Is Mohs Surgery Painful? Here’s What To Know
Mohs surgery is a gold-standard technique for the precise removal of skin cancer, known for its high success rate and minimal tissue disruption. However, one of the most common questions or concerns patients have before undergoing this procedure is, “Will it hurt?” Understanding what to expect during and after the surgery can help alleviate anxiety and ensure patients are fully prepared. This post will discuss how Mohs surgery is performed, the measures taken to ensure patient comfort, and tips for a smooth recovery.
What Is Mohs Surgery?
Mohs surgery is a specialized procedure designed to treat certain types of skin cancer, including but not limited to basal cell carcinoma, squamous cell carcinoma, and some melanomas.
The process: Mohs surgery involves removing thin layers of cancerous tissue one at a time (referred to as stages). Each layer is immediately examined under a microscope to determine if cancer cells are still present. The surgeon continues this meticulous process until all margins are cancer-free.
Why it is preferred: Mohs surgery is especially beneficial for treating skin cancer located in critical, sensitive, or visible areas, such as the face, ears, hands, and feet, where preserving healthy tissue is crucial.
Benefits of Mohs Surgery:
- High cure rate: Studies show a cure rate of up to 99% for new cases of skin cancer and 94% for recurrent cases.
- Tissue conservation: By targeting only cancerous cells, this technique preserves as much healthy skin as possible and minimizes scarring.
Pain and Discomfort During Mohs Surgery: What to Expect
One of the primary goals of Mohs surgery is to keep patients comfortable throughout the procedure. Since the procedure is performed under local anesthesia, recovery is faster compared to general anesthesia or sedation.
Local Anesthesia Administration
Most patients report that Mohs surgery is not painful, though experiences can vary depending on individual sensitivity. Before the procedure begins, local anesthetic (like lidocaine) is injected to completely numb the treatment area. The anesthetic effect is relatively quick and typically takes anywhere from a few seconds to less than 2 minutes to work. Patients often describe a brief stinging or burning sensation as the anesthesia is administered. Once the area is numb, most people feel no pain.
Sensations during surgery:
While the area is numb, patients might feel mild pressure or movement as the surgeon works. There is no sharp pain during the removal, examination of tissue layers or repair of the surgical site.
Steps to Maximize Patient Comfort
Minimizing discomfort during the procedure is of upmost importance and surgeons take several steps to ensure the procedure is as pain-free as possible:
Administration and monitoring of anesthesia
The surgeon carefully injects anesthesia around the treatment site, ensuring complete numbness. Additional doses can be given if the procedure extends or if the patient feels any discomfort.
Minimizing discomfort
Surgeons use small-gauge needles for injections to reduce the initial pinch. Distraction techniques, like ice packs, conversation, or calming music, may be employed.
Breaks during the procedure
Patients can take breaks between tissue removal and analysis stages, which can help reduce stress and discomfort.
Post-Procedure Pain and Recovery
After the surgery, some discomfort is normal, but it is typically mild and manageable.
What to expect after anesthesia wears off
Patients might experience tenderness, swelling, or minor bruising around the surgical site. Pain levels are usually low; many patients describe the sensation as similar to a mild sunburn.
Pain management
Over-the-counter pain relievers like acetaminophen or ibuprofen are typically sufficient. Several studies have demonstrated that the combination of acetaminophen/ibuprofen provides pain relief similar to or better than opioid pain medications without the adverse effects associated with opioid pain medications.
The application of ice packs over and around the surgical bandages can also help reduce pain by minimizing inflammation and swelling.
Avoid the use of aspirin for pain control unless advised by your doctor for other medical reasons, as it can increase the risk of bleeding.
Tips for a Comfortable Recovery
A smooth recovery depends on proper post-operative care and adhering to your surgeon’s instructions.
Aftercare guidelines
- Keep the surgical site clean and covered with a bandage as directed.
- Use a cold compress to reduce swelling.
- Elevate the affected area, especially for surgeries on the face or extremities, to minimize swelling.
- Avoid any strenuous physical activity or any activity that could put pressure on the surgical site to allow proper healing and minimize the risk of bleeding or opening of stitches.
- If you experience unusual pain, excessive swelling, bleeding, or signs of infection, such as redness or pus, reach out to your surgeon promptly.
Addressing Patient Anxiety About Mohs Surgery
Many patients feel nervous about the potential for pain or the procedure itself. Addressing these concerns can make a significant difference.
- Discussing concerns with your doctor:
- Be open about your fears or past experiences with medical procedures. Your surgeon can adjust their approach to help you feel more at ease.
- Anxiety-reducing techniques:
- Practice deep breathing or guided meditation to calm your nerves.
- Bring a stress-relief item, like a favorite playlist or a stress ball, to the appointment.
- The role of a calm mindset:
- Staying relaxed can positively impact your experience, as stress and anxiety can heighten sensitivity to discomfort.
- While a preoperative consult is not always necessary, consider reaching out to your surgical team for one prior to the day of the Mohs surgery if you are feeling uncertain about the procedure. Knowing what to expect can help alleviate anxiety by providing knowledge and reducing uncertainty.
Mohs surgery is a highly effective, minimally invasive procedure for treating skin cancer. With the use of local anesthesia and various comfort measures, most patients find the process virtually pain-free. While minor discomfort is normal during recovery, it is manageable with proper care. If you are considering Mohs surgery and have concerns about pain, do not hesitate to discuss them with your surgical team — they are there to ensure your comfort every step of the way.