Mohs Micrographic Surgery
Healing well after Mohs surgery.
Careful wound care does a great deal for the final result. These are our full after-surgery instructions — the care instructions our office goes over with you come first.
Wound care
The daily routine
- Leave the post-operative bandage in place and avoid getting it wet during the first 24–48 hours. Before showering, remove the bandage and discard it.
- Cleanse the incision gently with soap and water, using your clean fingers, and avoid any trauma to the incision site.
- Pat the wound dry and apply a generous layer of Aquaphor or Vaseline ointment to the incision.
- Cover the wound with a Telfa dressing cut to the shape of the incision, and use paper tape to secure it in place.
- Repeat this process at least once a day, and optimally twice a day.
- If your procedure is on the lower leg, it is very important to clean the wound twice a day with soap and water or Hibiclens solution and apply the Aquaphor or Vaseline. Keep the leg elevated as much as possible for the first 7–10 days, and use a compression stocking if instructed.
General instructions
The first weeks at home
- When you get home, take it easy for 48 hours — no more activity than light walking.
- You may shower at any time after surgery as long as the bandage or dressing is kept dry for the first 24–48 hours. If it becomes wet, change the dressing.
- Sleep with your head or the surgical site elevated using several pillows when possible.
- To optimize healing, avoid any smoking for 2 weeks after surgery.
- For 2–3 weeks after surgery, refrain from heavy lifting over 10 lbs and strenuous exercise such as swimming, running, golfing, strenuous housework or yard work.
- It takes 3 months for the incision to be 80% as strong as it was before the procedure. If you feel any pulling or tugging on the incision, stop the activity — it could cause the incision to open up or widen the scar.
Pain and swelling
Keeping yourself comfortable
- Minimize swelling by keeping the operated site elevated as much as possible.
- Ice as soon as possible — at least 10 minutes on the hour helps the most for pain.
- A gentle ice pack, like a bag of frozen peas, helps with swelling especially in the first 2–3 days: 10 minutes on and 10 minutes off, maximum. It can be applied directly to the dressing or just below the incision.
- For pain control, you can use extra-strength Tylenol, 2 tablets every 6–8 hours. If you need to, you can add Advil or Motrin, 200 mg, 2–3 tablets every 8 hours.
Bleeding
What to do if the site bleeds
It is not unusual to have some minimal bleeding after the procedure. If you notice active bleeding, apply direct pressure to the dressing for 20 minutes, then monitor. If it is still bleeding, reapply the pressure again with an ice pack for 20 minutes — it should stop by then. If not, call our office directly, or go to the emergency room or urgent care if the bleeding does not stop. Products such as WoundSeal and BleedStop can be found over the counter and may help as well.
Infection
Signs to watch for
Monitor for infection — increasing redness, swelling, pain, drainage or fever. Call our office and take photos if you notice any of the signs of infection.
Your scar
What to expect over the year
Any treatment for skin cancer will leave a scar, and it is important to know that the scar will evolve over 8–12 months. Minimize direct sun exposure on the healing incision: it is good practice to put daily sunscreen on the incision beginning 2 weeks after the procedure, and a moisturizing lotion on at night, since direct sunlight can darken the scar line or cause persistent redness.
If you have a history of abnormal scarring, such as hypertrophic scars or keloids, or if there are any problems with the healing of the scar, we have treatments to optimize the result. Everyone heals differently, and the final scar appearance depends greatly upon the individual's ability to heal.
When to call
Signs that need our attention
- Bleeding that does not stop after 20 minutes of firm continuous pressure, repeated with an ice pack for another 20 minutes
- Increasing pain, redness spreading outward, warmth, pus or a foul odor
- Fever over 100.4°F
- Wound edges separating
- Numbness, weakness or changes in movement that are new or worsening
- Anything that simply does not feel right — call and ask
This page is general education and is not medical advice, diagnosis or treatment, and it does not create a physician–patient relationship. Individual circumstances differ; please discuss your own skin with a qualified clinician. If you are having a medical emergency, call 911.
Questions
Frequently asked
You may shower at any time after surgery as long as the bandage or dressing is kept dry for the first 24–48 hours. If it becomes wet, change the dressing. Let water run over the area rather than scrubbing it, and pat dry before redressing.
Extra-strength Tylenol, 2 tablets every 6–8 hours, with Advil or Motrin 200 mg, 2–3 tablets every 8 hours added if needed. Ice — 10 minutes on and 10 minutes off — helps most with pain and swelling, especially in the first 2–3 days.
Swelling and bruising can spread around the eye after surgery on the face or forehead, and it looks worse than it is. It usually peaks in two to three days and then improves. Call us if vision changes or pain increases.
It depends on the site and repair — often about one to two weeks. Your follow-up appointment will be scheduled before you leave.
The scar evolves over 8–12 months. Begin daily sunscreen on the incision 2 weeks after the procedure and moisturize at night, because sun can darken the scar line or cause persistent redness. If you have a history of abnormal scarring, we have treatments to optimize the result.
Questions before or after surgery? Call us.
Whether something has changed, something has been bothering you for years, or you simply want expert guidance on keeping your skin healthy, we’re here to help.