Mohs surgery is an effective treatment for many skin cancers, especially cancers on the face, ears, or neck. Mohs minimizes scars and preserves more healthy tissue than traditional surgical removal. But is Mohs a good option for melanoma? It depends.
What Is Mohs?
Mohs surgery involves removing skin cancer layer by layer. After removing each layer, the surgeon examines it under a microscope to check for cancer cells. If cancer cells are still there, the surgeon removes another layer.
Mohs surgery has excellent cure rates for most skin cancer. It leaves smaller scars than other procedures. Most people who have Mohs can go home the same day.
Why Isn’t Mohs Always a Good Option for Melanoma?
Doctors don't always recommend Mohs surgery for melanoma. Why?
Melanoma is different from the 2 most common types of skin cancers — basal cell carcinoma and squamous cell carcinoma. Unlike these other skin cancers, melanoma:
- Grows from different cells
- Can reach deeper layers of the skin
Because of these different cell types and deeper reach, melanoma cells need special stains to show up under a microscope. This can’t be done easily during a Mohs procedure.
Melanoma Can Move
Melanoma tends to spread to lymph nodes and other parts of the body more often than other skin cancers.
In other words, melanoma can be a more serious cancer. It often requires a treatment process that considers how far and deep it can spread. Because melanoma can spread deeper into the skin, you need to remove a larger amount of tissue, or margins, to get rid of it. Mohs isn’t an effective way to do that. It focuses on very small parts of the skin.
Do Doctors Ever Recommend Mohs Surgery for Melanoma?
Yes. Mohs can be a great option for removing melanoma in the face, ears, fingers, and toes. "Mohs may be an option for some very early-stage melanomas in areas where removing a wide margin would be hard to do,” says UVA Health dermatologist Bridget Bryer, MD.
What Kinds of Skin Cancer Can Mohs Surgery Treat?
Diagnosed With Melanoma?
Get a second opinion and learn about treatment options at UVA Health.
Mohs works well for surgeries where you don’t need — or want — to remove much of the surrounding skin and tissue. This includes basal cell and squamous cell carcinomas and other rare forms of skin cancer. They’re often confined to a small area. Mohs can be an effective cure for them.
“Mohs has great benefits in areas where taking bigger margins is more challenging and in skin cancers where you do not need a wide margin, for example, a basal cell carcinoma on the face,” says Bryer.
On the other hand, a provider might remove skin cancer with regular surgery. This simple, effective option works well on the torso, arms, and legs. Providers can remove basal and squamous cell cancers by cutting out the cancer and stitching the skin.
So How Is Melanoma Treated?
It’s complicated. There's no one right approach for every melanoma case.
When it comes to melanoma, you'll want experts who specialize in this serious skin cancer. You might need a whole team of dermatologists and cancer experts who have specialized in melanoma treatment.
You’ll want to find care from providers who:
- Offer a wide range of treatments
- Know when and why to use which treatments
Learn more about melanoma treatment.
