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Mohs micrographic surgery involves removing a skin cancer one layer at a time and examining these layers under a microscope immediately after they are removed. This procedure allows for a close examination of each layer of skin to detect cancer cells. It also allows a minimal amount of tissue to be removed while making sure that all the cancer cells are removed.

A local anesthetic is injected into the skin before the surgery. Your doctor then begins to remove the skin cancer and a small amount of healthy tissue, one layer of skin at a time. Each tissue layer is prepared and examined under the microscope for cancer cells. Surgery is complete when no more cancer cells are detected.

Recovery may take 2 to 4 weeks, depending on the extent of surgery.

Mohs micrographic surgery may be used for removal of skin cancer that:

  • Is likely to return. Mohs micrographic surgery is more effective in obtaining cancer-free margins for cancers that have irregular borders and a history of removal and recurrence.
  • Is located in visible areas or areas where skin tissue should be preserved, such as on the ears, nose, or eyelids.
  • Is growing quickly.
  • Has a high risk of spreading to other parts of the body, such as in some squamous cell carcinomas.
  • Occurs in children.

Mohs micrographic surgery can be an effective treatment for skin cancer. This technique preserves as much nearby healthy skin as possible. It is recommended for squamous cell carcinoma when the highest cure rate is desired while sparing as much healthy tissue as possible.1 And for basal cell carcinoma, Mohs surgery is the best treatment for sparing healthy tissue and preventing recurrence.2

Risks of surgery include:

  • Infection of the wound.
  • Scarring.
  • Discomfort or pain.
  • Bleeding.

Mohs micrographic surgery is the best procedure to preserve skin tissue surrounding the cancer. But it requires special training and equipment. And it is time-consuming and expensive.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Citations

  1. Grossman D, Leffell DJ (2012). Squamous cell carcinoma. In LA Goldman et al., eds., Fitzpatrick's Dermatology in General Medicine, 8th ed., vol. 1, pp. 1283–1294. New York: McGraw-Hill.

  2. Carucci JA, et al. (2012). Basal cell carcinoma. In LA Goldman et al., eds., Fitzpatrick's Dermatology in General Medicine, 8th ed., vol. 1, pp. 1294–1303. New York: McGraw-Hill.


By: Healthwise Staff Current as of: October 2, 2012
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Amy McMichael, MD - Dermatology

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