I had permanent stitches for Mohs on my nose. At 6 weeks, stitches are exposed. Is this common and could it cause infection?

Question

I had Mohs on the bridge of my nose almost 2 months ago. The surgeon used permanent stitches under the skin. I have had the permanent stitches trimmed once already when they were sticking out from under my skin, but I can see and feel them sticking out again now. Could exposed permanent stitches pose an increased risk of infection? What can I do other than going back to have the ends trimmed off again? Is it common practice to use permanent stitches for Mohs on the nose?

Raffy Karamanoukian, MD, FACS · Answer

Moh’s surgery on the face often requires surgical repair and reconstruction to reapproximate the skin edges. Flaps or direct closure techniques are used. It is important that you optimize scar healing during this phase in order to reduce longterm scars. For red scars, we use Vbeam laser, followed by fractional laser for scar topography and contour. We recommend Plato’s Scar Serum twice daily for the immediate postoperative period. Fractional laser is safe for scar laser therapy. 
There are treatments for swelling and edema of the scars. If there is residual sutures or edema, we advise you to follow a scar treatment protocol that can minimize the time to recovery. Our office specializes in scar revisions for Moh’s surgery. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

John Louis Ratz, MD · Answer

It is almost universal to use permanent stitches to sew the skin edges together with the knot exposed for easy removal. I'm assuming the knots in your stitches are buried. This is very unusual. You need to speak to your Mohs surgeon about the reasoning behind doing this, and ask how it can be corrected. Good luck.              jlr

F. Victor Rueckl, MD (in memoriam) · Answer

There are times when the skin simply doesn't like the permanent stitches and works them to the surface continually. You will need to have these either removed entirely OR at least trimmed each time it happens. Because yes, it could cause an infection as the stitches themselves once surfaced can hold onto bacteria and bother the skin even more. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

I had permanent stitches for Mohs on my nose. At 6 weeks, stitches are exposed. Is this common and could it cause infection?

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I had permanent stitches for Mohs on my nose. At 6 weeks, stitches are exposed. Is this common and could it cause infection?

Answers (3)

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Recommended reading

Everything you need to know about Mohs Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.