Mohs Surgery Recovery

What is the typical recovery and downtime from Mohs surgery? What should I expect for after care needs?

Doctor Answers 26

Wound healing after Mohs and reconstructive surgery

Typical recovery depends on the location of the cancer, the size of the defect, what type of reconstruction was required, and whether there are any complicating factors. Most of our patients return the day after surgery at which time the pressure bandage is removed the surgery site evaluated. After that the patient cleans the site twice daily with hydrogen peroxide; applies and antibiotic salve and a non-stick bandage. Sutures are removed for most sites at a week, and by then the site tends to be healing quite well. However, I tell patients that it takes a full 6-12 months to get the final cosmetic result after surgery, during which time we have them use sunscreens and possibly topical silicone gels to further improve the final result.

Los Angeles Dermatologic Surgeon
4.5 out of 5 stars 13 reviews

Expectations after Mohs

Depending on the location and extent of your cancer, you can expect swelling and bruising, tenderness and tightness.  I tend to have patients wear a bandage for 7 days after surgery and most wounds require some sort of wound care for 2-3 weeks.  Depending on the type of reconstruction after the cancer is removed by Mohs, you may have lumpiness or bumps from tissue redundancy or dissolvable sutures for 3-5 weeks after surgery.  Generally you can expect soreness for 24-48 hours, but most patients are surprised that the surgical site is less tender than they expected.  One of the best things you can expect after Mohs is a smaller wound defect and higher cure rate compared to any other surgical method used to treat skin cancers.  

Michael Howard Swann, MD
Springfield Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Plan for Mohs surgery aftercare

• Your surgical wound will require care during the weeks following the surgery.

• You should plan on wearing a bandage for 10-14 days.

• Plan to avoid strenuous physical activity for 2 weeks.

• You may experience a sensation of tightness across the area of your surgery that improves with time.

• Skin cancers frequently involve small superficial nerves, and months may pass before your skin sensation returns to normal. A numb sensation may be expected over the area. This is common and usually expected, but typically will return to normal with time. In very rare instances, the numbness may be permanent.

• Complete healing of the scar takes place over 3-12 months.

• During the first few months the site may feel “thick, swollen or lumpy”, and there may be some redness. Gentle massage of the area (starting about one month after your surgery and excluding grafts) will speed the healing process.

• The defect created by the removal of the skin cancer may be larger than anticipated. There is no way to predict prior to surgery the exact size of the final defect.

• There will be a scar at the site of removal. Unfortunately, there is no way to remove a skin cancer without some degree of scarring. However, having your scar look as small and as good as possible after cancer removal is important to the Mohs surgeon as well. Every effort is made to obtain optimal cosmetic results, but the primary goal is to remove the entire tumor. Again, Mohs surgery will leave you with the smallest wound, thus creating the best opportunity for optimal cosmetic results.

• There is a small chance that your tumor may re-grow after surgery. Previously treated tumors and large, longstanding tumors have the greatest chance of recurrence.

Chad L. Prather, MD
Baton Rouge Dermatologic Surgeon

Mohs surgery recovery

Your recovery after your Mohs surgery will be a function of whether surgical defect is allowed to heal on its own or whether it is stitched. Stitches on the face will result in a suture removal in approximately 5 to 7 days. After this time, the area should be closed and well on its way to healing. It will be safe to apply makeup, sunscreen, etc at this time and there will be no need for bandages. If it is allowed to heal on its own (no stitches) it may take anywhere from 3 to 5 weeks and will need to be covered with Vaseline and a bandage. FYI a large head-to-head study of Vaseline versus antibiotic ointment showed similar infection rates however the people using the antibiotic ointment developed an allergic reaction approximately 15% of the time. Therefore, there is no advantage to antibiotic ointment over pure petrolatum ointment

Shawn Allen, MD
Boulder Dermatologist
5.0 out of 5 stars 1 review

Mohs Recovery

Wound healing after Mohs surgery can be quite variable depending on the location, size of the defect, and type of repair. Typically, my younger patients are anxious to return to their jobs the next day which is appropriate in most cases; however, I let them know that they will have a fair amount of swelling/bruising and will need to wear a bandage for at least a week. The majority of swelling does subside significantly within the first week after surgery. A pre-operative consult with your Mohs surgeon can give you a better idea of the type of recovery, scar and healing you can expect for your individual skin cancer and treatment.

Mary Alice Mina, MD
Atlanta Dermatologic Surgeon

Plain vaseline or Aquaphor may be preferable for wound care to minimize allergy

More and more dermatologic surgeons are moving to just plain vaseline or Aquaphor for post-op wound care as there is significant prevalence of allergy to neomycin, bacitracin and/or polysporin. Sometimes it may not be easy to distinguish wound infection vs. allergic reaction to topical antibiotics. The hallmark of infection is pain and the hallmark for allergic reaction is itching. Prophylactic oral antibiotics may not always be necessary; however if one experiences pain in surgery site after first 3-4 days, you should call your Mohs surgeon for consideration of oral antibiotics and re-evaluation to rule out post-op infection or hematoma (entrapment of blood drainage).

William Ting, MD
Bay Area Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Many factors contribute to your recovery

Your recovery all depends on the location of the surgery, the extent of the removal and size of the defect prior to closure, the amount of tension and the type of closure. Swelling is more likely to occur around the eyes, as well as bruising. Lips tend to swell also. Ears may be more painful postoperatively than other sites. Usually within two to four weeks, the closure begins to look more presentable, but again, this all depends on the factors mentioned previously.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 38 reviews

Although large skin cancers can be seen with the naked...

Although large skin cancers can be seen with the naked eye, it takes a microscope to visualize cancer at the cellular level. The only way to prevent recurrence of localized skin cancer is to remove each and every cell; otherwise any remaining skin cancer cells can reproduce and cause a regrowth of the cancer.

Mohs surgery is a specialized method to remove skin cancer. It is named in honor of Frederick Mohs, the physician who developed the technique. Mohs surgery differs from other methods of treating skin cancer by the use of detailed mapping techniques and onsite microscopic examination of the surgically removed skin. Mohs skin cancer surgery allows for the tissue to be examined during the operation through a microscope to ensure that all of the cancer cells have been removed adequately, and that removal of healthy, cancer-free tissue is minimized. Using the Mohs microscopic surgery technique there is a 95% cure rate.

Mohs skin cancer surgery is then followed by careful reconstructive surgery to repair the defect (hole) and to yield an aesthetically pleasing result.

Your recovery from MOHS surgery will depend on the extent and depth of the area that was removed and the method in which is was "closed". Larger areas may require that your surgeon create flaps of skin that are rotated or otherwise moved around to reposition or redrape the skin in order to close the area of the defect (the hole). In other instances, a graft of skin may need to be taken from another area of your body and sutured into place in order to cover the area. Sometimes the surgeon will create a "purse-string" to cinch the hole closed.

Your surgeon may cover the area with a bandage, a patch, a pressure dressing, or other type of dressing to prevent shearing forces, bleeding, fluid collection, or dirt in the wound. Sometimes, the area is only closed with a few stitches and recovery is no more complicated that applying antibiotic ointment, keeping the wound clean and dry, and avoiding sun.

Regardless of the extent of the surgery, you should not smoke or use nicotine which decreases oxygen supply to the wound and will impair healing. Depending on the area, stitches usually come out in 5-7 days on the face or eyelids, or 7-14 days on the torso or extremities.

For the long term, you should remember to apply broad coverage sunblock everyday (even if it's cloudy) and avoid sun exposure during peak hours (10am-2pm) to stave off more sun damage which could lead to future skin cancer.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 39 reviews

Recovery from Mohs

Recovery after your Mohs procedure depends on the location of your cancer, the extent of the cancer, the size of the surgical defect, and the type of reconstruction that was performed to repair your surgical defect. For example, a 1 cm defect on your cheek in front of your ear that was repaired with a linear closure may feel sore or throb the night after surgery but should feel fine the day afterwards. A big cancer on your forehead that needed a large flap will likely cause bruising and swelling around your eyes that may last a week and give you a major headache that night. You may need pain medication in that case.

The actual Mohs procedure uses precise microscopic margin control to remove your cancer with the best cure rate and the most narrow margins. Once the cancer is out, your Mohs surgeon will discuss the best repair option for you...this should give you the best cosmetic result and take into account your lifestyle and ability to care for your wound. You should leave with specific directions about how to care for your wound, what you will need, and emergency contact information for the physician. Most facial repairs will throb a bit the night after surgery and leave some swelling and/or bruising around the incision site. Any repair above the eyebrows will likely give you a black eye or two. Sutures are typically removed in 7 days and the scar will settle and mature and fade over the next 3-12 months. Repairs on the trunk and extremities may feel tighter, can also cause bruising and swelling and may require you to remain inactive while sutures are in place, about 2 weeks. Repairs on the leg are more likely to open up and become infected without the proper wound care and can take the longest to heal.

I like to see all my surgical patients 3 months post to make sure we are both happy with the outcome of the repair and see if any "tweaks" need to be done. I expect that at 3 months, most scars will have flattened out and be a little pink. That discoloration typically fades over the next few months and the scar should just blend and not be noticeable. It is important to have a trusting relationship with your surgeon, open communication, realistic expectations, and patience.

Carin Litani, MD
Wellesley Dermatologic Surgeon

Mohs Surgery Recovery

Hi, and thanks for your question. It's hard to say definitively what your experience will be without knowing more specific details such as the location, size and type of skin cancer that you have. The good news is, Mohs surgery is the least invasive and most effective treatment for most skin cancers, so your recovery should be quite manageable. After the skin cancer has been completely removed, your doctor will explain your options for healing and recovery. Depending on the extent and location of your Mohs surgery, your options may include natural healing (granulation), or stitching the wound together using either a side-to-side closure, skin flap, or graft. It's not uncommon to experience redness, swelling, and discomfort for a few days after the surgery around the surgical site. You may also find that your scar goes through many changes in appearance and texture as it heals. If your wound is allowed to heal naturally, you may be caring for the wound for a few weeks. If your surgical wound is closed with stitches, then you will likely be doing wound care for 7-10 days which is typically how long the stitches stay in before being removed. The complete healing process can take several months to up to a year. Good luck!

Alysa Herman, MD
Coral Gables Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.