Mohs surgery is a specialized technique for removing skin cancer by examining tissue layers under a microscope until all cancer cells are gone. Although the procedure has a high cure rate, successful outcomes rely heavily on careful post-operative care, particularly restricting physical activity. These strict limitations on exercise are necessary to ensure the wound heals properly, minimize scarring, and avoid serious complications. Understanding the biological reasons for these restrictions is key to a smooth recovery.
The Critical Role of Blood Flow and Wound Tension in Healing
Strenuous physical activity increases the heart rate and systemic blood pressure, directly impacting the delicate surgical site. This surge in blood pressure can disrupt newly formed clots and small blood vessels at the incision, leading to increased bleeding. Excessive bleeding that pools under the skin forms a hematoma, a collection of blood that separates the healing tissues.
A hematoma compromises wound repair and puts significant pressure on the incision, potentially leading to infection or tissue death (necrosis). Movement that stretches the skin near the incision places force on the sutures. This tension can cause the wound edges to separate, a complication known as dehiscence, resulting in delayed healing and a wider scar.
A newly closed wound is significantly weaker than normal skin, making it highly susceptible to these internal and external pressures. Limiting activity minimizes blood pooling and prevents mechanical stress that could pull the stitches apart. Proper rest allows the body to focus on establishing a strong, stable repair foundation.
Identifying High-Risk Movements and Activities
High-risk movement after Mohs surgery extends beyond a typical workout session and includes several common daily activities. Any activity that significantly raises the heart rate or causes facial flushing is prohibited. This includes vigorous cardiovascular activities such as running, high-intensity cycling, or intense aerobics.
Heavy lifting is a major concern because straining muscles and holding one’s breath instantly elevates systemic blood pressure. Surgeons advise against lifting anything heavier than 5 to 10 pounds (roughly a gallon of milk) to avoid this internal pressure spike. Activities requiring the head to be below the heart, such as bending or stooping, are problematic for facial surgical sites. This positioning increases pressure in the head and neck area, raising the risk of bleeding.
For surgeries on the torso or limbs, even seemingly harmless movements can apply excessive tension to the repair. Activities like certain yoga poses or swimming that involve broad stretching or significant use of a large muscle group near the wound should be temporarily avoided. The goal is to eliminate any action that pulls on the skin surrounding the incision.
Navigating the Post-Surgical Timeline for Activity
The initial 48 to 72 hours following Mohs surgery is the most sensitive period. Absolute rest and minimal movement are necessary to allow the initial healing cascade to begin. During this time, the body forms stable clots and begins the inflammatory phase of wound repair.
Activity restrictions remain until the stitches are removed and the surgeon evaluates the site, typically one to two weeks post-procedure. Light, non-strenuous activity, such as slow walking, may be permissible if it does not cause throbbing or tension at the wound. Rigorous exercise and heavy lifting must be avoided until the repair gains more tensile strength.
When the surgeon gives clearance to resume a normal routine, the return to full activity must be gradual. Exercise should be reintroduced slowly, perhaps starting at 25 percent of the usual intensity and progressively increasing over several weeks. A full return often takes six weeks or longer. Patients should immediately stop any activity that causes warning signs, such as increased pain, throbbing, or new bleeding, as these indicate the healing wound is being overtaxed.