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Wound Care Instructions
Frequently Asked Questions
What side effects should I look for after Mohs surgery?
In most cases, Mohs surgery is a low-risk outpatient procedure. After surgery and reconstruction of the area, you may experience mild bleeding from the incision site, bruising, swelling, mild-to-moderate pain, and tenderness in the affected area. Any pain after Mohs surgery typically peaks 4-12 hours after the procedure and then gradually subsides over the following 3-4 days.
A combination of acetaminophen (Tylenol) and ibuprofen (Advil) taken together, at the same time, is recommended for pain. Worsening pain after four days is concerning and may indicate an infection.
We provide wound care instructions verbally and in writing. Additionally, we will call you during the day and the next day to follow up on your healing process after your Mohs surgery. Dr. Mario also tries to call all of his surgery patients at the end of the week to check on them. Most importantly, please do not hesitate to contact our office after any procedure; you are NOT bothering us to reach out. We would much rather have our patients reach out than have a problem and wait to contact us. Our surgery team provides a text number and a phone number. You may even call after hours and speak to Dr. Mario (just press “0” and ask the answering service to page Dr. Mario). We encourage it!
*Some patients should not take ibuprofen based on their other diseases. Patients with heart failure and chronic kidney disease are commonly advised not to take ibuprofen. Some patients on multiple blood-thinning medications (aspirin + Plavix, or aspirin + coumadin/Eliquis/etc.) will be advised not to take ibuprofen. If you have questions about this, please discuss them with Dr. Mario.
What happens after the skin cancer is removed?
After your Mohs skin cancer procedure, your doctor will immediately examine the wound and skin to determine the optimal way to manage the wound. Usually, that will mean suturing the wound closed. Sometimes, smaller wounds can heal without stitches. There is often no one correct answer, so frequently, it is decided after a discussion between Dr. Mario and the patient.
What should I avoid after Mohs surgery?
The healing time for areas without a lot of movements, such as the cheeks and forehead, is typically 1-2 weeks. For areas such as the arms that get more activity, typically, it is 2-3 weeks. For areas where there is a lot of movement (center of back, chest, or over a joint such as the shoulder or elbow), it can be 3-6 weeks.
Our advice is to ease back into regular activity slowly and then increase activity to higher levels if the wound feels okay. Basically, don’t rest for a week and then run a marathon on day eight after surgery. In most cases, you can return to work the next day. If your job is more physically demanding, we may recommend “light duty” during the healing period.
Will my hair grow back after Mohs surgery on the scalp?
The answer depends on a variety of factors. If the skin cancer goes deep and the wound is not sutured closed, the hair will likely NOT regrow. If it is sutured closed (sides of the wound are brought together), it likely WILL regrow. If a skin graft is required, then the hair will not regrow. If this concerns you, please ask Dr. Mario, and he can explain the options to you.
Is Mohs surgery more expensive than other treatments?
Mohs surgery is as cost-effective as standard skin cancer excision but with a higher cure rate and a smaller scar. With Mohs surgery, the doctor acts as both the surgeon and the pathologist (looks at the skin cancer under the microscope to make sure all of the cancer is out). An additional advantage is that you get the result (“all clear”) on the same day as the skin cancer removal. With a standard excision, the skin specimen is sent to an off-site laboratory, where the pathologist assesses it under the microscope. This can take up to one week.
One last factor to consider is that because the pathology result (“all clear”) happens on the same day with Mohs, more complex reconstructive surgery techniques such as skin flaps and grafts can be employed to close the wound after cancer removal.
Some doctors and plastic surgeons will use these techniques to close the incision before getting the result (“all clear”) from the pathology lab. This is dangerous for the patient because if they have to go back to remove more skin cancer because the result is positive, the orientation of the skin cancer will be lost due to the flap or graft. In this scenario, it is best to ask for a referral for a Mohs surgeon immediately.
Does health insurance cover Mohs?
Almost all insurances will cover the cost of Mohs surgery for skin cancer treatment. Some less common skin tumors may not be covered by insurance, but the most common ones, squamous cell carcinoma, and basal cell carcinoma, are covered.