Mohs surgery is a precise, highly effective procedure for removing certain types of skin cancer, including basal cell carcinoma and squamous cell carcinoma. Its unique approach allows the surgeon to remove cancerous tissue layer by layer while preserving as much healthy skin as possible. If you’ve been diagnosed with skin cancer, your dermatologist or surgeon may recommend Mohs surgery as the best treatment option—especially for cancers in cosmetically sensitive or high-risk areas like the face, ears, or hands.
In this guide, we’ll break down exactly how Mohs surgery works, why it’s different from other treatments, what you can expect during the procedure, and how recovery typically progresses. Texas Surgical Dermatology, led by Dr. Tri H. Nguyen who is a Mohs fellowship-trained specialist, provides Mohs surgery to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.
What Makes Mohs Surgery Different from Other Skin Cancer Treatments?
Traditional excision methods remove the visible tumor along with a margin of surrounding healthy skin to ensure all cancer cells are eliminated. The tissue is then sent to a lab for analysis, which can take several days. If cancer cells are still present in the margins, another surgery may be required.
In contrast, Mohs surgery examines the tissue in real time during your appointment. The surgeon removes one thin layer of skin at a time, immediately examines it under a microscope, and continues removing tissue only where cancer cells remain. This method:
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Minimizes removal of healthy tissue
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Has the highest cure rate (up to 99% for certain skin cancers)
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Allows same-day confirmation that all cancer has been removed
Who Is a Candidate for Mohs Surgery?
Your doctor may recommend Mohs surgery if you have:
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Skin cancer on the face, ears, scalp, hands, feet, or genitals (areas where preserving tissue is important)
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Recurrent skin cancer (cancer that has returned after previous treatment)
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Large, aggressive, or ill-defined tumors
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Skin cancer with borders that are hard to see under the skin
Step-by-Step Process of Mohs Surgery
Step 1: Preparation
Your skin is cleaned, and local anesthesia is administered to numb the area. You’ll remain awake and comfortable throughout the procedure.
Step 2: First Tissue Layer Removal
The surgeon removes a thin layer of visible tumor along with a small margin of surrounding tissue.
Step 3: Mapping and Microscopic Examination
The removed tissue is carefully mapped and marked to match its exact location on your skin. It’s frozen, sliced into thin sections, and examined under a microscope.
Step 4: Additional Layer Removal (If Needed)
If cancer cells are still present in any section, the surgeon removes another thin layer only from that precise location. This process is repeated until no cancer cells remain.
Step 5: Wound Repair
Once all cancer is removed, the wound is closed. Depending on size and location, closure methods may include direct suturing, skin grafts, or letting the wound heal naturally.
How Long Does Mohs Surgery Take?
The length of your appointment depends on how many stages are required to remove all cancer cells. Each stage—including tissue removal, processing, and microscopic examination—can take about an hour. Many cases are resolved in 1–3 stages, meaning you might be at the clinic for several hours.
Benefits of Mohs Surgery
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Highest cure rate: Up to 99% for certain skin cancers
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Tissue-sparing: Preserves as much healthy skin as possible
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Immediate results: No waiting days for lab results
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Lower recurrence rates: Reduces the chance of the cancer returning
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Precise targeting: Removes cancer cells without unnecessary damage
What to Expect After Mohs Surgery
Right After the Procedure
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Your wound will be bandaged, and you’ll receive instructions for at-home care.
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Mild discomfort, swelling, and redness are normal.
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Over-the-counter pain relievers are usually sufficient.
Recovery Timeline
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First 1–2 days: Rest and avoid strenuous activities.
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First week: Stitches may be in place; follow wound care instructions closely.
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1–2 weeks: Stitches are removed if present.
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Several weeks to months: Scarring continues to fade.
Potential Risks and Complications
Mohs surgery is generally safe, but as with any procedure, there are potential risks:
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Infection
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Bleeding or bruising
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Temporary numbness or tingling
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Scarring (which usually improves over time)
Your surgeon will take steps to minimize risks and provide detailed aftercare guidelines.
Tips for a Smooth Recovery
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Keep the wound clean and follow all dressing change instructions.
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Avoid heavy lifting and strenuous exercise for the first week or as directed.
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Use sunscreen daily to protect healing skin and reduce scarring.
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Report any unusual symptoms, such as increasing redness, swelling, or drainage, to your doctor.
Frequently Asked Questions About Mohs Surgery
Will I be asleep during Mohs surgery?
No, the procedure is done under local anesthesia, so you’ll be awake but comfortable.
Is Mohs surgery painful?
Most patients feel only pressure during the procedure. Any discomfort afterward is typically mild.
Will I have a scar?
Yes, but your surgeon will use techniques to minimize scarring. Over time, most scars fade significantly.
How soon can I go back to work?
Many patients return to desk work within a day or two, though this varies based on the size and location of the surgical site.
Does insurance cover Mohs surgery?
In most cases, yes—especially if it’s medically necessary for skin cancer removal.
Contact Us
If you’ve been diagnosed with skin cancer or suspect you may have a suspicious skin lesion, early treatment is essential. Our team specializes in Mohs surgery, combining medical expertise with precision techniques to remove cancer effectively while preserving your appearance. Contact us today to schedule a consultation and learn if Mohs surgery is right for you.
FOR MORE INFORMATION CONTACT OUR BOARD CERTIFIED IN DERMATOLOGISTS AT TEXAS SURGICAL DERMATOLOGY IN SPRING, TX
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Spring, Katy and other surrounding areas of Texas.
