Preetha Agarwal, M.D. Preetha Agarwal, M.D.

Mohs Surgery

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Mohs Surgery Patient Overview

Mohs micrographic surgery is a specialized procedure used to treat certain types of skin cancer, especially those that are high-risk or located in sensitive areas. The main goals are to completely remove the cancer while saving as much healthy skin as possible and achieving the best cosmetic result.1-6

What to Expect

Mohs surgery is usually done in a dermatologist's office under local anesthesia, so you will be awake but should not feel pain during the procedure.1,4,6 The surgeon removes the visible tumor and a thin layer of surrounding tissue. This tissue is quickly examined under a microscope to check for any remaining cancer cells. If cancer is found at the edges, the surgeon removes another thin layer only from the area where cancer remains. This process is repeated until all the cancer is gone.1-7

Mohs Surgery Process Diagram

Most people can go home the same day. After the cancer is removed, the wound is repaired. This may be done with stitches, a skin graft, or by letting it heal naturally, depending on the size and location.3,4,6

Why Mohs Surgery?

Mohs surgery is recommended for skin cancers that are more likely to come back, are large, have aggressive features, or are in areas where it's important to preserve healthy tissue (like the face, ears, or hands).1,2,5-8 It offers the highest cure rates and lowest recurrence rates compared to other treatments.1-3,5,7,8 For example, the chance of the cancer coming back after Mohs is about 1–4% for most cases, which is lower than with standard surgery.1,2,5,7,8

Recovery and Risks

Complications are rare but can include infection, bleeding, or delayed healing.3,6 Your doctor will give you instructions on how to care for your wound.

Patient Education

Studies show that using educational videos, pamphlets, and other materials can help patients better understand Mohs surgery and feel more prepared.9-14 If you have questions or concerns, ask your care team—they are there to help.

Follow-Up

Regular follow-up visits are important to check for any signs of recurrence and to monitor healing.1,2,5,7,8 If you have a history of multiple skin cancers or certain genetic conditions, your doctor may recommend more frequent check-ups.2

Summary

Mohs micrographic surgery is a safe, effective way to treat skin cancer, especially in high-risk or sensitive areas. It offers the best chance for cure while preserving healthy skin and appearance.1-8 Talk to your doctor about any questions or concerns you have before your procedure.

References

  1. Keratinocyte Carcinoma. Wehner MR. JAMA. 2025;:2840731. doi:10.1001/jama.2025.18749.
  2. Basal Cell Skin Cancer. National Comprehensive Cancer Network. Updated 2025-09-02.
  3. Mohs Micrographic Surgery: A Narrative Review of Current Practices, Emerging Trends, and Case-Based Insights. Maciejewska M, Bętkowska A, Czuwara J, et al. Advances in Therapy. 2025;:10.1007/s12325-025-03354-w. doi:10.1007/s12325-025-03354-w.
  4. Understanding Mohs Micrographic Surgery: A Review and Practical Guide for the Nondermatologist. Tolkachjov SN, Brodland DG, Coldiron BM, et al. Mayo Clinic Proceedings. 2017;92(8):1261-1271. doi:10.1016/j.mayocp.2017.04.009.
  5. Consensus for Nonmelanoma Skin Cancer Treatment: Basal Cell Carcinoma, Including a Cost Analysis of Treatment Methods. Kauvar AN, Cronin T, Roenigk R, Hruza G, Bennett R. Dermatologic Surgery. 2015;41(5):550-71. doi:10.1097/DSS.0000000000000296.
  6. Mohs Micrographic Surgery. Bowen GM, White GL, Gerwels JW. American Family Physician. 2005;72(5):845-8.
  7. Guidelines of Care for the Management of Cutaneous Squamous Cell Carcinoma. Kim JYS, Kozlow JH, Mittal B, et al. Journal of the American Academy of Dermatology. 2018;78(3):560-578. doi:10.1016/j.jaad.2017.10.007.
  8. Squamous Cell Skin Cancer. National Comprehensive Cancer Network. Updated 2025-09-02.
  9. Patient Education in Mohs Surgery: A Review and Critical Evaluation of Techniques. Patel P, Malik K, Khachemoune A. Archives of Dermatological Research. 2021;313(4):217-224. doi:10.1007/s00403-020-02119-5.
  10. Brief Educational Video Improves Patient Understanding of Mohs Surgery: A Randomized Controlled Trial. Lin MJ, Dubin DP, Younessi S, Khorasani H. Dermatologic Surgery. 2021;47(3):323-326. doi:10.1097/DSS.0000000000002843.
  11. Home Viewing of Educational Video Improves Patient Understanding of Mohs Micrographic Surgery. Mann J, Li L, Kulakov E, Bassett P, Birnie A. Clinical and Experimental Dermatology. 2022;47(1):93-97. doi:10.1111/ced.14845.
  12. Using a Multimedia Tool for Informed Consent in Mohs Surgery: A Randomized Trial Measuring Effects on Patient Anxiety, Knowledge, and Satisfaction. Delcambre M, Haynes D, Hajar T, et al. Dermatologic Surgery. 2020;46(5):591-598. doi:10.1097/DSS.0000000000002213.
  13. Modernizing the Mohs Surgery Consultation: Instituting a Video Module for Improved Patient Education and Satisfaction. Newsom E, Lee E, Rossi A, Dusza S, Nehal K. Dermatologic Surgery. 2018;44(6):778-784. doi:10.1097/DSS.0000000000001473.
  14. Web App- And Text Message-Based Patient Education in Mohs Micrographic Surgery-a Randomized Controlled Trial. Hawkins SD, Koch SB, Williford PM, Feldman SR, Pearce DJ. Dermatologic Surgery. 2018;44(7):924-932. doi:10.1097/DSS.0000000000001489.