Purpose of Mohs Surgery

Mohs surgery (also called Mohs micrographic surgery) is used to remove skin cancer lesions while sparing as much healthy tissue as possible. The Mohs surgery technique leaves the smallest possible scar, making it an ideal procedure for skin cancers located on the face.

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Diagnosis Related to Mohs Surgery

Mohs surgery can be used to remove all of the most common types of skin cancers and certain rare skin cancers, including one type of early-stage melanoma. Diagnoses associated with Mohs micrographic surgery include:

• Basal cell carcinoma (BCC): This is the most common type of skin cancer, affecting 2 million Americans each year. It occurs in areas exposed to the sun.
• Squamous cell carcinoma (SCC): This second-most common type of skin cancer is also associated with sun exposure. It may develop from pre-cancerous growth called actinic keratosis.
• Lentigo malignant melanoma (early stage lesions only): In this type of melanoma, the malignant cells stay close to the surface of the skin in its early stages. Other forms of melanoma are not suitable for Mohs surgery.
• Dermatofibrosarcoma protuberans (DFSP): This is a rare and slow-growing type of skin cancer.
• Extramammary Paget’s disease
• Melanoma in situ: Also called Stage 0 melanoma, this indicates that there are cancer cells in the top layer of skin, but they have not spread into the deeper layers.
• Merkel cell carcinoma: This rare type of skin cancer can be aggressive.

Receiving a skin cancer diagnosis does not automatically qualify a person for Mohs surgery. The procedure is reserved for removing skin cancers located on areas of the body with thin tissue layers, such as:

• Nose
• Lips
• Ears
• Scalp
• Back of the hands
• Top of the feet
• Genitals

Tests and Labs

Many times, a dermatologist can identify a lesion that qualifies for Mohs surgery simply through physical examination. Or, the doctor may perform a biopsy to determine if a lesion is cancerous. A biopsy requires removing a portion of the lesion for a pathologist to examine microscopically for the presence of cancer cells.

If a biopsy confirms melanoma, you may undergo further tests to determine if the cancer has spread beyond the skin. These tests may include:

• Imaging scans like computed tomography (CT) to look for tumors inside the body
• Lymph node biopsy near the skin lesion to see if the cancer has spread to the lymph nodes

For qualifying skin cancers, a dermatologist often can recommend Mohs surgery during the initial visit or as soon as the biopsy results come back. If the location of your skin cancer makes you a good candidate for a Mohs procedure, then you likely will be able to schedule the procedure soon after receiving a diagnosis.

A Word From Verywell

Mohs micrographic surgery often results in a very small scar because the procedure removes as little tissue as required to eliminate the cancer. Other types of skin cancer surgery can leave a more prominent scar because the surgeon usually removes larger areas of tissue (maralgins) on each side and underneath the visible lesion to ensure no cancerous cells remain. For best results with Mohs micrographic surgery, seek out a dermatologist with many years of experience in Mohs surgery or one who has received fellowship training in the procedure.