The Mohs Micrographic Surgery Process

Dr. David Roy • September 17, 2019

Mohs Micrographic Surgery Process | Pine Belt Dermatology

Skin cancer is common. In fact, over the past 30 years more people have had skin cancer than all other cancers combined. A fact that not many people are aware of. The three main types of skin cancer that are diagnosed each year in the United States are:

Basal Cell Carcinoma – over 4 million Americans a year are diagnosed.
Squamous Cell Carcinoma – over a million a year are diagnosed.
Melanoma – nearly 100,000 Americans per year are diagnosed.

While skin cancer has become extremely common, the good news is that when the cancer is detected early, the vast majority of skin cancers are curable. Left untreated, however, skin cancer can continue to grow and become disfiguring. They can eat through tissue and, in some cases, squamous cell carcinoma and melanoma can spread to lymph nodes or other parts of the body and even become life-threatening. Early detection and prompt treatment result in the best outcome.

Treatments for these different skin cancers vary by patient depending on the type, size, patient health, and location on the body. Treatments for skin cancers include excision, topical medications, scraping and burning, freezing, and radiation. While many of these skin cancer treatments result in a cure, sometimes the skin cancer comes back, or recurs. This happens because there are skin cancer cells that aren’t visible or may form roots that extend beyond the visible tumor. If all of the cancer cells are not completely removed, the cancer will grow back and require further treatment. This is where Mohs Surgery is most effective against basal cell carcinomas and squamous cell carcinomas. What are the advantages of this procedure?

Efficient, cost-effective treatment:

Single-visit outpatient surgery
Only local anesthesia is used.

When we do the procedure at Pine Belt Dermatology you are never put to sleep, we only numb the area being treated.

Lab work is done on-site

Precise results:

Physician examines 100% of the tumor margins.
Spares the healthy tissue.
Leaves the smallest scar possible.

The highest cure rate:

99% cure rate for skin cancer that has never been treated before.
94% for skin cancer that has recurred after a previous treatment.

So what is Mohs Surgery and what does his procedure’s process look like?

Mohs is performed by doctors who are specially trained to complete this surgery. They are specifically trained to be able to fulfill three roles:

Act as the surgeon who removes the cancerous tissue.
Act as the pathologist who analyzes the lab specimens.
Act as the surgeon who closes or reconstructs the surgical site wound.

Mohs surgery is completed in stages, all in a single visit to our office, while the patient waits in between stages. The surgeon will begin by removing a layer of tissue, and after removing it the surgeon examines it under a microscope. This allows the surgeon to know exactly where the cancer cells are, if any remain at all. From there we remove another layer of the tissue, but only in the precise location of the cancer cells. This is how we are able to preserve the healthiest amount of tissue. We’ll repeat this process until there are no cancer cells remaining.

Mohs surgery is the gold standard for treating basal cell carcinomas and squamous cell carcinomas, including those that are around delicate areas of the skin such as around the eyes, nose, lips, ears, scalp, fingers, toes, breasts, or genitals. This surgery is also ideal for basal and squamous cell carcinomas that are large, aggressive, growing rapidly, that have recurred after previous treatment, or that have indistinct edges. In some scenarios, Mohs can be used to treat some melanomas, but when it comes to treating melanoma, Mohs surgery is not typically the recommended treatment.

In some cases, the Mohs procedure only needs one stage and in others it can take multiple. The number of stages that the surgery will need depends on the area of the body the tumor is located, the size of the tumor, and the depth of the tumor. If surgery takes multiple stages, it is not uncommon for the entire Mohs process to take several hours. There have been a handful of surgeries I have performed that have lasted until well after working hours. However, the long process is worth it, because this allows us to safe the healthy tissue the most of any other treatment, which in turn leaves you with the smallest scar possible to treat the skin cancer. I like to say that Mohs surgery provides the highest cure rate, with the smallest cut.

Pine Belt Dermatology & Skin Cancer specializes in general, medical, surgical, and cosmetic dermatology, however we are best known for the quality of our skin cancer treatment. Mohs Micrographic surgery is a huge part of why we have a reputation of being the skin cancer experts. At the end of 2019, we will be opening a new office in Biloxi with another Mohs surgeon, Dr. Nguyen, further solidifying our reputation as the best at treating skin cancers. I encourage you to check out my future colleague’s bio in the link below!

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UV Safety Awareness Month, World Skin Health Day, and Understanding Hyperpigmentation & Melasma

June 29, 2026

At Pine Belt Dermatology & Skin Cancer Center, we believe education is key to protecting and maintaining healthy skin. July is significant for skin health, featuring both UV Safety Awareness Month and World Skin Health Day on July 8 . These occasions highlight the importance of sun protection and raise awareness of common concerns, such as hyperpigmentation and melasma . Understanding how ultraviolet (UV) exposure affects your skin helps prevent long-term damage and supports a healthier, more even complexion. Why UV Protection Matters The sun emits ultraviolet rays that can damage skin even on cloudy days. While many associate UV exposure with sunburn, its effects are broader. Repeated UV exposure accelerates skin aging, increases skin cancer risk, and contributes to pigmentation disorders. Common effects of excessive UV exposure include: • Sunburn and skin irritation • Premature aging, including fine lines and wrinkles • Dark spots and uneven skin tone • Increased risk of skin cancer • Worsening of hyperpigmentation and melasma Daily sun protection is one of the most effective ways to maintain healthy skin and reduce preventable damage. What Is Hyperpigmentation? Hyperpigmentation is a common condition where areas of skin become darker than the surrounding tissue due to excess melanin production. Multiple factors can contribute to hyperpigmentation, including: • Sun exposure • Acne scars and inflammation • Hormonal changes • Skin injuries or irritation • Certain medications While hyperpigmentation is mostly harmless, many seek treatment to improve skin tone as well as restore confidence. Understanding Melasma Melasma is a type of hyperpigmentation that shows up as brown or gray-brown patches, typically on the cheeks, forehead, nose, and upper lip. Melasma is frequently associated with: • Hormone changes during pregnancy • Birth control medications • Hormone replacement therapy • Genetic predisposition • Sun exposure Although melasma is not dangerous, it can be difficult to treat because UV exposure frequently triggers or worsens it. Even minimal sun exposure can increase pigment production and make discoloration more noticeable. Protecting Your Skin from UV Damage Whether you are concerned about skin cancer, hyperpigmentation, or melasma, daily sun protection is essential. Dermatologists suggest: • Using sun lotion with SPF 30 or higher every day • Reapplying sunscreen every two hours when outdoors • Wearing wide-brimmed hats and protective clothing • Seeking shade during peak sunlight hours • Wearing UV-protective sunglasses • Avoiding tanning beds Consistent sun protection helps prevent new pigmentation issues. World Skin Health Day: A Reminder to Prioritize Skin Care Observed annually on July 8, World Skin Health Day encourages preventive steps to maintain healthy skin. This is a reminder to perform regular self-exams, schedule dermatology visits, and address concerns early. If you notice persistent dark spots, changes in pigmentation, or new skin lesions, seek an expert assessment to determine the cause and identify treatment options. Supporting Healthy Skin Year-Round UV Safety Awareness Month and World Skin Health Day remind us that protecting your skin is an investment in long-term health. Practicing sun safety and understanding conditions like hyperpigmentation and melasma help preserve your skin’s health, appearance, and function. At Pine Belt Dermatology & Skin Cancer Center, our team provides personalized evaluations and treatments for pigmentation concerns, sun-damaged skin, and overall skin health. Plan a visit and learn how we can help you achieve healthier, more confident skin.

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When a ‘Rash’ Might Be Something More Serious

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When a ‘Rash’ Might Be Something More Serious At Pine Belt Dermatology & Skin Cancer Center, we recognize that rashes are common and frequently resolve quickly with minimal treatment. However, some rashes may signify underlying conditions that require prompt medical attention. Identifying when a rash is more than a minor irritation is key to protecting your health. Comprehending Common vs. Concerning Rashes Most everyday rashes result from irritants, allergies, heat, or minor infections and typically improve within a few days with over-the-counter treatments. However, if a rash lasts longer, worsens, or appears with other symptoms, it may signal a more serious issue. Identifying the difference between a routine rash and one that requires medical evaluation helps avoid complications and ensure appropriate care. Warning Signs to Watch For Certain features may indicate a rash requires clinical assessment, including: Rapidly spreading or worsening rash Severe pain, swelling, or blistering Signs of infection such as pus, warmth, or red streaks Fever or flu-like symptoms accompanying the rash A rash that does not improve after several days of treatment Dark, purple, or bruised-looking areas on the skin For example, a rash with fever may indicate a viral or bacterial infection, whereas painful blistering can suggest conditions such as shingles. In rare cases, rashes may signal autoimmune disorders or severe allergic reactions. Rashes That May Point to Underlying Conditions Some rashes may be linked to broader health concerns, including conditions that cause inflammation in the skin and other organs: Allergic reactions that may escalate into further severe responses Infections that spread beyond the skin if untreated Medication reactions that require immediate adjustment Persistent or unusual skin changes may be early signs of skin cancer or precancerous conditions, especially if they do not heal or continue to change over time. Why Early Evaluation Matters Delaying care for a worrisome rash may allow the underlying condition to progress. Early diagnosis improves treatment outcomes and helps prevent discomfort and complications. A dermatology specialist can assess the rash’s appearance, location, and progression, and may recommend diagnostic tests if needed. This approach assures treatment addresses the underlying cause, not just the visible symptoms. When to See a Dermatology Specialist If you are unsure about your rash, it is best to err on the side of caution. Consider seeking care if: The rash is persistent, painful, or unusual in appearance Over-the-counter treatments are not effective You experience additional symptoms such as fever or fatigue The rash interferes with your daily comfort or quality of life At Pine Belt Dermatology & Skin Cancer Center, our experienced providers supply comprehensive skin evaluations and customized treatment plans. We take time to understand your symptoms and deliver clear, effective solutions tailored to your needs. Protecting Your Skin and Your Health While many rashes are minor, some may be early warning signs of more serious health concerns. Monitoring skin changes and pursuing prompt medical advice can produce a notable effect. If you notice a rash that does not seem right, do not ignore it. Schedule a consultation with Pine Belt Dermatology & Skin Cancer Center for expert evaluation and peace of mind. Your skin is an important indicator of your overall health, and taking it seriously supports ongoing well-being.