Which is better as a skin cancer treatment: traditional excision surgery or Mohs surgery? Naples’ Skin Wellness Physicians team explains that no matter the approach, it’s first important to understand that skin cancer is one of the most common forms of cancer today, affecting millions of individuals each year. With this in mind, early detection and treatment are crucial for favorable outcomes.

When it comes to removing skin cancer, two primary surgical options are often considered: Mohs surgery and traditional excision. 

Traditional excision for skin cancer, also called wide local excision, involves the surgical removal of the cancerous cells along with some of the surrounding healthy tissue, called the surgical margin. A scalpel is used to cut away the cancer from the skin after it has been numbed. The resulting wound is then closed with stitches. The tissue that is removed is next sent to pathology for processing and interpretation. This is a standard treatment for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of all risk groups. 

Mohs surgery, a highly specialized and effective procedure, is thought to be one of the most effective treatments for certain common types of skin cancer and can be also used to treat rarer forms of the disease. Dermatologist Dr. Daniel Wasserman explains, “For Mohs surgery, thin layers of skin are removed from the lesion and margins, and each is examined under a microscope to determine whether any skin cancer remains. This highly advanced and precise process continues until the area is determined to be completely free of cancer cells. The procedure is the gold standard for high-risk, recurrent, or aggressive skin cancers, along with situations where the surgeon and patient want to preserve as much healthy tissue as possible—such as with highly visible cancers on the face or cancers in sensitive areas.”

The most suitable type of surgery for you depends on the size of the tumor, where it is located, and the risk group. In this article, we will further explore the differences between Mohs surgery and traditional excision for skin cancer, including their procedures, effectiveness, recovery, and considerations for choosing the most suitable approach.

Cure Rate

Mohs surgery is thought to be more effective than other types of skin cancer treatments. It is associated with an extremely high cure rate, often exceeding 99 percent for primary skin cancers. This is because the surgeon verifies the removal of cancer cells with precision during the procedure, minimizing the risk of leaving any behind. Traditional excision also has a high cure rate, but it may be slightly lower than that of Mohs surgery due to the surgeon’s inability to immediately examine the entire surgical margin. Mohs surgery’s ability to ensure that all cancer cells have been removed reduces the need for additional treatments. 

Tissue Preservation

Mohs surgery excels at preserving healthy tissue since it allows for precise removal of cancerous cells layer by layer. Traditional excision, on the other hand, typically requires the removal of a wider margin of healthy tissue, potentially resulting in a larger wound and more noticeable scarring.

Cosmetic Considerations

Mohs surgery is preferred for skin cancers on the face and other cosmetically sensitive areas because it minimizes tissue removal and scarring. Traditional excision may be a suitable option for skin cancers in less visible or sensitive areas. Mohs surgery can often provide better cosmetic results since the surgeon can preserve as much healthy tissue as possible. 

Duration

Mohs surgery is a more time-consuming procedure than traditional excision due to the need for minute examination of removed tissue layers. Traditional excision is usually quicker but may require additional time for laboratory analysis. Mohs surgery is typically a single-visit, outpatient procedure. 

Scarring

Another advantage of Mohs surgery is that it has a lower risk of scarring and fewer side effects. Scarring from Mohs surgery is often less noticeable than scarring from traditional excision, thanks to its tissue-sparing approach. However, the extent of scarring can vary based on individual healing and the location of the skin cancer.

Searching for more information on the benefits of skin cancer treatments like Mohs surgery? Contact Naples’ Skin Wellness Physicians for further details on this procedure. Call (239) 732-0044 or fill out a contact form to request a consultation if you would like to discuss skin cancer prevention and treatment.