Mohs surgery is a precise and effective treatment method for certain skin cancers. This procedure involves removing thin layers of skin containing cancer cells until no cancer remains, aiming to preserve as much healthy tissue as possible. Understanding the recovery process can help patients feel prepared and confident in managing their post-operative care.
Immediate Aftermath
Immediately following Mohs surgery, the surgical site will be addressed, often with a method of wound closure such as direct closure, a skin flap, or a skin graft. In some cases, the wound may be left open to heal naturally. An initial dressing will be applied to the area to protect the wound and help prevent bleeding in the immediate post-operative period. Patients typically experience some initial sensations like numbness, mild pressure, and possibly minor bleeding or oozing from the wound.
Wound Care and Recovery
Patients are usually instructed to change dressings once or twice daily after an initial period, often 24 to 48 hours, keeping the wound covered and moist. Cleaning the wound involves gently washing with mild soap and water to remove any drainage or crusting, then patting it dry. Applying a generous layer of ointment like Polysporin, Vaseline, or Aquaphor helps keep the wound moist, which supports optimal healing and can minimize scarring.
Activity restrictions are in place to prevent tension on the surgical site and promote healing. Strenuous exercise, heavy lifting, excessive bending, or stretching of the surgical area should be avoided for a period, typically one to two weeks, as these activities can increase the risk of bleeding or wound separation. Showering is generally permitted the morning after surgery, but prolonged soaking of the wound in baths or swimming is often restricted until sutures are removed or the wound is fully closed to minimize infection risk. The initial healing timeline can vary, with smaller wounds potentially healing in 4-6 weeks, while larger or complex sites might take 8-10 weeks.
Managing Discomfort and Potential Issues
After Mohs surgery, it is common to experience mild to moderate pain, which can typically be managed with over-the-counter pain relievers such as acetaminophen or ibuprofen. Swelling and bruising around the surgical site are also expected, often peaking within the first few days post-procedure. Applying cold compresses for 10-15 minutes at a time can help alleviate swelling and discomfort.
It is important to monitor the wound for signs that could indicate a complication. Symptoms of infection include increasing redness, warmth, tenderness, pus-like discharge, a foul odor, or fever. While some oozing is normal, persistent bleeding that soaks through dressings and does not stop with direct pressure requires medical attention. Allergic reactions to dressing materials or topical ointments can also occur, manifesting as increased itching, rash, or redness beyond the wound area. Contacting the surgeon’s office immediately is recommended if any concerning symptoms develop.
Long-Term Healing and Scarring
The appearance of a Mohs surgery scar evolves over time, with complete maturation typically taking several months to a year or more. Initially, the scar may appear red or raised, but it generally flattens and fades over this period as new blood vessels support the healing process and collagen remodels. Techniques for scar optimization can be started once the wound is fully closed.
Gentle massage of the scar with lotion or oil can help improve blood flow and soften the scar tissue. Additionally, silicone sheets or gels can be applied to create a hydrating barrier, which may reduce redness and thickness of the scar. Protecting the healing scar from sun exposure is important to prevent hyperpigmentation and improve its cosmetic outcome, often requiring sunscreen with SPF 30 or higher. Follow-up appointments with the dermatologist are important for continued skin cancer surveillance and to address any concerns regarding scar appearance.