Mohs Surgery

October 7, 2025

This page was reviewed under our medical and editorial policy by Gaurav Singh, M.D., assistant clinical professor, Department of Surgery, City of Hope® Cancer Center Chicago

Mohs surgery is the most effective way to treat certain skin cancers, with up to a 99% cure rate. Named after Dr. Frederic Mohs, the physician who developed the procedure in the 1930s, it’s also referred to as Mohs micrographic surgery. Mohs surgery is performed by surgeons with highly specialized training in the procedure.

What Skin Cancers Does It Treat?

Mohs surgery effectively treats many different types of skin cancer, and is most often utilized for patients with basal cell carcinoma or squamous cell carcinoma. This is in part because these types of skin cancer are the most common cancers, and more commonly occur in areas of the body with skin tissue that is delicate and/or cosmetically sensitive, including: 

• The face (eyelids, lips, ears and nose)
• The head and scalp
• The mouth and lips
• The genitals
• Fingers and toes
• Shins 

Mohs surgery can also be performed to treat melanoma and other less common types of skin cancer, including atypical fibroxanthoma, sarcomas such as dermatofibrosarcoma protuberans, extramammary Paget’s disease and others.

What Is Mohs Surgery?

Mohs surgery is a surgical procedure that removes 100% of a patient’s skin cancer while preserving as much of the normal tissue as possible. This is performed by cutting around and below the cancer to remove a disc of tissue with the smallest possible margin and saving a maximum amount of normal skin. 

This skin is processed and examined under a microscope in real time to determine whether additional cuts are necessary. The surgery is complete when microscopy confirms that the tumor has been entirely removed. 

Mohs surgery is performed under local anesthesia by a highly trained surgeon. It includes the following steps.

• The Mohs surgeon examines the visible part of the skin cancer lesion, and then surgically removes the skin cancer.
• The Mohs surgeon is also a pathologist and examines tissue under the microscope to determine whether additional cuts are necessary.
• If the tissue does contain cancer cells, additional skin is removed only where the cancer is seen under the microscope, allowing for maximum preservation of normal skin. This new sample is then examined under the microscope for the presence of cancer.
• This process is repeated until a disc of tissue is removed that does not contain any cancer cells.
• Reconstructive surgery is then performed to create the smallest possible scar.

Who Performs Mohs Surgery?

Mohs surgery is performed by a trained surgeon — a doctor who specializes in treating cancer using a variety of surgical techniques. Many surgical oncologists who treat skin cancer also complete specialized fellowships that train them to effectively and accurately perform Mohs micrographic surgery. 

Other experts that may be involved with Mohs surgeries include pathologists, who have expertise in examining tissue samples for signs of cancer, and plastic or reconstructive surgeons, who specialize in procedures that can help manage changes to the body’s appearance and function after a cancer surgery. 

Mohs Surgery Versus Excision 

Mohs surgery is a common treatment option for basal cell carcinoma and squamous cell carcinoma. Another is a procedure called a wide local excision. The main differences between the two are that:

• Wide local excision removes a wider and deeper amount of tissue than a Mohs surgery. This results in a much larger scar.
• Mohs surgery fully examines the pathologic margins, compared to 1% of the margin examined by traditional excision.
• Mohs surgery has a cure rate of 99%, while cure rates are lower for wide local excision.
• Wide local excision may be more cost-effective 

When determining which option may be best for their patients, doctors take into account a number of factors, including the location and size of the skin cancer and the individual patient’s overall goals and health.

Mohs Surgery Recovery

In most cases, recovery from Mohs surgery involves resting at home and following the recommendations provided by the cancer care team. After Mohs surgery, patients should:

• Follow their doctor’s guidelines for how to clean their wound and apply bandages or any medicines that are prescribed to help with the healing process
• Ensure they have over-the-counter pain medicine, in case they experience any soreness at the site of the wound
• Attend any appointments that they have with their cancer care team to remove stitches or monitor how well the wound is healing
• Work with their cancer care team to create a plan to screen for new or recurrent skin cancers

Patients who undergo Mohs surgery may return to work the day after the procedure. Wound care typically persists for a few weeks, and final scar formation takes a full year.

Risks

There are very few serious risks associated with Mohs surgery. But as with any surgical procedure, there are some risks that patients should be aware of. These include:

• Infection at the site of the wound
• Loss of blood during surgery
• Problems with a wound healing or scarring
• Damage to the nerves around the site of the wound (neuropathy)
• Return of the cancer (recurrence)