Mohs Micrographic Surgery

Your dermatologist will evaluate the type, size, location, and behavior of your skin cancer to determine if Mohs surgery is the most appropriate treatment. It is commonly recommended for:

• Cancers in cosmetically or functionally sensitive areas (like the face or hands)
• Aggressive or recurring tumors
• Cases where preserving as much healthy tissue as possible is important

If you’re not sure whether you need Mohs surgery, begin by looking at the concerning spot and see if it shows the ABCDE skin cancer characteristics. You can always schedule a same-day Spot Check to have a specific area examined. Or, if you haven’t had a skin check recently, we recommend a comprehensive Full-Body Skin Cancer Screening to ensure your skin is healthy and any concerns are addressed early.

Mohs surgery is performed by a skilled team of staff, including a dermatologic surgeon, highly trained surgical assistants, and expert lab technicians. Your Mohs team works together to ensure you leave your visit feeling comfortable and confident after your skin cancer treatment.

Mohs surgery treats the most common types of non-melanoma skin cancers:

• Basal Cell Carcinomas (BCC)
• Squamous Cell Carcinomas (SCC)
• Some rare tumors and malignancies

The general dermatologists at Apex Skin work closely with the Mohs surgeons and will discuss with you in detail if Mohs is recommended for your individual diagnosis.

Mohs is performed as an outpatient procedure using local anesthetic. One of our skilled dermatologic surgeons will start by gently scraping at the lesion with a special tool to assess tumor depth, which helps determine the size and depth of the first layer for examination. The goal is to remove as much visible tumor with the first layer while leaving a margin of healthy tissue behind. Additional stages may be required to remove microscopic tumor cells that may extend beneath the skin.

• Generally takes 1.5 to 3.5 hours
• On average, 2 to 3 tissue layers are needed to achieve clear margins
• Each layer takes about 30 to 40 minutes to process
• Bring a book or reading material to help pass the time
• Visit length may increase with complex repairs (sutures)

Generally, there are no restrictions prior to Mohs surgery. We recommend that patients continue all physician-recommended medications, including blood thinners. Patients are encouraged to eat a meal prior to their procedure, as your visit may be several hours long. Please refrain from alcoholic beverages for 1-2 days before and after the procedure to minimize post-op bleeding.

• Most discomfort managed with Tylenol
• Avoid NSAIDs like Motrin, Aleve, or Advil unless directed
• Resume most normal activities the next day
• Pressure dressing to be worn 1–2 days
• You’ll receive personalized wound care instructions

Mohs is performed with sterile surgical instruments and one-time use supplies, so post-op infections are minimal. Antibiotics are prescribed on a case-by-case basis, usually for complex surgical repairs to prevent infection if the patient is at risk.

Ideal for:

• Sensitive areas like the face, head, hands, feet, or genitalia
• Particularly large or recurrent tumors
• Patients with compromised immune systems
• Cases where preserving healthy tissue is a top priority

• Entirely in-office procedure
• Same-day treatment and results—leave skin cancer free!
• Efficient and patient-friendly process
• Minimal scarring

Mohs has a 99% cure rate. In the unusual instance that your skin cancer reoccurs in the same area, you would typically notice changes at the site around 1–3 years later.

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As with any surgical procedure, there are a few rare complications that may happen. We take the utmost care to prevent these during the procedure.

• Bleeding: Some bleeding during surgery is expected. It is uncommon, however, for bleeding to occur after surgery. If you take blood thinners like aspirin, coumadin, plavix, we ask that you continue these medications, or talk to the prescribing doctor to see if it is appropriate to stop these medications. Those patients on blood thinners are at higher risk of bleeding after the procedure.
• Allergic reaction: Allergic reaction is very rare. It can occur due to local anesthesia or the adhesive of the bandage.
• Scarring: A scar will always result from Mohs surgery. Scars usually mature over several months and become cosmetically acceptable. Some scars will be pink and bumpy for a few months. Scars that do not mature well can often be cosmetically altered. If surgery is needed to improve the appearance of a scar, the procedure is usually performed 6-12 months after the original surgery.
• Numbness or nerve damage: Most scars are numb because small sensory nerves have been cut during the procedure. Sometimes, adjacent skin is also numb following a repair. This sensation usually goes away over time. Very rarely is a tumor located around nerves that control movement. In such cases, muscle movement may be impaired as a result of nerve damage caused by the removal of the tumor.
• Recurrence: Tumors recur in some patients even after Mohs surgery has been carefully performed. A recurrence will usually look like a small bump or a red scaly area on or close to the surgical site or scar. Recurrences are not usually apparent for one to three years. Recurrences are almost always treated again with Mohs surgery because of the technique’s high cure rates.

• Most insurance plans typically cover Mohs surgery (subject to deductibles)
• Medicare generally covers about 80%; secondary insurance may cover the rest
• Commercial insurance coverage varies—check with your provider
• Copayments are due at the time of the visit

Yes. While Mohs surgery is often the preferred treatment for certain types of skin cancer due to its precision and high cure rate, other options are also very common and may be appropriate depending on your diagnosis. These can include:

• Topical or oral medications for superficial cancers
• Light Therapy
• Cryotherapy (freezing the lesion)
• Scraping
• General Surgery

Your provider will help determine the best treatment plan based on the type, size, and location of your skin cancer—as well as your overall health and preferences. You can also read this article to learn more!