Florida has the unenviable distinction of being the skin cancer capital of the United States . Many people here have had excessive sun exposure (UV damage), often leading to skin cancer. Although large skin cancers are readily visible on the skin surface, to remove them completely requires microscopic examination to visualize the cancer at a cellular level. In Mohs Surgery, which is performed under local anesthesia, the technique combines surgical removal of the skin cancer with immediate microscopic examination of the removed tissue in order to identify any residual cancerous tissue. The surgeon continues the process of removing tissue and studying it under the microscope until all cancer has been removed. Typically, the surgeon then reconstructs the surgical wound by using a variety of repair techniques.

The Mohs technique has the highest cure rate of all skin cancer treatment methods, and involves the surgical removal of the least amount of tissue possible in order to adequately treat the cancer

Why Mohs surgery? - Skin cancers can be deceptively small on the surface of the skin, much like an iceberg, where only the tip shows, much more can be below the surface.  Cancers may have roots and just cutting off the top will not get rid of the roots.  Recurrent skin cancers following previous treatments may send out roots deep under the scar.  Mohs surgery is designed to treat cancers by tracking out the cancerous roots.  Because of this, prior to Mohs surgery, it was impossible to predict how much skin would have to be removed.  The final surgical defect may be only slightly larger than the initial skin cancer but occasionally the roots are extensive and could results in a sizable defect.  Keep in mind though that Mohs surgery removes only the cancerous tissue, while normal skin is spared. 

Insurance coverage for Mohs surgery  -Medicare and most insurance companies cover the cost of Mohs surgery and repair, if needed, following removal of the cancer.  Please contact your insurance carrier for the most current coverage information related to this treatment.  If you contact our office billing we may be able to help you with your questions. 

Three Main Types of Skin Cancers

Basal cell carcinoma: This is the most common skin cancer and is typically found on sun exposed areas such as the face, ears, and arms. It is often flesh-toned to reddish in color and can be a pearly, nodular bump or a raw, ulcerated sore. Fortunately, it grows slowly, but if left untreated, it can cause extensive local destruction of tissue.

Squamous cell: This may appear as a red bump or non-healing sore in sun exposed areas. Compared to basal cell carcinoma, it is more aggressive in growth and has more potential to spread internally to other organs.

Melanoma: This is the least common, but most aggressive, skin cancer. If caught early, the cure rate is excellent, but in more advanced stages it is often fatal. It usually appears as a red to black spot or bump, which may be a new lesion or a change in an existing mole. Remember the ABCDs of abnormal moles: Asymmetry; Border which is notched, irregular, or blurry; Color which is dark, uneven, or multicolored; and Diameter greater than 6 mm, or about the size of a pencil eraser. Melanoma may be completely flat and smooth, or raised.

Additional Information

It is thought that much of the UV damage we get occurs by the time we are 18 years old. However, further damage can be prevented by using a sunblock containing zinc oxide daily, wearing sun protective clothing and a hat, and avoiding sun exposure from 10 am to 4 pm . In addition to knowing the signs of skin cancer, one should also have a skin exam performed by a dermatologist annually.