procedures are available to reduce or even eliminate the appearance of the scar using skin flaps, skin grafts, laser treatments, dermabrasion, dermal filler injections and more. These procedures may be performed at the same time as Mohs surgery or at a later date. Your surgeon may also utilize certain techniques to reduce visual scarring, including placing stitching in the skin’s natural crevices or out-of-sight areas.
Compared to other skin cancer treatments, Mohs Surgery has a very high success rate. Basal cell carcinomas have a 97-99 percent cure rate, while squamous cell carcinomas are cured 94 percent of the time.
Risks of Mohs Surgery
Although Mohs surgery is considered safe for most patients, there are certain risks involved with any type of surgical procedure. Some of these risks may include numbness, muscle weakness, tenderness, itching, pain and failure of skin grafts. These risks are considered rare and, if they do occur, are usually mild and temporary. Patients can reduce the risk of complications by choosing an experienced Mohs surgeon to perform their treatment, and by following the surgeon’s instructions after the procedure.
To learn more about the benefits of Mohs surgery, please call our office today to schedule a consultation and find out if this procedure is right for you.
Skin Cancer & Atypical Mole (Dysplastic Nevus) Removal
Skin cancers such as basal cell and squamous cell carcinomas, and dysplastic nevi (atypical or pre-cancerous moles) require complete removal to ensure that they won’t grow or spread over time. This can be accomplished through surgical excision, an office-based procedure that uses a local anesthetic and typically takes thirty minutes to perform. Depending on the type of procedure, your Advanced DermCare surgeon may place one or several layers of sutures, which will need to be removed in 1-3 weeks depending on the anatomical site. You will leave our office with a pressure dressing, which should stay in place for roughly 24 hours.
Prior to performing your surgery, we will discuss what to expect, including activities and medications to avoid before and after your procedure. If feasible, we ask you to hold blood thinners such as aspirin and ibuprofen, although you should never discontinue these without first checking with your primary care physician. After surgery, you should plan on restricting heavy lifting, running or activities that may put excessive stress or tension on your surgical site. You should never schedule any surgery right before traveling out of town, since we will want to see you immediately in the rare event of a complication such as bleeding or wound infection.
In some cases, your physician may recommend alternative treatments for superficial skin cancers such as basal cell carcinomas or Bowen’s disease – a non-invasive form of squamous cell carcinoma. Depending on the location and size of these skin cancers, you may be a candidate for a simple scraping procedure called electrodessication and curettage or treatment with a topical chemotherapy cream.
Remember: if you are diagnosed with a skin cancer or atypical mole, you have a greater risk of developing future skin cancers and should be followed regularly for screening examinations.
Benign Skin Lesion Removal
Benign (non-cancerous) skin growths include melanocytic nevi (moles), seborrheic keratoses, cysts, warts, vascular growths such as cherry hemangiomas, and sun-induced spots such as ephelides (freckles) and solar lentigines (brown age spots). Though most of these growths will remain harmless, some may rarely develop into cancer over time. In addition, skin cancers sometimes mimic benign lesions.
Skin growths such as “moles” exhibiting any of the following warning signs should be examined by one of our providers immediately:
- Sudden growth.
- Itching, irritation or bleeding.
- Rapid changes in color, size or shape.
- Multiple colors.
- Location where it can’t be easily monitored, such as on the scalp.
Depending on their depth, location and color, as well as the patient’s skin type, age and other factors, treatment for benign but unattractive skin growths may take the form of cryotherapy (liquid nitrogen freezing), laser or pulsed light therapy, microdermabrasion, a scraping procedure called electrodessication and curettage, or surgical excision.
Contact our office to learn more about Mohs Micrographic Surgery, Mole Removal or to make an appointment.