What is the downtime after Mohs Surgery?
Mohs surgery for the treatment of skin cancer is performed without general anesthesia and at an outpatient facility or dermatologist’s office. So after Mohs surgery, there is little to no traditional downtime to speak of. However, aspects of the healing process may cause patients to alter their normal schedules for awhile.
“It’s true,” says Dr. Adam Mamelak, fellowship-trained Mohs micrographic surgeon at Sanova Dermatology in Austin, Texas. “It’s a minimally invasive procedure, but still surgery, so patients need to know what to expect.”
For example, Dr. Mamelak claims that it is completely normal to have some redness and swelling around the surgery site or ‘wound’ after the Mohs procedure. This redness and swelling will gradually disappear over the next few days to a week. Also, there may be some drainage from the wound. This should also stop after a few days.
Certain areas of the body, like the soft tissue around the eyes, may swell a lot and bruise. That could cause a person to temporarily experience vision problems or feel self-conscious about being seen in public. Headaches, redness and minor discomfort may also occur.
The swelling, headaches and discomfort may be addressed immediately after surgery with the use of ice packs and pain medications. “It is normal to have mild to moderate pain for a day or two following the procedure,” says Dr. Mamelak. “I often find ice works better than any prescription medicine, especially the day of surgery.” Dr. Mamelak advises applying ice for 10-15 minutes, every hour after surgery until bedtime to significantly minimizes swelling a discomfort. Depending on the individual’s unique circumstances, medication and ice may no longer be needed after the first 48 hours have elapsed. In most instances, any residual bruising will disappear on its own within 1-2 weeks. Any swelling related vision problems tend to resolve quickly as well.
Some patients may experience post-operative bleeding. “The surgical wound can ooze a bit, but real bleeding is rare after surgery,” says Dr. Mamelak. If bleeding occurs, it is typically minimal and easily controlled with the use of pressure bandages. “Applying direct pressure to the wound for 10 minutes, without stopping, will usually stop any oozing.” In certain situations, temporary restrictions in activity and exercise to avoid disrupting the wound and subsequently causing more blood loss.
Post-surgical infections are not common and are considered a complication of surgery, not a part of the expected downtime. Studies show that infection can occur in 1-2% of surgeries. If you suspect your wound is infected, if the redness or swelling around the wound does not subside, if pus is expressed from the wound, or if you experience prolonged pain or worsening pain after 3 to 4 days, fever or chills, contact your surgeon immediately.
In general, patients have stitches in their skin for 1-2 weeks after their Mohs procedure. They are also often advised to keep their surgery site covered with a bandage. A bulky pressure bandage is often applied immediately after surgery. This is usually replaced with a smaller bandage after a few days.
If you have questions about Mohs surgery, or for more information about the downtime and recovery process after the procedure, please contact Dr. Mamelak at Sanova Dermatology today at (512) 837-3376.