Seven facts to know about Mohs micrographic surgery for skin cancer
A skin cancer diagnosis can bring plenty of questions, but learning what happens next can make treatment feel more manageable. Mohs micrographic surgery offers a precise, tissue-sparing way to remove certain skin cancers. Surgeons at Associates in Dermatology in Westlake, Ohio, remove the cancer in thin layers, examine each layer under a microscope, and continue only where cancer cells remain.
Here are seven helpful facts about the procedure.
1. Mohs surgery removes cancer layer by layer.
During Mohs surgery, the surgeon first removes the visible tumor and a thin layer of surrounding tissue. The tissue is carefully mapped and microscopically examined. When cancer cells remain in one area, the surgeon removes another thin layer only from that location. This process continues until the examined margins show no remaining cancer.
2. It preserves healthy skin.
Mohs surgery aims to remove the cancer while sparing as much unaffected tissue as possible. This feature can prove especially valuable in areas where every millimeter matters, including the nose, eyelids, lips, ears, hands, and feet. Preserving healthy skin can support both function and the repair process.
Skin cancer advocates stress importance of early detection, prevention
Tiffany Tarpley: I’m working to make sure that you are aware of issues that impact your health. But somewhere around the corner, we’ll be spending a lot more time in the sun, but too much sun exposure raises your risk for skin cancer. It’s the most common type of cancer in the United States. It’s also one of the most preventable, but most skin cancer cases go undetected until it’s too late.
Dr. Mihir Shah: We will diagnose about 200,000 melanomas and there’ll be about 10,000 deaths from melanoma. There’ll be 5 million non-melanoma skin cancers diagnosed this year. And that’s more than every other cancer combined.
Tiffany Tarpley: As National Skin Cancer Awareness Month wraps up. I spoke with a local dermatologist and skin cancer survivor about the importance of checking your skin year round.
Dr. Mihir Shah: How are you?
Narrator: Mary Conley lives in Brook Park, and she visited her dermatologist last June for a regular checkup. During the appointment, her doctor noticed something abnormal.
Patient: She examined me, looked everything over when she went up to my face and she said, I’m not real happy with this. The spot was right here. Uh, on the side of my nose.
Narrator: Mary had a biopsy a few days later.
Patient: They Called me and they said that, uh, it was skin cancer and they needed to do some surgery.
Narrator: Mary was diagnosed with basal cell skin cancer. The most common type
Dr. Mihir Shah: Basal cell carcinoma is not as deadly compared to melanoma. Um, now it is something we recommend treating because it will continue to grow. It bleeds, it becomes painful.
Narrator: Mary was referred to Dr. Mihir Shah, a dermatologist and reconstructive surgeon in Westlake for MOS surgery.
Dr. Mihir Shah: Mos surgery is basically where we remove the cancer, and then once we know the cancer is out, we put stitches in to get that patient put back together.
Narrator: The surgery was a success. But Mary says the experience was frightening.
Patient: It was, it was scary. It really was. Um, you never realize how vain you are until they’re chopping up your face. My goodness, By the time they finished cutting, it was pretty big. The whole, in my face.
Tiffany Tarpley: I think they said quarter, quarter Size.
Patient: It was devastating. It really, really was.
Narrator: Mary tells me she never paid attention to her skin, despite spending a lot of time in the sun for decades.
Patient: In the early sixties, nobody really realized, you know, the dangers of the sun. We’d just lay on the beach and cook like from 10 o’clock in the morning until 4 o’clock in the afternoon.
Tiffany Tarpley: So what about now?
Patient: Since the surgery, I don’t even go in my yard without a sun hat, glasses, and sunblock.
Narrator: Dr. Shah says, anyone can develop skin cancer no matter your age or skin tone, but skin cancer is easily preventable.
Dr. Mihir Shah: We usually recommend wearing a sunscreen every single day at least in SPF 30. But higher is better if you can try and avoid the peak hours of the day. So usually, you know, between 10 and 2, that’s when the sun is kind of the strongest.
Narrator: Dr. Shah also suggests checking your skin for unusual spots every month.
Dr. Mihir Shah: If you notice something that’s changing or growing, if you have one that really sticks out to you, you wanna bring that to our attention. That way we can look at it and really make sure that it’s nothing to worry about.
Narrator: That’s advice Mary hopes everyone will listen to.
Patient: I think it’s important for people not to just go, oh, it’s just a little freckle. Um, haven’t looked at. You can’t be too careful. You really can’t.
Narrator: Since Mary was treated for basal cell skin cancer early, the chances of it coming back are very low.
Patient: And I feel doubly blessed because I am a survivor, breast cancer 27 years ago.
Tiffany Tarpley: Oh, wow.
Patient: And a recent survivor of bladder cancer. So I am, I am a walking miracle. God has definitely blessed me.
Tiffany Tarpley: Well, this morning I’m also following a major study out of Cleveland Clinic that looks at the connection between your genetics and developing skin cancer researchers started by creating a registry of patients with a family history of melanoma or other types of cancer. The study found that 10% to 15% of those patients had a gene mutation that makes them susceptible to developing cancer. Doctors suggests getting tested for the gene if a first degree relative has been diagnosed with melanoma in the past. Testing may make it easier for doctors to treat the cancer.
Dr. Joshua Arbesman: Some of the genetic changes in certain genes may affect treatment for, for the melanoma or the cancers that the patients may develop. That there are certain new treatments that actually are better or work better in patients that have a genetic change in one of these genes.
Tiffany Tarpley: While things like adequate sun protection play a huge role in preventing skin cancer, this study indicates genetics may just as play just as big of a role here. So I think it’s just important, right, awareness for all of us to remember to put on that sunscreen, no matter our skin tone, skin complexion, it’s important that we protect ourselves in.
3. Doctors often recommend this treatment for specific tumors.
Not every skin cancer requires Mohs surgery. A dermatologist may recommend it for certain basal cell carcinomas or squamous cell carcinomas that appear in high-risk locations, have poorly defined borders, grow aggressively, return after treatment, or develop within scar tissue. The tumor type, size, location, and medical history all influence the treatment decision.
4. Most patients stay awake during their procedure.
Mohs surgery usually takes place in an outpatient office or surgical setting with local anesthesia. Patients remain awake, but the treatment area becomes numb. Each stage’s surgical portion may move quickly, but tissue preparation and examination create waiting periods between stages. Patients should reserve much of the day because the number of stages can vary.
5. The procedure offers a high cure rate.
Mohs surgery provides the highest potential cure rate for many common skin cancers, with reported cure rates reaching up to 99 percent for some previously untreated tumors. Its precision lets the surgeon examine tissue margins during the appointment rather than estimating how far the cancer extends.
6. Wound repair varies from patient to patient.
After the surgeon confirms the cancer is gone, the next step is to repair the area. A small wound may heal naturally, while another may need stitches, a skin flap, or a graft. The surgeon considers the wound’s size, depth, location, and nearby structures when recommending a repair method.
7. Aftercare supports comfortable healing.
Patients receive instructions for cleaning the site, changing the bandage, managing discomfort, and recognizing possible complications. Temporary swelling, bruising, tenderness, or tightness can occur. Keeping follow-up appointments and continuing regular skin examinations also matter because a previous skin cancer increases the need for ongoing surveillance.
Schedule a Skin Cancer Consultation
Searching for a Mohs procedure “near me” can be the first step toward learning about treatment options. The team at Associates in Dermatology provides Mohs surgery services in Westlake, OH, and the surrounding communities, with offices serving patients in Westlake, Middleburg Heights, and Lorain. Contact the practice to schedule an evaluation and receive guidance based on your diagnosis, health history, and individual treatment needs.
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