Mohs procedure for basal cell cancer on my scalp - which procedure would be best?

Question

I have a small pea size basil cell cancer on my scalp and my dermatologist suggested Mohs surgery on it. A friend said she just had hers excised instead. Which procedure would be better? I have long hair and don't want a bald spot.

Salar Hazany MD, FACMS · Answer

For scalp BCCs, Mohs surgery is often recommended because it has the highest cure rate and removes the least amount of healthy tissue. That’s especially important on the scalp, where taking extra tissue can mean a more noticeable bald spot. Standard excision can work for low-risk tumors, but it uses fixed margins, which can sometimes remove more hair-bearing tissue than necessary.
That said, technique matters a lot. Some surgeons are very experienced with scalp repairs and use methods that help preserve surrounding hair follicles and position scars so they’re better hidden by your hair. For a small lesion, that can make a big difference cosmetically.
If avoiding a bald spot is your main concern, I’d ask your surgeon about their experience with scalp closures and hair preservation&mdash;because that can impact your outcome just as much as the procedure itself.

Mohs procedure for basal cell cancer on my scalp - which procedure would be best?

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