Mohs Surgery and Scarring: Tips for Minimizing Post-Procedure Scars

Mohs surgery is a highly effective procedure for treating skin cancer. It boasts an impressive cure rate of up to 99% for certain skin cancers, such as basal cell carcinoma and squamous cell carcinoma, making it one of the most trusted treatments available. Scarring is a normal part of healing and as with any surgical procedure, including Mohs, scarring along incision sites will occur. Understanding how to manage and minimize scarring is crucial for optimal healing and appearance. This blog post will provide comprehensive tips and strategies to help you minimize the appearance of scars after undergoing Mohs surgery.

Immediate Post-Surgery Care

Proper post-operative care is the foundation of successful healing and minimizing scarring. Here are some key steps you can take to optimize healing and scarring:

Proper Wound Cleaning Techniques

Cleaning your surgical site as instructed by your healthcare provider helps prevent infection and supports healing. Typically, this involves gently washing the area with mild soap and water, followed by patting it dry with a clean towel. Avoid scrubbing the area, as this can irritate the wound and increase your risk for infection,potentially worsening scarring.

Importance of Keeping the Wound Moist

Keeping the wound moist as instructed by your surgeon is essential for reducing scar formation. Studies show that wounds that are kept moist with ointments such as petroleum jelly or antibiotic creams can heal faster and result in less visible scarring. Covering the wound with a sterile bandage can further help maintain moisture and protect the site from bacteria.

Protecting the Surgical Site from Sun Exposure

Ultraviolet (UV) rays can darken scars, making them more noticeable. To protect your healing skin, apply a broad-spectrum sunscreen with an SPF of 30 or higher once the wound has closed. Additionally, wear protective clothing or a wide-brimmed hat if the surgical site is on your face or scalp.

Non-Medical Mohs Scar Management

While medical treatments can be helpful, non-medical approaches also play a significant role in scar management.

Massage Techniques for Scar Tissue

Gentle scar massage can improve circulation, break down scar tissue, and make scars less noticeable. Use clean hands and apply light pressure in circular motions for about 10 minutes, twice a day. Start massaging only after your wound has fully healed and consult your doctor for guidance.

Proper Nutrition for Optimal Healing

A nutrient-rich diet supports the body’s natural healing processes. Include foods high in vitamins A, C, and E, as well as zinc and protein, which are essential for collagen production and tissue repair. For example, citrus fruits, leafy greens, nuts, seeds, and lean meats are excellent choices.

How Hydration Helps

Staying hydrated ensures that your skin remains supple and heals efficiently. Drinking enough water helps maintain skin elasticity, minimizes dryness, and supports the overall healing process. Aim for at least 8 glasses of water per day, and adjust based on your activity level and environment.

Medical Interventions for Mohs Scar Management

If non-medical methods are not enough to achieve your desired results, several medical treatments can help improve the appearance of scars.

Topical Treatments

• Silicone gels and sheets: Silicone-based products are widely recommended for minimizing scars. They work by hydrating the skin and flattening raised scars.
• Corticosteroid creams: These can reduce inflammation and prevent excessive scar tissue formation. Corticosteroid cream use should be discussed with your doctor and not be applied long term to an area.

Injectable Treatments

In cases of abnormal wound healing when scars become thick and raised, steroid injections can be used to soften and flatten hypertrophic or keloid scars. These are often administered over several sessions for optimal results.

Laser Therapy Options

Laser treatments, such as fractional lasers or pulsed-dye lasers, can improve the color and texture of scars. These therapies target the scar tissue while stimulating collagen production to improve the skin’s appearance.

Surgical Scar Revision

In cases of severe scarring, surgical scar revision may be an option. This involves removing the scar tissue and re-suturing the area with more precise techniques to minimize its appearance. This procedure is typically reserved for scars that significantly impact function or aesthetics.

Long-Term Scar Care

It is important to remember that the final healing phase of scar wounds known as the remodeling phase can last up to a year or longer. Time is a scar’s best friend, however there are several steps you can take to optimize the healing process. Scar management does not end after the initial healing or undergoing scar intervention treatments. There are several long-term lifestyle changes that are essential to keep scars as minimal as possible:

Continued Sun Protection

Even years after surgery, scars can darken or appear lighter when surrounding normal skin darkens with sun exposure. Regularly apply sunscreen and cover the area to prevent hyperpigmentation.

Regular Moisturizing

Hydrated skin heals better and looks healthier. Use a fragrance-free moisturizer to keep your scar tissue supple and reduce itchiness or tightness.

Makeup and Camouflage Techniques

For scars in visible areas, makeup can provide temporary coverage. Look for products designed for scar camouflage, such as those labeled non-comedogenic and dermatologist-tested. Green-tinted primers can neutralize redness, making scars less noticeable.

When to Consult a Professional

Although most scars fade over time, some may require additional attention. Consult a healthcare professional if you notice:

• Signs of abnormal scarring, such as keloids or hypertrophic scars
• Persistent redness, swelling, or pain
• Concerns about the appearance of your scar

Professionals can recommend treatments tailored to your specific needs, ensuring the best possible outcomes.

While Mohs Surgery does carry the potential for scarring, its high success rate in treating skin cancer makes it an invaluable procedure. Fortunately, there are numerous ways to minimize the appearance of scars, from immediate post-surgery care to advanced medical treatments. By following these recovery tips and consulting with your healthcare provider, you can support optimal healing and feel confident in your skin’s recovery.

Discuss the potential for scarring and your scar management plan with your surgeon during your pre-surgical consultation to ensure you are fully prepared for the healing process.

Keemberly Kim, MD is a board-certified dermatologist and board-certified Mohs Surgeon with fellowship training in cosmetic dermatologic surgery. Dr. Kim completed her dual fellowships in Mohs surgery and dermatologic oncology at the University of California Davis and an American Society of Dermatologic Surgeons accredited cosmetic dermatologic surgery fellowship at the Laser and Skin Surgery Center of Northern California. She has a special interest in skin cancer, Mohs surgery and cutaneous reconstruction, as well as cosmetic treatments including neurotoxins, fillers, and laser procedures. Dr. Kim is fluent in Spanish and has a special interest in treating ethnic skin.