Peninsula Dermatologic Surgery Mohs



321 Middlefield Road, Suite 245
Menlo Park, CA 94025
T 650.326.7222 F 650.326.7332

FREQUENTLY ASKED QUESTIONS

You can find more information about skin cancer, prevention, sunscreens, resources and articles in our Education Section.

FAQ ABOUT SKIN CANCER

1. What is skin cancer?
Cancer is unregulated replication of cells that our bodies cannot stop.  As the cancer cells replicate, they form a tumor. It is this tumor which invades and damages your normal healthy tissue. The most common cause of skin cancer is long-term exposure to sunlight.

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2. What are basal cell and squamous cell carcinoma?
The most common skin cancer is basal cell carcinoma (accounting for 80% of skin cancers) which arises from the cells on the lowest layer of the epidermis. The next most common skin cancer,  squamous cell carcinoma (16% of skin cancers), is derived from the epidermal cells (keratinocytes).

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3. How common is skin cancer?
Skin cancer is the most common form of cancer in humans. Over 2 million new cases of skin cancer will be diagnosed this year in the United States.

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4. How is skin cancer treated?
The treatment of skin cancer has four goals:
1. completely remove the cancer,
2. preserve normal skin,
3. preserve function, and
4. provide an optimal cosmetic result.

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5. What is dermatologic surgery?
Dermatologic surgery is a subspeciality recognized by the American Medical Association dedicated to the diagnosis and treatment of medically necessary and cosmetic conditions of the skin. The purpose of dermatologic surgery is to diagnose and remove skin cancer but also to reconstruct (repair) and/or improve the function and appearance of skin tissue.

6. Who is a Mohs/dermatologic surgeon?
A Mohs/dermatologic surgeon is a board-certified dermatologist who has undergone additional extensive fellowship training to become an expert in Mohs micrographic surgery, reconstructive surgery, and cosmetic proceedures.

FAQ BEFORE SURGERY

1. Do I need to fast before surgery? Are there any dietary restrictions?  Can I drink alcohol?
No. We recommend that you eat breakfast and take all of your normal medications. There are no dietary restrictions but we suggest that you refrain from drinking alcohol for 2 days before and after your surgery. Alcohol thins the blood and increases your bleeding risk.

2. What anesthesia do the doctors use?  Will I be sedated?
The doctors use local anesthesia only. You will not be sedated during the procedure. In most cases, the anesthesia is the exactly the same as the biopsy.

3. How long will the surgery last?  How long will I be there?
Given that Mohs surgery occurs in stages, we never know exactly how long you will be here. On average, patients are here for 4-6 hours. (If you are scheduled for an excision and NOT Mohs surgery, plan on 45 minutes.)

4. Do you have internet access?  Can I bring my cell phone?
Yes!  We have complimentary wi-fi and you are welcome to bring your laptop. Cell phones do not interfere with our surgical equipment and can be used while you wait between stages.

5. Can I drive?
This depends mostly on the site of your surgery.  You will not be sedated so mentally you will be able to drive. However, if the site is near your eye (including upper cheek and nose) the post operative bandage may obstruct your vision especially if you wear glasses. Other examples include a surgery on the neck which may make it difficult to turn your head while backing up a car, or a surgery on the foot which may prohibit you from operating the vehicle.  If you have any questions,please ask us when you schedule your appointment

FAQ AFTER SURGERY

1. What will I look like when I leave the office?  How will I feel when I leave the office?
When you leave the office there will be a large pressure bandage in place. This consists of a mound of gauze and white elastic tape to prevent bleeding. The area will be numb from the local anesthesia for approximately 2-3 hours after surgery. After the anesthesia wears off, the amount of discomfort is variable. It depends on the site, the size of the defect and closure. Most people feel a little tired/fatigued after the procedure.

2. Can I go back to work?
You CAN go back to work after Mohs surgery; however most people do not. Given the large bandage, post-operative discomfort/fatigue, and our recommendation to apply an ice pack every hour, you may find working that afternoon to be difficult.

3. Can I exercise?
In order to provide you with the best surgical outcome, we recommend that you do NOT exercise until your stitches are removed.  The primary goals during the post-operative period are to 1) minimize stretching of the wound and 2) prevent bleeding in the wound. Stretching of the wound occurs when the skin around the stitches moves (e.g. playing tennis with a wound on your upper back, or climbing stairs with stitches in your leg).  Bleeding occurs when your blood pressure and pulse increase with exercise.  Taking a walk for example is acceptable as this exertion keeps the blood pressure and heart rate below peak levels.

If you do not have any stitches, there are no restrictions on physical activities after the first 48 hours.

4. Can I travel after surgery?
You should not fly for 48 hours after your surgery. All other travel depends on the surgical site and chosen closure. If stitches are placed, they will need to be removed 1-2 weeks depending on the site. Ideally, you would be back in town for suture removal.  We do understand that some of our patients have very busy travel schedules, and we can absolutely work with you.  Please let us know your needs when you schedule your appointment.

5. Can I get the stitches wet?
Starting the day AFTER surgery, it is fine for the stitches to get wet under running water (e.g. showers are fine).  However, the stitches should NEVER be immersed or soaked in water for a long period of time (e.g. in a pool).  Wet bandages should also be changed immediately.

6. Can I shave?
No, you do not want to cut the stitches on the surface of the skin.

7. Do I have to keep the wound covered?
The two most important things to remember in post operative care are 1) keep the wound free of scabs and 2) keep it lubricated with ointment. The purpose of a band-aid is to keep the ointment on the wound and prevent it from drying out. It is okay to leave the wound uncovered as long as you reapply the ointment every 2-3 hours throughout the day.

8. What pain medicines can I take?
For over-the-counter pain relief, we recommend that you take Tylenol (acetaminophen)–either 1 extra-strength tablet or 2 regular strength tablets every 6 hours. Please refrain from aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve) as these thin your blood and increase the risk of bleeding. Your surgeon may also provide a prescription pain medication.

9. Should I use Vitamin E oil or scar reducing creams after the stitches are removed?
Research shows that the use of these products yields no significant difference in the cosmetic outcome of your surgery.  During the initial wound healing period, keeping the skin lubricated benefits you the most.

10. Who do I call if I have any problems or if other issues arise?
If it is a life-threatening emergency, call 911. Otherwise, please call us at 650-326-7222. If it is after hours and you need to speak with a physician, please call the same number 650-326-7222. Our answering service will then page the doctor on call.