The Importance of Mohs Surgery in Dermatology

Mohs surgery (also known as Mohs micrographic surgery) is a highly effective surgical technique widely used for treating skin cancer. The procedure is named after its inventor, Dr. Frederic Mohs, who first introduced it in the 1930s.

Mohs surgery allows cancerous tissue to be removed, while preserving the greatest amount of normal surrounding tissue. Mohs surgery is often used to treat basal cell carcinoma and squamous cell carcinoma. It can also be used to treat other types of skin cancer, including melanoma. In this case, a modified version of Mohs can be used, known as slow Mohs. The surgeon will remove the affected areas and a thin margin of the skin until the Melanoma is fully removed. This can take several appointments, depending on the size and location of the Melanoma.

What Does Mohs Surgery Involve?

The goal of Mohs surgery is to remove as much of the cancerous tissue as possible, while preserving healthy tissue and minimizing scarring. The surgical technique involves the removal, in layers, of skin tissue affected by the cancer, and the examination of the skin cells under a microscope to determine if the cancer was fully removed or not.

How is Mohs Surgery Performed?

Mohs surgery is typically performed on an outpatient basis and can take several hours to complete. The procedure involves the following steps:
1. Local anesthesia. The patient is given local anesthesia to numb the area being treated.
2. Skin cancer removal. The surgeon removes the visible skin cancer and a small margin of surrounding tissue.
3. Mapping and processing. The tissue is mapped and processed in a laboratory to create a detailed map of the cancer.
4. Repeat removal. The dermatologist removes additional layers of tissue, mapping and processing each layer until no cancer cells remain.
5. Reconstruction and pain management. Once the cancer has been completely removed, the wound is reconstructed using plastic surgery techniques to minimize scarring. Most people are able to control their pain after the procedure with over-the-counter pain medication like acetaminophen (Tylenol).

Advantages of Mohs Surgery

Mohs surgery has several advantages over other types of skin cancer treatment, including:

• Preserving healthy tissue, minimizing scarring and improving cosmetic outcomes.
• Allowing for precise removal of cancerous tissue, minimizing the risk of recurrence.
• Allowing for real-time mapping of the tumor, ensuring that cancerous tissue is removed.

Surgical Excision to Treat Melanoma

Melanomas are removed by a surgical excision with a wide margin, which means the removal of skin cancer, utilizing a safety margin of normal-appearing skin around the cancer. Some melanomas are best removed with a procedure called a staged excision (removal in stages) with delayed repair.

Topical Treatment and Adjuvant Therapy

Topical treatment for skin cancer includes chemotherapy for superficial, thin lesions with or without adjuvant (additional) laser resurfacing therapy.

Choosing the Right Dermatologist for Mohs Surgery and Excisions

Meet Our Dedicated Experts

Elevated Dermatology specializes in skin cancer surgery led by Dr. Christopher Messana, fellowship-trained Mohs surgeon, and Dr. Kate Messana, a dedicated dermatopathologist. Biopsies and excisions are performed in-office.

Dr. Christopher Messana has the highest level of training and expertise in diagnosing and treating skin cancer, and has successfully treated thousands of skin cancers. He completed a Mohs micrographic surgery and dermatologic oncology fellowship at the prestigious Cleveland Clinic, after his dermatology residency training.

Recommended Websites

If you would like to read more about skin cancer and Mohs surgery, Dr. Christopher Messana recommends these helpful and reliable websites:

• skincancermohssurgery.org
• skincancer.org
• mohscollege.org/for-patients

Additionally, please see our website information on skin cancer and moles and melanoma.