How to Mitigate Scarring Related to Mohs Surgery

Posted on: 6 March 2017

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Were you just diagnosed with skin cancer? If so, your dermatologist may have recommended Mohs surgery. This surgery was created by Dr. Frederic Mohs and, today, has an amazing success rate: the American College of Mohs Surgery (ACMS) says that the cure rate is between 95% and 99%.

The surgery itself is fairly short, and your dermatologist will remove thin layers of the cancer until only healthy tissue remains. But even though this procedure only mildly disturbs your surrounding skin compared to other options, you may be worried about scarring. There are things you can do during your recovery period and after to improve your skin's appearance.

What you can do immediately after surgery to mitigate scar tissue

Before you go in for Mohs surgery, you should ask your dermatologist for a list of dos and don'ts. After a treatment, your dermatologist will apply a pressure dressing. This bandage should be left over the wound for at least a day or longer depending on your doctor's instructions.

After you get the go-ahead to remove the bandage, you'll need to follow a daily regimen to encourage healing and reduce scarring. This may include

  1. Cleaning and rinsing the surrounding area (not the wound itself) with gauze, warm water, and a gentle soap recommended by your doctor.

  2. Drying the area thoroughly with gauze

  3. Washing your hands with soap and water, and then drying them before applying petroleum jelly directly to the wound.

  4. Replacing your old bandage with non-stick gauze (this is important since some material could get stuck in the wound and pull new skin off when the dressing is changed) and covering the gauze with a bandage.

During this time you may be tempted to leave your wound open—after all, oxygen is good for healing right? However, this will actually impair healing and cause a scab to form, thus increasing the possibility of scar tissue.

While some swelling and bruising is normal after surgery, you should call your dermatologist if it doesn't go down within a couple days. You will need to keep the surgical site elevated to reduce inflammation during this time. As long as your wound is covered, you can also ice the area to reduce swelling and mitigate scarring.

What you can do if you still have scarring, even after following doctor's orders

Even if you follow instructions to the letter, some scarring may occur anyway. You should talk to your dermatologist; he or she may recommend

  • laser resurfacing, where a laser dissolves damaged skin cell layers until underlying ones are more uniform in appearance

  • dermabrasion, where the skin is "sanded" down to even out the texture and encourage new skin growth

  • intralesional injections, where a corticosteriod is injected into the scar tissue to break it up and reduce inflammation

  • subcision (a minor surgery), where the skin is punctured with a needle to break up scar tissue that is more severe

Even after you have one of these treatments, your skin may still be a bit rough and swollen as new layers comes to the surface. Ultimately, patience will be your ally as your scarring heals. It may take many months after Mohs surgery for your skin to fully heal, and more time after that should you pursue a second treatment for the scarring. Talk to a dermatologist like those at East Carolina Dermatology and Skin Surgery, PLLC for more information about Mohs surgery and ways to prevent scarring.