Why Mohs Surgery Has the Highest Cure Rate for Skin Cancer

If you've been told you have a skin cancer on your face, you've probably heard the words "Mohs surgery." It can sound intimidating, but the procedure has been refined over more than 80 years to do one thing better than anything else: cure skin cancer while removing the smallest amount of healthy tissue possible.

How standard excision works

In a traditional excision, the dermatologist takes a tumor with a margin of healthy-looking tissue around it, sends it to a pathology lab, and waits 5–7 days for results. The pathologist slices the specimen at a few intervals — covering roughly 1% of the actual tumor edge — and reports whether the visible margins are clear.

If the report comes back with positive margins, you go back for another excision a week or two later.

How Mohs is different

In Mohs, a board-certified physician (who is both surgeon and pathologist for that day) takes a thin, oriented layer of tissue, processes it on-site within an hour, and personally reviews 100% of the deep and lateral margins under the microscope. If any cancer cells are seen, the surgeon takes another precise layer in only that location — sparing healthy tissue everywhere else. They repeat until the margins are clear, then close the wound the same day.

The reason cure rates jump to ~99% (vs. 90–95% with excision) is that you can't catch what you don't look at. Mohs looks at all of it.

When Mohs is the right choice

The recognized indications include:

• Skin cancer on the face, ears, lips, eyelids, scalp
• Skin cancer on the hands, feet, or genitals
• Recurrent skin cancers
• Aggressive subtypes (sclerosing/morpheaform basal cell, infiltrative SCC)
• Tumors > 2 cm
• Patients who are immunosuppressed

For trunk and limb skin cancers in cosmetically less-critical areas, standard excision is often appropriate.

What it's like as a patient

Most patients are surprised by how undramatic the day is. You're awake the whole time, on local anesthesia. You wait in our office between layers — typically 1–2 layers, each followed by 30–60 minutes of microscope work. The closure is done the same day. You go home with a small dressing and instructions in your preferred language.

Most patients return to office work within 1–3 days.

Bottom line

Mohs surgery is the most effective skin cancer treatment we have for the right indications. If your dermatologist recommends it, that's why. And if you have a skin cancer on a face or other critical area and Mohs hasn't been mentioned, ask.