Mohs Micrographic Surgery

What are the 3 most common types of skin cancer?

The 3 most common types of skin cancer are: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma.

Basal Cell Carcinoma is the most common and least invasive type of skin cancer. It grows at a slower rate and rarely spreads to other parts of the body. They commonly look like open sores, red patches, shiny bumps, pink growths, or scars.

Squamous Cell Carcinoma, the second most common type of skin cancer, can grow more quickly and spread to other parts of the body, internally. They often look like rough red patches, open sores, warts or elevated growths with a central depression. They also may crust over or bleed.

The third most common, and potentially life threatening type of skin cancer, is Melanoma.  According to the Skin Cancer Foundation, Melanoma kills an estimated 10,130 people in the US every year. Although it is not the most common type of skin cancer, it causes the most deaths. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue or white.

Melanoma Warning Signs

The American Academy of Dermatology uses the acronym ABCDE to recognize a melanoma—any time you notice a new mole or that an old mole is starting to look different, look for these signs:

  1. Asymmetry – Melanoma lesions are often irregular/not symmetrical in shape.
  2. Border – They usually have irregular borders that are difficult to define.
  3. Color – Look for the presence of more than one color (blue, black, brown, tan, etc.) or the uneven distribution of color.
  4. Diameter – They are often greater than 6 millimeters in diameter (approximately the size of a pencil eraser).
  5. Evolution – The evolution of your mole(s) has become the most important factor to consider when it comes to diagnosing a melanoma. Knowing what is normal for YOU could save your life. If a mole has gone through recent changes in color and/or size, bring it to the attention of a dermatologist immediately.

Please note that not all melanomas fall within the ABCDE parameters so visit your dermatologist regularly to catch any potential issues early. Contact us today at our Sebring or Winter Haven location to schedule your yearly skin exam, or to have us examine and monitor any concerning moles you may have.

How do you treat skin cancer?

There are several treatments for skin cancer. Each treatment depends on the type, location, and size of the skin cancer, and whether any previous treatments have already been used.

The different types of skin cancer treatment available are:

  • Shave Removal
  • Surgical Removal
  • Curettage and Electrodessication
  • Cryo Therapy
  • Mohs Micrographic Surgery

Many of these treatments have high cure rates, but Mohs has the highest, especially for the most difficult tumors.

What is Mohs Micrographic Surgery?

Mohs Micrographic Surgery is a tissue-sparing surgical treatment that is done in multiple steps and offers a very high cure rate for skin cancer. With a success rate of up to 99%, it has the highest success rate of all skin cancer treatments.

In order to preserve surrounding healthy tissue, the surgeon removes the skin cancer layer by layer. Each layer is examined under a microscope until the tissue around the tumor is healthy and cancer-free. Mohs surgery enables surgeons to identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed.  The precision of Mohs typically results in smaller scars than traditional excision procedures.

The procedure is performed in multiple steps on an outpatient basis:

  1. A local anesthetic (usually Lidocaine) is injected around the surgical site.
  2. The lesion is then surgically removed so that the surface underneath and edges can be microscopically examined.
  3. The tissue is cut, dyed and put on microscopic slides, and a map of the tumor is drawn so that any cancer cells that are found can be located on a microscopic level.
  4. The Mohs surgeon examines the slides under a microscope to look for cancer cells.
  5. More tissue is removed and examined until all of the cancer cells are gone.
  6. Once all cancer cells have been removed, the surgeon may close the area with sutures, flaps or grafts.

Fellowship-trained Mohs surgeons are trained in reconstructive techniques designed to reduce or even eliminate the appearance of scars using skin flaps, skin grafts, and other approaches.

Dr. Alex W. Kennon, here at Lakeside Dermatology, is a Board Certified Dermatologist and Fellowship-trained Mohs Surgeon.

What should you expect on the day of surgery?

When you arrive to our office, you will need to sign in and complete the check in process. Then you will be taken to an exam room where the area of the skin cancer that is to be removed will be injected with a local anesthetic and numbed. Dr. Kennon will then remove a thin layer of the tumor and any bleeding will be stopped with an electric cautery machine. You will then be bandaged and moved back into the waiting room where you can watch TV, read, or use whatever electronic device you brought to pass the time. While you wait, the tissue that was removed will be taken to our in-house lab where it will be cut, dyed and made into microscopic slides. These processes can take around an hour or more to complete. If examination under the microscope shows that that the tissue still has cancer cells, the procedure will need to be repeated. More tissue will be taken only from where cancer cells are found. While we strive to remove only the tissue where the cancer cells are present, sometimes they can grow deep and develop roots beyond what you can see, causing the final size to be larger than the initial excision. It usually requires one to three sessions before the skin cancer is removed completely. These sessions are completed in the same day. Once all cancer cells have been removed, the wound will either be bandaged and left to heal or it may be closed with sutures, flaps or grafts.

How should you prepare for surgery?

Continue to take your usual medication unless otherwise directed. Eliminate aspirin or any medication containing aspirin (ex: Bufferin, Anacin, etc.) two weeks prior to the surgery. Three days prior to surgery stop any medication containing ibuprofen (ex: Advil, Nuprin, Motrin, etc.) If you need something for pain, take acetaminophen (ex: Tylenol).

Make sure to try to have a good night’s sleep and eat a light breakfast. If possible, wear a shirt that buttons down the front. If the surgery is to be performed on the face, do not wear makeup or jewelry. Make sure to bring a good book, magazine, tablet, iPad or other electronic device with you. You will be spending a large amount of time waiting while the slides are prepared and examined.

Once the processes are complete and depending on the size and location of the wound, it will either be bandaged and allowed to heal on its own or will need to be repaired with sutures or even a skin graft or flap.  If left to heal on its own, you will need to keep the area clean and change the bandage daily for 3 to 6 weeks.  If the wound is closed with sutures, skin grafts or flaps, you should keep the area clean and dry until your next visit. 

Surgery Reminder List

What should you expect after surgery?

Most patients experience some discomfort or slight pain, swelling, drainage, redness and occasionally some bleeding. This is common and nothing to worry about. For the pain/discomfort, take Tylenol (as directed). For swelling you can use an ice pack. Redness will disappear eventually but if it becomes very red and itchy, you may be allergic to the bandage tape or ointment. If this occurs, or you have any other concerns, please call our office at (863) 659-4201 in Sebring and (863) 845-1551 in Winter Haven. Drainage for the first week or two is normal but if a thick, bad smelling fluid comes out of the wound, call our office. You may need an antibiotic. Some bleeding is normal, but if it starts bleeding through the bandages, place a steady but firm pressure over the wound for 20 complete minutes. Do not lift the bandage to see if it has stopped bleeding until after the full 20 minutes has lapsed. If it is still bleeding, repeat for an additional 20 minutes. If it continues after 40 minutes of steady, firm pressure, call the office (if still during office hours) or go to the nearest emergency room.

During the healing process you may have some itching, tightness, drawing and numbness to the area. This is completely normal. To relieve some of these symptoms you can rub a small amount of petroleum jelly or Mederma on the scar tissue. Scars are unavoidable, but if you receive a scar that is unacceptable, surgical scar revision may be considered. This can be done by a plastic surgeon.  We would advise you to wait 1 full year before having this done. It can take up to a full year or more for the scar to improve completely.

What should you do about future skin cancer?

Now that you have had skin cancer, it is very important to have your skin checked every 6 to 12 months, or sooner.  Even though most of the damage that causes skin cancer was done before you were 20, it is always important to protect your skin from further sun damage.  You can do this by applying sunscreen to all exposed skin, even your ears, and by wearing a broad brimmed hat and protective clothing. Apply sunscreen 30 minutes before you go outside to allow the ingredients to bind to the skin, and reapply every 2 to 4 hours.

Contact Lakeside Dermatology today at our Sebring or Winter Haven office to schedule your appointment.

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Our Locations

Hours of Operation

We are closed for lunch from 1:00 pm to 1:30 pm.

Sebring, FL

Monday:

8:00 am-4:00 pm

Tuesday:

8:00 am-4:00 pm

Wednesday:

8:00 am-4:00 pm

Thursday:

8:00 am-4:00 pm

Friday:

8:00 am-12:00 pm

Saturday:

Closed

Sunday:

Closed

Winter Haven, FL

Monday:

8:00 am-4:00 pm

Tuesday:

8:00 am-4:00 pm

Wednesday:

8:00 am-4:00 pm

Thursday:

8:00 am-4:00 pm

Friday:

8:00 am-11:00 am

Saturday:

Closed

Sunday:

Closed