Chandler Jansen, MD, Micrographic Surgery and Dermatologic Oncology Fellow, handles a tissue sample in the dermatology clinic on the UI Health Care university campus on Monday, Sept. 30, 2024.

Mohs Surgery

Mohs surgery is an advanced technique for removing skin cancer. This surgery has a cure rate of up to 99%
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Mohs surgery provides the highest cure rates for many types of skin cancers and early-stage melanomas.

The procedure involves removing the affected skin layer by layer and then immediately reviewing each layer under a microscope.  This process is repeated until the cancer cells are gone and the margins are clear. This allows your skin cancer to be removed more accurately and without damaging the healthy skin around it. It also allows for same-day reconstruction of the area since we know that the margins are clear.

With a 99% cure rate, Mohs surgery is one of the most effective treatment options available for the treatment of certain types of skin cancers.

Our approach to Mohs surgery

At University of Iowa Health Care, specialists with the Department of Dermatology and Holden Comprehensive Cancer Center work together to evaluate your skin cancer and provide the most advanced and effective treatment options available, including Mohs surgery.

Our surgeons are able to pinpoint the exact area of your tumor by evaluating the tissue around it for remaining cancer cells. This means they’ll remove less healthy skin while accurately removing all cancer cells in the area.

Additionally, this multidisciplinary approach to treatment allows your care team to perform all pre-operation evaluations, the surgery itself, and any necessary reconstruction on the same day, eliminating the need for you to plan for multiple visits.

How Mohs surgery works

Before your procedure, you will meet with your dermatologic surgeon for a physical exam, a review of your medical history, your test results, and your skin cancer diagnosis.

They will also discuss what you can expect and give you instructions for the morning of surgery. These will include instructions on what to wear, what medications you should take, and if you should eat breakfast the day of surgery.

Morning of Mohs surgery

Mohs surgery can take all day. You will need someone to drive you home.

When you get to the hospital for your surgery, your doctor will once again explain the procedure and answer any questions you may have. You will also sign a consent form during this time.

If you are feeling nervous, your provider can give you medicine to relax before they prepare you for surgery.

During Mohs surgery

The first thing your surgeon will do is inject an anesthetic into the area to numb the surrounding skin and tissue.

They will then remove the skin that contains the cancer cells layer by layer to preserve as much healthy skin as possible.

The skin removed from the skin cancer area is then immediately tested for cancer cells while you wait. If cancer cells are still present, a second layer of skin is removed. This continues until there are no more cancer cells. Depending on the size of your tumor, the surgery could take anywhere from a few hours to a whole day.

Wound management and reconstruction

Your surgeon will discuss several ways to approach wound management following your Mohs surgery. These include:

  • Letting the wound heal on its own
  • Using stitches to close the wound
  • Borrowing tissue from either the surrounding skin (skin flap) or from another area of your body (skin graft)
  • Reconstructive plastic surgery (for larger tumors)

Recovery

After the surgery, your wound will be bandaged. Before you leave the hospital, your provider will teach you how to care for the wound and may give you pain medications and/or antibiotics, if needed. You will need to wear a bandage on the wound for about two to seven days.

Your provider may schedule follow-up appointments to see if your wound is healing properly. Call your provider right away if you experience any of the following:

  • Excessive bleeding
  • Signs of infection, including redness, swelling, drainage, fever, or pain
  • Nausea or vomiting

Who can benefit from Mohs surgery?

Mohs surgery is an effective treatment option for various types of skin cancer, including:

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Early-stage melanoma

Your provider may recommend Mohs surgery for your skin cancer if it is recurring or invading the surrounding tissue, or if you have a suppressed immune system.

Not sure whether Mohs surgery is right for you?

When you call, we’ll help you find a provider who meets your needs.
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