Treating Skin Cancer on the Face

A condition that requires aggressive removal, along with a delicate, aesthetic eye.

Skin cancer is a growing concern. Every hour a person dies of melanoma, and this year alone, over 76,000 new cases of melanoma will be diagnosed. On average skin cancer screen­ings take about 10 minutes, which could potentially save your life.

Skin cancers often occur on the face, around the eyes, ears, lips and on the nose. When dealing with removing cancerous tissue on the face, patients will require Mohs surgery. While removing the margins of the cancer fully is critical, making the incisions and closures as aesthetically pleasing is also a primary goal.

Mohs micrographic surgery is a safe and effective treatment for skin cancer. During Mohs surgery, cancerous tissue is removed in small sections. While the patient waits, a pathologist examines each tissue specimen for malignant cells. If malignant cells are found, more tissue is removed until the cancer is eradicated. This comprehensive micro­scopic examination helps to target only cancerous tissue, significantly reducing damage to healthy sur­rounding tissue. Developed by Frederic E. Mohs, M.D., in the 1930s, Mohs surgery excises not only the visible tumor, but any “roots” extending beneath the surface of the skin. Five-year cure rates of up to 99 percent for first-time cancers and 95 percent for recurring cancers have been docu­mented.

Mohs surgery is primarily used to treat basal and squamous cell carcinomas, the two most common types of skin cancer, although it can be used for melanoma and other types of cancer. Mohs surgery is often recommended for recurring cancers, as well as those in difficult-to-treat areas, such as the nose, eyelids, lips, hairline, hands, feet and genitals, in which preserving as much tissue as possible is extremely important.

The Mohs Surgery Procedure

Mohs surgery is performed as an outpatient proce­dure in a physician’s office. It may be performed by a team of highly trained specialists, each member of which specializes in a different part of the surgery, or by one experienced surgeon capable of perform­ing the entire procedure. During Mohs surgery, the treatment area is numbed with a local anesthetic.

Small layers of skin are removed, and each layer is examined microscopically to see if it contains malignant cells. Excision continues until the cancer is completely removed. Most Mohs proce­dures can be performed in three or fewer stages and take approximately 4 hours.

At Luminary Dermatology, we have three fellow­ship trained Mohs surgeons, Dr. Cary Dunn, Dr. Shauntell Solomon, and Dr. Harib Ezaldein, and have recently added a highly respected board-cer­tified plastic surgeon, Dr. Michael Van Vliet, who is doing Mohs closures to close the loop on the full spectrum of services for our patients. Patients no longer need to be referred out to a plastic surgeon for closure of their excisions.

Recovery from Mohs Surgery

After Mohs surgery, patients experience mild dis­comfort, bleeding, bruising, and swelling. Pain medication is prescribed if needed, although most patients require only over-the-counter medication.

Mohs surgery leaves scars, although they are often smaller than those from other excision pro­cedures. Reconstructive procedures, including skin flaps and skin grafts, can reduce the promi­nence of, or even eliminate, scars; they can be performed at the same time as the Mohs surgery or at a later date. If possible, surgical techniques, including placing stitches in the skin’s natural creases or out-of-sight areas, are used to make scarring less visible.

Luminary Dermatology boasts three Fellowship Trained Mohs Surgeons. Dr. Ezaldein, Dr. Dunn, and Dr. Solomon are three of the top Mohs micrographic surgeons that Florida has to offer! Click here to learn more about them and their astounding qualifications.