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How Is Mohs Surgery Different from Traditional Excisional Procedures?

When you learn that the strange mole or growth on your skin is actually skin cancer, your first thought is probably “Cut it off.” However, simply excising the cancer may not be sufficient to cure it. You may need a special surgery called Mohs.



If you’ve been told that you have skin cancer, you have a lot of company. One in five women and men in the United States will develop skin cancer by age 70. Every hour, two people in the U.S. die from skin cancer. However, melanoma skin cancers detected at an early stage have a 5-year survival rate of 99%. 

When you received a diagnosis of skin cancer, that wasn’t the news you were hoping for. Whether it was caught during a routine screening, or you noticed changes on a mole or a new growth and sought help, the fact that you now have a diagnosis means that you have a good chance of actually curing your skin cancer.


At Central Utah Dermatology, our expert surgical dermatologists recommend two different types of treatment for skin cancer: excision or a specialized surgical procedure called Mohs micrographic surgery. We perform both in the safety and comfort of our Richfield, Utah, office.


When is Mohs the better choice, and how does it differ from excision? 


Excision is simple and fast

A traditional surgical excision is a relatively fast and simple procedure that removes your entire skin cancer. In addition to removing the cancer, we also remove a border of healthy skin, referred to as the “margin.” Removing the margin increases the chances that all skin cancer cells have been removed and the lesion won’t recur.


The skin cancer can be removed (i.e., excised) with a scalpel or razor. Sometimes, other methods, such as electrodesiccation or freezing are used. Excision is best for thin or uncomplicated skin cancers.


Only about 1% of the healthy tissue margins are microscopically examined for cancer cells. Excision is also more likely to leave a scar than Mohs surgery.


We may recommend excision when we detect a suspicious lesion during a screening. We then send the excised tissue to the lab for analysis. We contact you when the results are ready.


Mohs takes time, but usually cures

Mohs surgery is a highly specialized procedure, and dermatologists must undergo extensive training to perform it. Mohs has a very high cure rate: 99% for newly diagnosed lesions and  94% cure rate for recurrent lesions.


Unlike excision, Mohs isn’t fast. It’s a slow, step-by-step procedure that may take hours. Your dermatology surgeon removes a very thin slice of the tumor, one layer at a time. Once they reach skin level, they also remove a margin of healthy skin.


After removing each layer, your surgeon examines it under a microscope to determine whether any cancerous cells remain. The surgery continues until they reach an area where no cancer cells are evident in any of the tissue, including the margin.


Unlike excision, which only examines 1% of margin tissue for cancer cells, 100% of the margin is stained and examined during Mohs. Once your Mohs surgery is complete, you’re confident that not a single cell of cancer remains in the treatment site.


Mohs has grown in favor

Due to its high cure rate and to the fact that it leaves more healthy skin in place, resulting in smaller scars, Mohs is now performed on a greater variety of cancers. Although each individual’s needs may be different, we generally recommend Mohs for:

  • High-risk nonmelanoma cancers

  • Large cancers in low-risk areas

  • Cancers with uncertain borders

  • Recurrent cancers

  • Those that couldn’t be completely excised

  • Cancers with particular microscopic patterns

  • Cancers in scar tissue or inflamed areas


We also recommend Mohs for high-risk areas such as those on the:

  • Nose

  • Eyelids

  • Lips

  • Ears

  • Hands

  • Feet

  • Genitals


Because we examine each layer during the procedure itself, you don’t have to wait for results. In most cases, you may not even need stitches to close the wound. We may simply bandage the surgical site and give you aftercare instructions.


Find out if you’re a candidate for Mohs surgery to treat your skin cancer or book a skin cancer screening by contacting our Central Utah Dermatology office today. Call our friendly office team or use our online booking form

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