Mohs Surgery

The Unmatched Precision of Mohs Surgery for Skin Cancer Treatment

Mohs surgery is widely regarded as the gold standard for treating the two most common forms of skin cancer: squamous cell carcinoma and basal cell carcinoma. This highly specialized procedure, performed under local anesthesia, involves the meticulous, layer-by-layer removal of cancerous tissue. What distinguishes Mohs surgery is its real-time examination of each tissue layer under a microscope after removal, ensuring that the process continues until only healthy, cancer-free tissue remains. This methodical approach guarantees the complete eradication of cancerous cells.

Why Choose Mohs Surgery for Skin Cancer?

Mohs surgery boasts unparalleled effectiveness in dermatologic oncology, with cure rates nearing 99 percent. Its success stems from the precision with which it targets and removes all cancerous cells while preserving as much healthy tissue as possible. Unlike other treatments that may estimate tumor margins visually, Mohs surgery ensures a microscopic examination of the entire surgical margin, significantly lowering the risk of recurrence.

This high degree of accuracy not only offers the highest cure rates but also minimizes the need for additional treatments. Patients who undergo Mohs surgery can take comfort in knowing they have chosen a treatment that offers the best possible outcome for eradicating skin cancer, providing both peace of mind and a superior level of care.

The cure rate for Mohs surgery is the highest of all treatments for skin cancer — up to 99 percent even if other forms of treatment have failed. This procedure, the most precise method of tumor removal, minimizes the chance of cancer regrowth and lessens the potential for scarring and disfigurement.

At Pinehurst Dermatology & Mohs Surgery Center, our Mohs surgeons are board-certified and specialize exclusively in Mohs surgery and related dermatological procedures. This focused practice allows them to refine their skills and stay updated on the latest advancements in the field.

Our patient promise is dedicated to your care. Our Mohs surgeons undergo extensive training beyond medical school and residency to ensure you receive comprehensive skin cancer care.

The Mohs process includes a specific sequence of surgery and pathological investigation. Mohs surgeons examine the removed tissue for evidence of extended cancer roots. Once the visible tumor is removed, Mohs surgeons trace the paths of the tumor using a map of the excised tissue and a microscope.

Once the obvious tumor is removed, Mohs surgeons:

• remove an additional, thin layer of tissue from the tumor site.
• create a “map” or drawing of the removed tissue to be used as a guide to the precise location of any remaining cancer cells.
• microscopically examine the removed tissue thoroughly to check for evidence of remaining cancer cells.

If any of the sections contain cancer cells, Mohs surgeons:

• return to the specific area of the residual tumor indicated by the map
• remove another thin layer of tissue only from the specific area(s) where cancer cells were detected
• microscopically examine the newly removed tissue for additional cancer cells

If microscopic analysis still shows evidence of disease, the process continues layer-by-layer until the cancer is completely gone. Selective removal of only diseased tissue using Mohs Surgery allows the preservation of much of the surrounding normal tissue. This systematic microscopic search reveals the roots of the skin cancer which is why Mohs surgery offers the highest chance possible for complete removal of the cancer while sparing the normal tissue. Cure rates exceed 99 percent for new cancers and 95 percent for recurrent cancers.

On the morning of your surgery, please shower and wash your hair to reduce the risk of surgical site infection. Have your normal breakfast unless specified otherwise. Upon arrival, complete a medical history form, bringing a list of medications. Discontinue Erectile Dysfunction medication 72 hours before surgery, and aspirin, ibuprofen, or herbal supplements 10 days prior if not medically advised. Alcohol should be avoided 48 hours before surgery. Refrain from makeup, perfume, nail polish, and jewelry. Arrange transportation, as a mild sedative may be administered. Nursing home patients must bring a companion for assistance.

These are general recommendations. We recommend working closely with your specific provider to plan and prepare for your Mohs surgery.

After undergoing Mohs surgery, patients need to plan for a smooth recovery.

• Firstly, arrange for someone to drive you home after the procedure, as you may feel groggy from any anesthesia used. 
• Plan to take it easy for a day or two, avoiding strenuous activities.
• And, follow your surgeon's post-operative care instructions diligently, which may include keeping the wound clean and dry. 

Usually, one return visit is all that is needed to examine the healed surgical site or to remove your surgical dressings. Afterward, you may return to your referring physician for routine check-ups. Lifetime annual skin exams and dermatological checkups are considered essential.

After having one skin cancer, statistics show that you have a higher chance of developing a second skin cancer. You should have your skin checked by your referring dermatologist at least once a year for four years not only to examine the treated skin cancer but also to check for new skin cancers.