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The Mohs Procedure Used to Remove My Basal Cell Carcinoma

I have always been a sun-worshipper. Now I am paying the price for years of exposure to the sun.

Basal cell carcinoma is the most common form of skin cancer. It can cause the destruction of the surrounding tissue. It is most important to have it diagnosed early so it can be treated.

Basal cell carcinoma is the most common form of skin cancer. It can cause the destruction of the surrounding tissue. It is most important to have it diagnosed early so it can be treated.

Years of Sun Exposure

Dr. Frederic E. Mohs developed the procedure for removing basal cell carcinoma in 1936. It is widely used now by dermatologists. I think by now everyone is aware that chronic exposure to sunlight is the leading cause of basal cell carcinoma.

When I was a child growing up in the South, my mother knew the danger of the sun. When I worked in the fields picking cotton or hoeing the corn, she made me wear a sunbonnet with a wide brim. The men all wore wide-brimmed straw hats.

As the years went by, however, it became important for me to get a deep, golden tan. I have always been a sun worshipper. I no longer wore a hat when I worked outside in the garden. Now I am paying the price for years of exposure to the sun.

Protect Your Skin

To reduce the sun’s harmful ultraviolet rays, we should limit our skin’s exposure by wearing sunglasses, broad-brimmed hats, and protective clothing. We should use sunscreen, rated SPF 15 or higher, on our exposed skin. Yes, even on cloudy days! We should avoid tanning parlors. We should inspect our skin for any changes and routinely visit our dermatologist for skin exams.

Did you know it's possible for your dog can develop skin cancer from too much sun? Don’t laugh when you see a dog wearing sunglasses!

Basal Cell Carcinoma: Most Common Form of Skin Cancer

Basal cell carcinoma is the most common form of skin cancer. It can cause the destruction of the surrounding tissue. It is most important to have it diagnosed early so it can be treated.

Please don’t think that skin cancer cannot kill. It can. I lost a dear friend who developed melanoma. She noticed a new brown spot on her forearm and didn’t see a dermatologist because she just thought it was a new “age spot,” which is very common as we get older. By the time she did see a doctor, the melanoma had metastasized into her lymph nodes.

Watch for Any Suspicious Changes

Be on the lookout for any new spots or any changes to spots you already have on your body.

I go to the dermatologist if I see anything the slightest bit suspicious. I had a brown area on my forehead that looked like a bruise.

I also had “something” about two inches away from that area that bothered me because it was raised, brown, and just unattractive.

I also had “something” on my scalp that my daughter (who is also my barber) kept asking me to have checked.

I made an appointment to see my dermatologist, who is also a plastic surgeon.

This is a basal cell carcinoma

This is a basal cell carcinoma

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Your Doctor Should Examine the Entire Body

The dermatologist did a complete body look; well, almost a full body look. He didn’t see anything suspicious on my body. Then he concentrated on my forehead.

He remarked that the two areas I was concerned about were nothing to worry about. He commented on the area my daughter was concerned about, and said that was nothing to worry about, either.

He then called my attention to a tiny area in the middle of my forehead that I really had not even noticed before. He informed me that he wanted to biopsy that spot.

He gave me something to numb the area, and then he took a sample to be sent to a pathologist.

What Is the Mohs Procedure?

Mohs Surgery, also called chemosurgery, was developed by Dr. Frederic E. Mohs in 1936. This surgery is performed by a trained and experienced surgeon. In my case, my dermatologist is also a specialist in the Mohs procedure.

In order to diagnose, a common practice among dermatologists is to scrape, burn, freeze, and use radiation and excision to remove suspicious lesions. This tissue is then examined by a pathologist.

If basal cell carcinoma is confirmed, the Mohs procedure will likely be performed.

Using the Mohs procedure, tissue is excised and examined under the microscope immediately so that the entire process can be done in one visit. The advantage of the Mohs procedure is that it removes all cancer, minimizes recurrence, and leaves little scarring.

Yes, I Had a Basal Cell Carcinoma

The next day, the doctor called to tell me I had a basal cell carcinoma. I immediately did some research on the internet about this type of cancer. I found that it is a more common skin cancer.

It seldom kills, but it can cause significant destruction and disfigurement of the surrounding tissues. These cancers affect 3 out of 10 Caucasians—and in 80% of these cases, they are found on the head and neck.

Most of these are caused by chronic sun exposure, and people who are fair-skinned (as I am) are more likely to develop it. These usually start out as an open sore, a red patch, a bump, or just a scar-like area. I had none of these signs. As I said, I had not even noticed the tiny little “thing.”

He told me to return the following day for a procedure called Mohs Micrographic Surgery. He fully explained the procedure and what I could expect. It would be performed in his office under local anesthesia. The Mohs procedure offers the highest cure rate for basal cell carcinomas.

The American College of Mohs Surgery (ACMS)

Members of the American College of Mohs Surgery (ACMS) have taken a 1-2 year specialized course after completing their medical residency. To become a member of this organization, a surgeon must have completed at least 500 cases of Mohs surgery. My dermatologist is a member of the ACMS.

The basal cell cancers that are likely to benefit from the Mohs surgery are those that are located in sensitive areas around the eyes, nose, lips, scalp, ears, fingers and toes, or genitals. These are the large, aggressive types, and the usual procedures may not remove all of the cancer cells.

In the Mohs procedure, all of the cancer cells are removed in steps.

My Experience With the Procedure

I was very nervous on the day of the procedure. If I were a drinking person, I would have belted down a couple of stiff drinks that morning before I went in.

After some warm reassurance from my doctor that everything would be just fine, he anesthetized the area on my forehead, waited about 15 minutes, and then removed the first layer of cells.

He told me to just relax and give him time to examine the tissue under the microscope. He would be able to tell if he got all the cancer cells, and that would be the end of the procedure.

After about 45 minutes, he came back and said he needed to remove some more of the lesion.

It took three additional attempts to make sure he got all of the cancer cells. He assured me that the Mohs procedure removes only tissue containing cancer cells. By this time, I could just imagine a big hole in the middle of my forehead.

Then he explained that he would make a clean incision across the area and suture it up. Later on, I saw five sutures in a neat little row.

I was instructed to use the antibiotic cream he gave me twice a day on the area and then return in seven days for suture removal, which I did. It has now been four weeks since I had the Mohs procedure done. It is healing very nicely. I don’t think I’ll even have a scar.

I am disappointed that I still have the big brown spot and the other “thing” on my forehead, but at least the basal cell carcinoma is gone! He told me about some creams that may bleach out the brown spot. I might try one of those later on.

Learn to Spot Any Changes on the Skin

We know that it is impolite to point at other people, but you should point out a suspicious spot on another person—you could save their life! Learn how to spot changes in your own skin. If you see a “funny” spot on a friend or loved one, don’t hesitate to call it to their attention. Maybe they are like me. Maybe they just haven’t noticed it. My daughter, the barber, has found numerous skin cancers on her client's scalps.

Here are some important tips to protect your skin.

  • Limit exposure to the sun
  • Try to stay out of the sun between the hours of 12-3 p.m. Schedule your walks, etc., for later in the day.
  • Wear sunglasses
  • Wear a broad-brimmed hat
  • Use a broad-spectrum sunscreen, rated SPF15 or higher, on all exposed skin
  • Avoid sun tanning parlors
  • Inspect your skin regularly
  • See your dermatologist regularly for an exam

Did you know your skin is the largest organ you have? Protect your skin, and it will protect you for the rest of your life.

A New Lesion

It has been about six months since I had the Mohs Procedure done to successfully remove the basal cell carcinoma from my forehead.

I noticed a new suspicious spot in a new area on my forehead. I made an appointment to go in and have the doctor take a look. Without hesitation, he said he needed to do a biopsy on it. I received a phone call from him two days later with the results. Now I had a Squamous Cell Carcinoma!

Squamous cell carcinoma is just as dangerous as basal cell carcinoma, it seems. I need to have the Mohs procedure again. I set up the appointment and will have that done right away.

I am getting a little tired of having all this surgery done on my forehead. I am now paying the price of all those wonderful suntans I got on my face years ago.

The sun is a wonderful thing. Just remember to always use protection when you enjoy the sun!

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


RTalloni on April 03, 2015:

Glad to see this highlighted again just before the sun season begins in earnest so people can learn more about the need for sun protection.

Mary Hyatt (author) from Florida on April 03, 2015:

Hi,PegCole17 We have SO many people here in S. Fl. that develop skin cancers from basking in the sun. I've had several cause I worked in my garden without any protection, but not any more. I try and care for my skin now. I'm glad your mom did well from her Mohs surgery.

Happy Easter, Mary

Peg Cole from North Dallas, Texas on April 03, 2015:

Glad I saw this article today. This information is quite important and it will help others to be aware of changes in their skin.

My mom recently had a squamous cell carcinoma removed from her temple and her ear. The MOHS procedure was used to determine that the edges were clear. We were fortunate to have such a friendly and caring staff that took care of her.

Mary Hyatt (author) from Florida on November 18, 2014:

Hi, Country-Sunshine You are so right, people should have exams done once a year. I certainly do. I do not have any scarring from the procedures, thank goodness. I do hope your hubby is well now.

Thanks for reading and commenting, Mary

Country Sunshine from Texas on November 18, 2014:

Very useful information! My husband had Mohs surgery on his nose several years ago. He did end up with quite a scar, but decided not to have plastic surgery done. Everyone should visit their dermatologist at least once a year, or like you've pointed out, when you notice a new spot on your skin.

Mary Hyatt (author) from Florida on August 26, 2012:

Good Morning, SunsetSky. Yes, I was pleased with the outcome of the Mohns surgery on my face. There is NO scar there now at all.

Thanks for reading and for taking the time to comment. Mary

Mary Hyatt (author) from Florida on August 26, 2012:

Hi, midget38. People just have to remember to take better care of their skin especially when they are young. If not, they will pay for it later in life.

Thanks for reading and commenting, Mary

SunsetSky from USA on August 26, 2012:

I'm happy to hear that they caught it early and it had a good outcome. I've never heard of the Mohs procedure, even when studying cancer types. Thank you for sharing!

Michelle Liew from Singapore on August 25, 2012:

Mary, thanks for sharing what must've been a difficult experience. I'd like to share this hub because I think it would help so many! This is especially true if they love sun tanning. Thanks for the write!

Mary Hyatt (author) from Florida on August 18, 2012:

Hi, oceansnsunsets. Nice to see you today! Before the Moh's surgery, doctors would excise some tissue, send it out to have a pathologist examine it, then the patient had to return to the lst. dr. for further excision. This way it's done at one time in the dr's office.

I hope you never get basal cell carinoma, but if you do, look for a good dr. who does the Moh's procedure. My best, Mary

Paula from The Midwest, USA on August 18, 2012:

Mary, I learned about the Moh's procedure several months ago, and I think that it is such a brilliant way for doctors to be completely thorough without being overly invasive and cutting into any unnecessary skin.

Thanks for sharing your story as well. I am fair skinned and wouldn't be surprised if I also got skin cancer one day! If I do, I hope to get this procedure done to get it all thoroughly and know exactly what is going on. Thanks for the reminders of how to protect our skin more. Why more people don't do that, is beyond me! We know more now than ever, and more to help us than ever.

Mary Hyatt (author) from Florida on July 04, 2012:

Good Morning, Jaye, it's too bad we don't live near each other. We could get together for coffee with our two little dogs, and talk about all we do have in common!

I'm glad you got a second opinion on your basal cell carcinoma! I hardly any scar now from my Mohs procedure. I have some other "spots" that don't look good, but the Dr. don't worry, they are nothing.

I was bad about being the first of my friends to get a tan when I was young. I didn't know the potential danger. Like you, I use a good sun block now.

Thanks so much for the votes, I do appreciate that. Have a happy and safe 4th of July!

Jaye Denman from Deep South, USA on July 03, 2012:

It looks as though we have even more in common than we thought! I, too, had a basal cell carcinoma removed--last year. It was on my nose.

I went to a dermatologist who didn't even biopsy it, but used a chemical on it which did nothing. I went to another dermatologist who did a biopsy and diagnosed it as basal cell. A plastic surgeon removed the cancer with a flap procedure. I was left with a slight scar, but am thankful all the skin cancer cells were removed by the surgery.

The surgeon told me that people often get more than one basal cell carcinoma because of prior sun damage. I never did a lot of tanning (with fair skin and green eyes, I always freckled or burned), but just living in the Deep South was enough to expose me to sun damage. For many years I didn't realize the need for sunblock, but now use it religiously.

Very good hub. Voted UP, USEFUL and INTERESTING.


Mary Hyatt (author) from Florida on June 22, 2012:

Hi HBN, I had never heard of this procedure either until I had my experience. I'm glad they got all of your basal cell cancer in your cheek before it had a chance to do further damage. When I work outside in the garden now, I am certainly more careful. Your suggestion about timing walks is a good one; I'm going to add that, thanks.

Thanks, too, for the vote, and the share. I apprecite that!

Bye for now.....

Gail Sobotkin from South Carolina on June 22, 2012:

Great hub about a cancer that effects a large part of the population.

I did not know about this particular procedure but I like the idea that those trained in it only remove the areas of skin and underlying layers that have cancer cells in them.

I have very fair skin and did have a basal cell carcinoma lesion removed from my cheek about 20 years ago and although I love the beach I generally take the precautions you suggested and have not had any new lesions.

In addition to the precautions you suggested, I try to avoid being in the sun between 10 and 3 when the exposure is strongest. Prefer to take my walks in early AM or in the evening.

Voted up, useful and interesting. Thanks for sharing this potentially life saving information. I will also share it.

Mary Hyatt (author) from Florida on June 20, 2012:

Hi drbj, thanks for reading and for the nice compliment on my Hub about basal cell cancer. I'm trying to make people aware of the dangers of the sun. You know yourself, living in S. Fl. of the danger, I'm sure. Bye for now...

drbj and sherry from south Florida on June 20, 2012:

Very, very important information about basal cell carcinomas, mary. You did an excellent job with your meticulous research and well-written explanations. Thank you for taking the time and effort.

Mary Hyatt (author) from Florida on June 20, 2012:

Good Morning, teaches 12345. Good to see you! If more people could see these poor people who have lost most of their noses and part of their face would protect their skin from basal cell cancer and others.

I will protect mine from now on!

Have a wonderful day!

Mary Hyatt (author) from Florida on June 20, 2012:

Thanks, Peggy W. You are so right. It is extremely important for people to wear sunglasses to protect their skin.

Regards, Mary

Dianna Mendez on June 19, 2012:

We live in South Florida where protecting yourself from sun damage is essential in preventing burns and cancer. Your hub post is one that should be read and followed by everyone! Thanks for the advice.

Peggy Woods from Houston, Texas on June 19, 2012:

Thanks Mary, for the link to my hub about the importance of wearing sunglasses. These hubs kind of go hand in hand with regard to protecting oneself from sun damage.

Mary Hyatt (author) from Florida on June 19, 2012:

Hi AliciaC, thanks for the nice compliment. I'm glad you found my Hub useful and important. People need to be more aware of the importance of protecting their skin, I think. I take better care of mine now.


Linda Crampton from British Columbia, Canada on June 19, 2012:

This is a very important and useful article, mary! Your description of your personal experience and your advice will be very helpful to everyone who reads this hub.

Mary Hyatt (author) from Florida on June 19, 2012:

Hi, RTalloni, I sure hope your hubby is OK now. He really had to go through quite an ordeal, I'd say. I saw some patients in the Dr. Office that had their noses operated on and they look terrible! Part of their noses were gone. I'm sure they will have reconstructive surgery done. I was lucky. You can just barely see my scar after 4 weeks. I do love that sun, though. I'm just more careful to protect my skin now.

Mary Hyatt (author) from Florida on June 19, 2012:

Hi Peggy W, I was bored to death when I had my procedure! I just sat in the same chair waiting for the Dr. to come back in and form me he had to "get a little bit more". I should have packed a lunch. You were lucky to have a nice comfortable place to wait for results.

Thanks for linking to this one. I'm going to check out your Sunglasses Hub. Thanks for the votes and the share! Goodnight.

Mary Hyatt (author) from Florida on June 19, 2012:

Hi, Joyce. good to see you! I'm glad you see your dermatologist twice a year, that is pretty smart. I have a daughter that tans too much, and I try to tell her she will pay for it later. Thanks so much for the votes! Goodnight.

RTalloni on June 19, 2012:

Well-done and important. Glad to see this timely post so others can learn from your experience.

Paying the price--yes, indeed. My husband had the Mohs procedure for basal cell a few years back. The doc took his ear apart and put it back together--amazing. We grew up in the Florida sun and the consequences are not fun.

Peggy Woods from Houston, Texas on June 19, 2012:

Hi Mary,

What a terrific and important topic for a hub! My fraternal grandmother had Mohs surgery done on a tumor that appeared in her ear. My mother and I accompanied her and in between microscopic viewings to see if all the edges were clear, we could relax in a solarium setting with cups of coffee or tea or juices. It was at the Methodist Hospital annex in the Houston Medical Center. What a great way to experience day surgery!

I did a hub on the importance of wearing sunglasses that you might wish to see. Kind of goes hand in hand with protecting all of our tissues exposed to the sun. Think that I will link this article to that one.

Voted up, interesting, useful and will share.

Joyce Haragsim from Southern Nevada on June 19, 2012:

Living here in Southern Nevada we have to protect ourselves. Now both of us visit the dermatologist every six months for sun exposure when we much younger.

I get too many sunrays from the passenger side of the car on my face just below the visor line.

Voted up useful and interesting, Joyce.

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