What is MOHS Surgery?

Mohs surgery is an effective procedure for the removal of specific skin cancers. The procedure was developed in the early 20th century at the University of Wisconsin School of medicine and is now practiced throughout the United States. The procedure is different from other skin cancer treatments in that it uses an examination of the removed cancerous tissue, so that all and extensions of the cancer can be removed. Due to the tissue being removed and examined, Mohs surgery has been the highest reported cure for cancer. Doctors performing this surgery have specialized skills in dermatology, dermatologic surgery, dermatopathology, or Mohs surgery.

Basic and advanced training in Mohs surgery is taught at specific residency programs and fellowships. Also the Mohs surgeon has the required laboratory facilities on location. Your Mohs surgeon can provide you with detailed information regarding his or her training in the above disciplines, as well as all applicable professional affiliations.

It is important to note that Mohs surgery is not effective for the treatment of all skin cancers. Mohs micrographic surgery typically is reserved for those cancers that have recurred or have a high risk for recurrence. Mohs surgery also is indicated for cancers located in areas such as the nose, ears, eyelids, lips, hairline, hands, feet, and genitals, in which maximal preservation of healthy tissue is critical for cosmetic or functional purposes.

How is Mohs Surgery Done?


There are three steps involved in Mohs surgery:

1. The skin is made completely numb using a local anesthetic. The visible cancer is removed with a thin layer of additional tissue. This takes only a few minutes and the patient may then return to the waiting room. A detailed diagram (a Mohs map) of the removed specimen is then drawn.

2. The skin is color coded to distinguish top from bottom and left from right. A lab technician freezes the tissue and removed very thin slices from the entire edge and under the surface. The slices are placed on a film slide and colored for examination. This lab work may take up to an hour.

3. Your doctor then will carefully examine these slides under a microscope. The examiner will look for more signs of cancerous tissue. The entire undersurface and the complete edge of the specimen is examined.

If more cancer is found on the microscopic slides, your doctor uses the Mohs map to remove additional tissue only where cancer is present. This allows the Mohs surgery technique to leave the smallest possible scar as during each stage cancer is immediately looked for. Only tissue around the "roots" and extensions of cancer is removed.

How long does it take?

Usually less than one hour. This can depend on lab work. Most cases can be completed in three of fewer stages, requiring less than four hours. However, no one can predict how extensive a cancer will be because the size of a skin cancer's "roots" cannot be estimated in advance. We therefore ask that you reserve the entire day for surgery, in case additional surgical sessions are required.

Will it leave a scar?

Yes. Any form of surgery will leave a scar. Mohs surgery; however, will leave one of the smallest possible surgical defects, and therefore a smaller final scar.

What happens after the surgery is completed?

When the cancer is removed, your doctor will discuss with you your options. These may include: 1. allowing the wound to heal naturally, without additional surgery (often produces the best cosmetic result), 2. wound repair by your doctor, 3. wound repair by the referring physician or making arrangements for wound repair, or 4. referral to another surgeon for wound closure.

How do I prepare?

Get plenty of sleep and eat normally before Mohs Surgery. If you are taking prescriptions, continue to take them unless otherwise told by your doctor. Avoid taking medications that contain aspirin for ten days before your surgery. Do not take any aspirin substitutes such as Advil, Motrin, Nalfon, Naprosyn within 24 hours of your surgery. Tylenol is acceptable at any time before the surgery. Patients often read during surgery. Do not attempt to drive yourself home.

Will I have pain after surgery?

Most patients do not complain of significant pain. If there is discomfort, Tylenol or Vicodin is usually all that is needed for relief. Sometimes, more significant pain medications will be prescribed when needed. Bruising and swelling around the wound is common.

Does insurance usually cover the cost?

Yes. Insurance policies cover the costs of Mohs surgery and the surgical reconstruction of the wound. Please check with your insurance carrier for exact information relating to your surgery - your doctor most likely accepts Medicare.

Who is the best doctor for this procedure?


Below is a list of doctors that have published articles specifically on mohs surgery. These doctors did more than take a course on mohs -- they have actual publications. To view all doctors please go click here.

Prospective evaluation of surgical site infection rate among patients with mohs micrographic surgery without the use of prophylactic antibiotics.


Dr. Sherry L. Maragh, MD - 45155 Research Pl Ste 140, Ashburn, VA 20147

How many nonmelanoma skin cancers require mohs micrographic surgery?


Dr. Mark L. Welch, MD - 8503 Arlington Blvd Ste 150, Fairfax, VA 22031

Utilization of a new tissue expander in the closure of a large mohs surgical defect.


Dr. Amir A. Bajoghli, MD - 1359 Beverly Rd Ste 200, McLean, VA 22101

Workforce characteristics of mohs surgery fellows.


Dr. Josephine C. Nguyen, MD - 8901 ROCKVILLE PIKE, Bethesda, MD 20889

Extramammary Paget's disease: surgical treatment with mohs micrographic surgery.


Dr. Ali Hendi, MD - 5454 Wisconsin Ave, Chevy Chase, MD 20815

Dermatofibrosarcoma protuberans of the vulva treated using mohs micrographic surgery.


Dr. Ali Hendi, MD - 5454 Wisconsin Ave, Chevy Chase, MD 20815

The use of a microscopic grid to localize tumor on sequential mohs micrographic surgery sections.


Dr. Kenneth W. Neal, MD - 611 S Carlin Springs Rd Ste 406, Arlington, VA 22204

mohs surgery for the treatment of melanoma in situ: a review.


Dr. Marianne E. Dawn, MD - 7671 Quarterfield Rd Ste 200, Glen Burnie, MD 21061

Simultaneous intraoperative mohs clearance and reconstruction for advanced cutaneous malignancies.


Dr. Peter C. Revenaugh, MD - 10755 Falls Rd Ste 110, Lutherville, MD 21093

Sterile versus nonsterile gloves during mohs micrographic surgery: infection rate is not affected.


Dr. Mary F. Farley, MD - 600 Ridgely Ave, Annapolis, MD 21401

mohs micrographic surgery for granular cell tumor using S-100 immunostain.


Dr. Mary F. Farley, MD - 600 Ridgely Ave, Annapolis, MD 21401

mohs micrographic surgery for melanoma: a case series, a comparative study of immunostains, an informative case report, and a unique mapping technique.


Dr. Mary F. Farley, MD - 600 Ridgely Ave, Annapolis, MD 21401

Guidelines of care for mohs micrographic surgery. American Academy of Dermatology.


Dr. John W. Skouge, MD - 1302 Bellona Ave, Lutherville Timonium, MD 21093

mohs micrographic surgery for the treatment of difficult skin cancers.


Dr. John W. Skouge, MD - 1302 Bellona Ave, Lutherville Timonium, MD 21093

mohs micrographic surgery.


Dr. John W. Skouge, MD - 1302 Bellona Ave, Lutherville Timonium, MD 21093

Recurrent and metastatic primary cutaneous mucinous carcinoma after excision and mohs micrographic surgery.


Dr. Allan C. Harrington, MD - 101 Ridgely Ave Ste 10, Annapolis, MD 21401

Utilization of mohs specimen as a sizing template in full-thickness skin grafts.


Dr. Allan C. Harrington, MD - 101 Ridgely Ave Ste 10, Annapolis, MD 21401

mohs micrographic surgery is accurate 95.1% of the time for melanoma in situ: a prospective study of 167 cases.


Dr. Natalie I. Bene, MD - 400 Pine Grove Commons, York, PA 17403

Advances in immunostains used in mohs surgery.


Dr. Donald R. Stranahan Jr., MD - 403 Marvel Ct, Easton, MD 21601

mohs needs a better look.


Dr. Michael A. Alexiou, MD - 2062 Pro Pointe Ln, Harrisonburg, VA 22801

Dense inflammation does not mask residual primary basal cell carcinoma during mohs micrographic surgery.


Dr. Elizabeth M. Billingsley, MD - 500 University Dr Ste 100, Hershey, PA 17033

Management of a hidradenoma with mohs micrographic surgery.


Dr. Klaus F. Helm, MD - 500 University Dr Ste 100, Hershey, PA 17033

How many sections are required to clear a tumor? Results from a web-based survey of margin thresholds in mohs micrographic surgery.


Dr. Todd V. Cartee, MD - 500 University Dr Ste 100, Hershey, PA 17033

Periorbital mohs Reconstruction: Characterization of Tumor Histology, Anatomic Location, and Factors Influencing Postoperative Complications.


Dr. Elizabeth M. Billingsley, MD - 500 University Dr Ste 100, Hershey, PA 17033

Periorbital mohs Reconstruction: Characterization of Tumor Histology, Anatomic Location, and Factors Influencing Postoperative Complications.


Dr. Christie T. Ammirati, MD - 500 University Dr, Hershey, PA 17033

Periorbital mohs Reconstruction: Characterization of Tumor Histology, Anatomic Location, and Factors Influencing Postoperative Complications.


Dr. Brett F. Michelotti, MD - 500 University Dr, Hershey, PA 17033

mohs Micrographic Surgery for Cutaneous Metastasis of Breast Cancer.


Dr. Elizabeth M. Billingsley, MD - 500 University Dr Ste 100, Hershey, PA 17033

mohs micrographic surgery for angiolymphoid hyperplasia with eosinophilia.


Dr. Michael D. Ioffreda, MD - 500 University Dr Ste 100, Hershey, PA 17033

mohs micrographic surgery for angiolymphoid hyperplasia with eosinophilia.


Dr. Christie T. Ammirati, MD - 500 University Dr, Hershey, PA 17033

An overview of mohs micrographic surgery for the treatment of basal cell carcinoma.


Dr. Christie T. Ammirati, MD - 500 University Dr, Hershey, PA 17033

mohs surgical extirpation of a basal cell carcinoma in a patient with familial multiple trichoepitheliomas.


Dr. Galen H. Fisher, MD - 7001 Forest Ave Ste 301, Richmond, VA 23230

Treatment options for squamous cell carcinoma of the dorsal hand including mohs micrographic surgery.


Dr. Clifford T. Hepper, MD - 5899 Bremo Rd Ste 100, Richmond, VA 23226

Suprascapular nerve injury during mohs surgery and review of the surgical anatomy of the nervous structures of the supraclavicular triangle.


Dr. Dawn E. Hirokawa, MD - 3710 Kennett Pike, Wilmington, DE 19807

mohs surgery. Vigilance for the weak link.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

mohs surgery and malignant melanoma.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Squamous-cell carcinoma treated by mohs' surgery: an experience with 414 cases in a period of 15 years.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

The fellowship in mohs' surgery: a personal experience.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Pseudoepitheliomatous hyperplasia following mohs micrographic surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Sebaceous carcinoma of the eyelid: treatment with mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Chemosurgical report: recurrence (persistence) of tumor following excision by mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Eccrine adenocarcinoma--report of a case, treatment with mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

The interaction between propranolol and epinephrine as observed in patients undergoing mohs' surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Chemosurgical report: a nongeometric approach to wound closure following mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

False-negative tumor-free margins following mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

mohs surgery report: spindle cell fibrohistiocytic tumors: classification and pathophysiology.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

mohs surgery report: design of an appropriate rhombic flap for a circular defect created by mohs microscopically controlled surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Chemosurgical report: indications for a geometric approach to wound closure following mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

Defect subdivision as a technique to repair defects following mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063

The principle of cosmetic junctions as applied to reconstruction of defects following mohs surgery.


Dr. Leonard M. Dzubow, MD - 101 Chesley Dr Ste 100, Media, PA 19063
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