Mohs micrographic surgery is performed with local anesthesia, but it isn’t always a short appointment. After each layer of tissue is removed, it’s examined in a frozen section laboratory, where the tissue is rapidly prepared and checked for cancer cells under a microscope. That staged process is what lets the surgeon evaluate the surgical margins (the edges of the removed tissue) before deciding whether another layer is needed.
Medication, food, transportation, and antibiotic instructions vary from patient to patient. The directions from your Mohs surgeon’s office take priority over anything you read online, especially if you take prescription medications or may need wound reconstruction.
What To Know Before Mohs Surgery
Mohs surgery is an outpatient technique used to treat basal cell carcinoma and squamous cell carcinoma, particularly in areas where preserving healthy skin matters. A prior biopsy identifies the cancer being treated; Mohs surgery removes and examines tissue in stages until no cancer cells appear at the margins.
The number of stages can’t be predicted before the procedure. Some appointments involve one stage, while others require additional layers and more time for laboratory processing. Wound closure (whether stitches, a skin graft, or a skin flap that moves nearby tissue to cover the wound) can also add time to the day.
When planning how to prepare, reserve the full day rather than scheduling the appointment around other commitments. Ask the office whether there are case-specific plans for reconstruction, sedation, or a separate procedure that could affect your instructions.
Review Your Medications & Medical History
A complete medication review helps the surgical team plan safely. Before the appointment, share every prescription medicine, over-the-counter product, vitamin, herbal supplement, medication allergy, and relevant health condition, not just the medicines you take daily.
Don’t stop blood thinners, aspirin, or any other prescribed medication on your own. Stopping certain medicines without guidance can create serious risks. Any change should come from the Mohs surgeon or the clinician who originally prescribed it.
Information to confirm with the office:
- Current medicines: Provide names, doses, and frequency for every prescription, supplement, and nonprescription product.
- Medical history: Mention heart conditions, joint replacements, immune system concerns, bleeding problems, diabetes, and prior reactions to anesthesia or antibiotics.
- Antibiotic planning: Ask whether your medical history affects whether antibiotics are needed before or after the procedure.
- Recent changes: Report new prescriptions, dosage changes, hospitalizations, or a new diagnosis before surgery.
Some patients need additional planning because of their health history or the anticipated repair. The office can explain whether lab testing, medication adjustments, or other precautions apply to your situation.
Plan for the Morning of Surgery
Fasting isn’t automatically required for office-based Mohs surgery performed with local anesthesia. Many patients are instructed to eat normally, but follow the eating and drinking directions you receive, especially if sedation or a separate reconstructive procedure is planned.
A good night’s sleep makes a long appointment easier. Avoid alcohol if instructed, and arrive with enough time to check in without rushing. Choose loose, comfortable clothing that gives the team access to the treatment area and can accommodate a bandage afterward.
Pack for a longer visit:
- Identification and insurance information: Bring the documents requested during scheduling.
- Medication details: Carry an updated medication list and any relevant medical information the office requested.
- Permitted food and drinks: Bring water or a snack only if the office says it’s appropriate for your appointment.
- Something to do: A book, headphones, or a puzzle helps pass the time between stages.
- Comfort items: A light layer is worth packing if the office tends to run cool during longer visits.
Confirm parking, arrival time, and whether a companion may wait with you before leaving home. Small logistical details are easier to settle the day before than on the morning of surgery.
Arrange Transportation & Plan Your Afternoon
Many patients drive themselves home after Mohs surgery, but that depends on the treatment site, the type of repair, any sedating medication, and the surgeon’s instructions. A procedure near the eye, for example, may make driving impractical even with local anesthesia.
Keep the rest of the day open. Don’t schedule exercise, childcare, travel, or tasks that require bending or lifting until you know your post-procedure instructions. If you’ll need help at home with meals, pets, or routine activities, arrange it in advance.
Ask how the wound may be closed after cancer removal. Depending on its size and location, closure may involve stitches, a skin graft, a skin flap, or healing from the inside out without stitches. Before the appointment, also ask when you can shower, how to care for the bandage, which activities to avoid, when stitches might be removed, and who to contact if you experience bleeding, pain, a loose bandage, or another concern.
When To Call the Office Before Your Appointment
Call before arriving if you become ill, develop a fever, are hospitalized, or have a significant change in your health. It’s also worth calling if you missed an instruction, started a new medication, aren’t sure whether to take a blood thinner or supplement, or have questions about eating before the visit. Don’t make an independent medication change because an online checklist suggested it.
Questions about anxiety, pain control, reconstruction, and expected appointment length are all appropriate to raise before surgery. The surgical team can explain what to expect and account for your individual medical needs, but only if you ask.
A Simple Preparation Checklist
Preparing for Mohs surgery is mostly about confirming details rather than following a universal set of rules. Review your office instructions, provide a complete medication and health history, plan for a full-day appointment, and arrange transportation and support based on the guidance you receive.
If you’re preparing for Mohs surgery, the team at Pop Dermatology can answer individualized preparation questions. Contact the office at (856) 226-0727 to clarify the instructions that apply to your care.