Mohs surgery is a precise method for removing skin cancer, particularly beneficial for delicate areas like the nose due to its ability to preserve healthy tissue. This technique involves removing thin layers of cancerous tissue and examining each layer under a microscope until all cancer cells are gone. Because of the nose’s prominent location and intricate structure, recovery from Mohs surgery in this area has specific considerations. Understanding the healing process can help manage expectations and promote a smoother recovery.
Immediate Post-Surgery Experience
Immediately after Mohs surgery on the nose, a pressure dressing will be applied to minimize bleeding and reduce swelling. Patients can expect mild to moderate discomfort, which is often manageable. Swelling and bruising are common reactions, typically peaking within 24 to 72 hours. Some patients might also experience temporary numbness around the surgical site.
Wound Care and Recovery
Proper wound care is fundamental for preventing infection and encouraging optimal healing. Your medical team will provide specific instructions, which generally involve keeping the wound clean and dry. This often includes gently cleansing the area with mild soap and water after 24 to 48 hours, then carefully patting it dry. After cleaning, applying a thin layer of petroleum jelly or an antibiotic ointment, if prescribed, helps keep the wound moist and prevents scab formation, which can hinder healing. The wound should then be covered with a fresh, non-stick dressing, secured with paper tape.
Pain after Mohs surgery is typically mild to moderate and can be managed with over-the-counter pain relievers like acetaminophen. Applying cold compresses to the surgical site for 15-20 minutes at a time, several times daily, can help reduce swelling and discomfort. Elevating your head, especially while sleeping with extra pillows, can also minimize swelling, particularly around the eyes if surgery was on the upper nose.
To prevent complications and support healing, avoid certain activities. Limit strenuous physical activity, heavy lifting, and excessive bending for at least seven days, or as advised by your doctor, to reduce bleeding and wound disruption. Also avoid forcefully blowing your nose, especially if a skin graft was placed. Refrain from swimming pools, hot tubs, and soaking the wound until fully healed to prevent infection.
Healing Timeline and Appearance
The healing process after Mohs surgery on the nose progresses through several stages, with the appearance of the wound changing over time. In the first one to two weeks, you can expect continued swelling and some bruising, though these should gradually subside. A scab will likely form over the wound; avoid picking it, as this can interfere with healing and increase scarring.
By three to four weeks, new skin begins to form, and the scab naturally falls off, revealing pink tissue. Over the next few months, the surgical site improves as scar tissue remodels and softens. While initial healing takes four to six weeks, complete scar maturation and blending with surrounding skin can take up to a year or longer.
The final scar appearance is influenced by the initial cancer size and location, individual healing characteristics, and diligent wound care. Sun protection is crucial for long-term scar care. Apply sunscreen with an SPF of 30 or higher and wear a wide-brimmed hat after the wound has healed to prevent discoloration and promote better scar appearance.
When to Contact Your Doctor
While some discomfort, swelling, and bruising are expected after Mohs surgery, certain signs indicate potential complications that warrant prompt medical attention. You should contact your doctor if you experience increasing pain that is not relieved by medication, or if the pain becomes severe. Spreading redness, warmth, or increased swelling around the surgical site, especially if accompanied by pus or a foul-smelling discharge, could signal an infection.
A fever, particularly if it is persistent, is another important symptom to report. While minor bleeding or oozing is common, excessive bleeding that soaks through dressings and does not stop after applying firm pressure for 20 minutes should be reported immediately. Any new or worsening numbness, or changes in sensation beyond the initial post-operative period, also warrants a call to your healthcare provider.