Slow Healing After Scalp Mohs Surgery

Regardless of having conventional surgery or Mohs surgery, some wounds on the convex part of the scalp do continue to break down and almost heal and then break down again. Eventually, many of these heal, but some need further treatment. If the wound extends down to the bone, it may not heal without further surgical reconstruction.  If it is infected, or colonized with significant amount of bacteria or yeast, without infection, it may not fully heal.  There are different ways of dealing with wounds. Moist wound care is often helpful with special compresses and antibiotic ointment (there are a few, but you should have your physician prescribe one as the over-the-counter ointments often cause allergic reactions on the skin if used for a many days continually). Sometimes the doctor needs to even inject the wound with medicine. If there is "proud flesh" which is granulation tissue, the protein and blood vessels create a moist red wound that rises over the skin surface and the skin edges can't migrate over the wound the heal it. In this case the wound is cauterized, often with a chemical in the office. Finally, if there is anything suspicious about the wound's appearance, cultures or even a biopsy to rule out residual cancer is worthwhile.

Any non healing wound should be check for cancer or infection with a biopsy. I would suggest seeing your surgeon 

Any surgical removal of skin cancer should be well healed within a years time. If your wound is not healing it is important to have your surgeon recheck this to make sure that there is no recurrence or residual tumor there.

You did not specify if he/she closed the wound or left it to heal in on its own (secondary intention).  Regardless, if it is not healed one year after the fact, something is probably wrong, and this should be brought to the attention of your original surgeon.

When I see wounds that don't heal over a year's time, I worry about a recurrent tumor.  It is very rare with Mohs to have a recurrence, but it does occasionally happen.