Mohs Skin Cancer Surgery: Your Questions Answered

May is Skin Cancer Awareness month, and it’s quite appropriate: as the weather continues to warm up and we spend more and more time outdoors, we also spend more time thinking about the impact the sun is having on our skin. The shocking fact that 1 in 5 Americans will have skin cancer at some point in their lives points out just how many of us sustain more sun damage than we realize. At Dermatology Associates of Atlanta (DAA), we recognize that the first step toward lowering your risk of skin cancer is knowledge, so to build your knowledge about skin cancer and effective treatments, we’re tackling your questions about a highly-effective yet less well-known skin cancer treatment called Mohs surgery. Our highly experienced Mohs surgeons, Dr. Scott Karempelis and Dr. Joseph Payne, have seen first-hand how Mohs surgery can successfully treat even some of the most persistent skin cancers.

What is Mohs surgery?
Mohs surgery is a time-tested method for skin cancer removal. Though advancements have improved the procedure throughout the years, the method was developed by Dr. Frederic Mohs in the 1930s. Today, Mohs surgery is the most technically advanced, precise, and effective method for removing skin cancer. The outpatient procedure begins by the surgeon removing the surface tissue that appears to have been affected by the cancer. The surgeon then examines the removed tissue under a microscope to determine whether there are “roots” indicating that the skin cancer has spread beyond the removed tissue. If so, the surgeon removes additional tissue, examines it closely, and continues the process until the cancer has been fully removed.

What advantages does Mohs surgery have over other treatments?
Skin cancer can be deceptive, and the small “roots” through which it spreads to surrounding tissue can be impossible to see with the naked eye. By examining tissue microscopically throughout the procedure, our Mohs surgeons have a much higher ability to remove all affected tissue. Some other treatment methods don’t involve examining the tissue for remaining cancer, while others analyze the tissue later, so there’s a risk of requiring additional treatments to eliminate the rest of the cancer. The unique method used in Mohs surgery gives it a 98-99% cure rate, and makes it especially valuable for cancers with a high risk of recurrence.

Mohs surgery also has advantages from a cosmetic perspective. Especially when the skin cancer is located on sensitive areas like the face, it’s important to minimize the damage to the skin. By removing tissue little by little, our Mohs surgeons can remove only as much tissue as they need to, avoiding larger-than-necessary incisions.

Then why isn’t Mohs surgery used to treat all cancers?
With such a high cure rate, some patients wonder why Mohs surgery is only used to treat around 20% of skin cancer cases. While it is a highly effective surgery, Mohs is still a surgical procedure, and because it can be a relatively lengthy operation, it’s typically reserved only for patients who need it. Some less-invasive treatments, like topical chemotherapy, can successfully eliminate skin cancer without removing any tissue.

What can I expect the aesthetic results of Mohs surgery to be?
As with any surgical procedure, there is a risk for scarring. However, our Mohs surgeons take several steps to minimize scarring compared to a more traditional surgical excision. The Mohs method ensures that the resulting scar will be as small as possible, and in many cases, the result is that the incision can simply be closed with sutures at the end of the procedure. If the affected area is too large for sutures, a flap or skin graft can be used to minimize scars. In some cases, the procedure can be done in conjunction with a reconstructive surgeon to accelerate the healing process. As the treatment area heals, cosmetic treatments like laser skin resurfacing or chemical peels can be used to further improve the appearance of scars while rejuvenating the facial skin.

How is DAA equipped to handle my Mohs surgery?
After nearly 40 years of serving the Atlanta area, our dermatology practice is highly experienced in the many treatment methods available for skin cancer, and depending on each patient’s type of cancer and their medical needs, we can recommend the best possible treatment. For patients who are a good fit for Mohs surgery, Drs. Scott Karempelis and Joseph Payne are highly skilled Mohs surgeons. Combined with our expertly equipped and maintained surgical suite, our Mohs surgeon’s expertise can help you achieve the best possible medical and aesthetic outcome.

Skin cancer may be an extremely prevalent condition, but it’s also highly preventable. At DAA, we’re dedicated to helping our patients have a thorough understanding of skin cancer prevention, detection, and treatment. The earlier that cancer is detected, the higher the likelihood of a positive outcome. Contact us to schedule your annual skin cancer screening, and join us on Facebook, Twitter, and Google+ for more tips and information about keeping your skin healthy.