Home » Mohs Micrographic Surgery

Skin cancer is by far the most common form of cancer in the U.S., with more than 9,500 people diagnosed each day. A skin cancer diagnosis can be overwhelming, but treatment is possible and new technologies have greatly improved outcomes. Our highly-trained surgeon, Dr. Peter Ehrnstrom, is an expert in a leading outpatient procedure called Mohs Micrographic Surgery, a cutting-edge technique that sees cure rates as high as 99%. Dr. Ehrnstrom performed the first Mohs Surgery procedure ever in Alaska in 1994. Read on to find out more about Mohs Surgery, its results, and whether it’s the right treatment for you.

What is Mohs Surgery?

Mohs Micrographic Surgery is a specialized procedure that removes skin cancers at the microscopic level. Mohs Surgery allows surgeons to examine and remove skin tissue using an intricate level of precision and control. During Mohs Surgery, cancerous tissue is removed and microscopically examined to be sure all the “roots” and extensions are eliminated while keeping as much healthy tissue intact as possible.Working at the microscopic level also results in minimal scarring, so Mohs Micrographic Surgery is also ideal for skin cancers on highly visible areas, such as the head and neck.The procedure began as a technique called chemosurgery, developed in the 1930s by Dr. Frederic Mohs, who combined the surgical removal of cancerous tissues with the immediate microscopic examination of the tumor and its underlying roots. Today, it’s the single most effective technique for removing basal and squamous cell carcinomas, with a cure rate of up to 99%.

What to Expect with Mohs Surgery

Mohs Surgery is performed by our highly qualified Mohs surgeon as an outpatient procedure under local anesthesia in one of Alaska Center for Dermatology’s surgery suites. It has a superior cure rate for skin cancer and is often considered even after a prior treatment has failed. However, it is important to understand that no method at any time, including Mohs Surgery, can promise 100% cure rates.The Mohs technique allows the surgeon to cut away the maximum amount of the tumor while leaving the surrounding healthy tissue largely untouched. This leads to reduced scarring in highly sensitive or visible areas, and results that are significantly better than other conventional treatments. In fact, Mohs Surgery has a high cure rate of 95% to 99% (vs. cutting out, scraping and burning, or radiation).When performing the procedure, our Mohs Surgeon is both the surgeon and the pathologist following a strict protocol that’s been perfected over decades. This includes:

  1. Examining the roots of the skin cancer. Much like the tip of an iceberg, a tumor’s roots may extend beyond its visible portion. If these roots aren’t removed, cancer will likely recur.
  2. Removing the visible portion of the skin cancer surgically.
  3. Color-coding the removed tissue with a dye, dividing it into sections, and drawing a map.
  4. Examining the undersurface and edges of the tissue under a microscope in order to ensure that all the skin cancer is out. The tissue is examined in an on-site CLIA-certified laboratory.
  5. Marking the exact area on the map where any skin cancer persists in order to remove another layer of skin from precisely, and only, those areas.

The process continues until there is no longer any evidence of skin cancer remaining. At this point, the surgeon will reconstruct the area using plastic surgery techniques such as complex closures, flaps, and/or grafts.

What Types of Skin Cancer Does Mohs Surgery Treat?

Basal cell carcinoma and squamous cell carcinoma are the two most common types of skin cancer that are treated using Mohs Micrographic Surgery. Other rarer forms of skin cancer may also be treated with Mohs Micrographic Surgery.While finding a new skin cancer growth isn’t usually considered an immediate threat, it should be removed as soon as possible. We recommend this because regardless of its type, skin cancer will not go away on its own. The longer a skin cancer is left untreated, the larger it grows and the higher the risk of it spreading through the body. Skin cancer can be fatal if left untreated.Read more about skin cancer here.

Does My Insurance Pay for Mohs Surgery?

Most insurance policies cover the costs of Mohs Surgery and reconstruction of the surgical area, although you may be responsible for any deductible or copayment required by your policy.If you do not have insurance that covers the Mohs Micrographic Surgery, please let our Alaska Center for Dermatology team know, and we’ll be happy to work out an alternative payment plan. Additionally, if you are a Medicare enrollee, be sure to mention any special supplemental policies. Please bring all health insurance cards and policy numbers with you when you come in for your appointment.Find out more about insurance information here.Book an appointment here.