Looking after your skin after Mohs surgery comes down to four things: keep the wound clean, moist and covered while it heals, protect it and the rest of your skin from the sun, look after your general health, and check your skin every month. Your surgeon’s own aftercare instructions come first, as they depend on how your wound was repaired.
- Keep the wound moist and covered. Wounds that dry out and scab heal more slowly.
- Clean it with mild soap and water, not hydrogen peroxide or iodine, which can damage new tissue.
- Once the skin has closed and your surgeon agrees, use a broad-spectrum SPF 30 or higher every day.
- Diabetes, smoking and poor circulation can slow healing, so tell your surgeon about your health and medicines.
- Check your skin monthly and keep every follow-up appointment. Having had one skin cancer raises your risk of another.
How does a Mohs wound heal?
A wound heals in four overlapping stages, from clotting in the first few hours to scar remodelling that can go on for up to two years. Knowing which stage you are in tells you what is normal.
- Clotting (minutes to hours): blood clots over the wound straight after surgery. Leave it undisturbed.
- Inflammation (days 1 to 5): some redness, warmth and mild swelling are normal. This is your immune system clearing the area.
- New tissue (days 5 to 21): new tissue fills the wound. Studies of wound healing phases show that a wound kept moist under a dressing avoids a hard scab, while a dry wound is slower to grow new skin across its surface.
- Remodelling (weeks to months): collagen reorganises, and the scar slowly softens and fades. This stage can last up to two years.
How should I clean and dress the wound?
Gently, and on a routine. Unless you’ve been told otherwise, clean the area once or twice a day with mild soap and water, pat it dry with a clean cloth, then apply a thin layer of petroleum jelly or the ointment your surgeon recommended and cover it with a non-stick dressing. Dressings are usually changed once a day, but follow the instructions you were given.
Things to avoid:
- hydrogen peroxide or iodine-based antiseptics, which damage new tissue
- letting the wound dry out and form a hard scab
- picking at crusts
- skipping a dressing change because the wound “looks fine”
Once the wound has fully closed, silicone gel sheets are one of the best-supported ways to reduce a scar’s thickness and redness while it remodels. Ask your surgeon when it’s safe to start. Our guide to minimising scarring has more practical advice for Mohs patients.
Why does sun protection matter so much after Mohs surgery?
Sun on a healing scar can leave it darker than the skin around it, and UV is the main cause of skin cancer that you can do something about. After a basal cell or squamous cell carcinoma, protecting the rest of your skin matters as much as protecting the scar.
- Apply a broad-spectrum SPF 30+ sunscreen every morning, and reapply every two hours when you’re outdoors.
- Wear a wide-brimmed hat that shades your face, ears and neck.
- For long spells outside, wear clothing labelled UPF 50+.
- Stay in the shade around the middle of the day, when UV is strongest.
- Don’t use sunbeds.
No single method covers everything. Sunscreen wears off, a hat can shift in the wind, and shade doesn’t block UV reflected off water, sand or pavements, so use them together. Keeping a small tube of sunscreen by the front door or in your bag makes the habit much easier to keep.
If your cancer was classed as higher risk, our high-risk skin cancer guide explains what raises the chance of it coming back. Family members helping with sun habits may find our practical guide useful, and you can read more about skin cancer treatment.
Your general health and healing
How quickly your skin heals depends on your general health as well as on wound care. Older age, diabetes, a weakened immune system and poor blood flow can all slow healing, and diabetes can also raise the risk of infection. None of this means a problem is likely, but these conditions need managing.
- Eat some protein at each meal, such as eggs, fish, lean meat, dairy, beans or lentils. Your body needs it to rebuild skin.
- Drink six to eight glasses of fluid a day.
- If you have diabetes, keep your blood sugar as steady as you can. This lowers the risk of infection.
- Don’t smoke. Nicotine narrows blood vessels and reduces the oxygen reaching the wound.
- Walk gently to keep your circulation going, but avoid strenuous exercise until your surgeon says it’s fine.
Serious complications after Mohs surgery are rare. Before your follow-up appointment, write down your medicines, supplements and health conditions so your surgeon can spot anything that might affect healing. Our guide to follow-up after surgery covers what to expect and the warning signs to look out for.
How do I check my own skin after Mohs surgery?
Check all of your skin once a month, including the area around your scar. Having had one basal cell or squamous cell carcinoma raises your risk of another, either at the same site or somewhere new.
- Find a well-lit room with a full-length mirror and a hand mirror.
- Check your face, scalp, ears and neck, using the hand mirror for places you can’t see directly.
- Check your chest, stomach and back. A partner can help with your back.
- Look at your arms, hands and fingernails.
- Check your legs and the soles of your feet.
- Note any new spots, changes in existing moles, and any area that bleeds, crusts or doesn’t heal.
Your specialist can examine a spot under a dermatoscope (a lit magnifier) and take a biopsy if needed. They’ll also tell you how often you need follow-up appointments, which depends on the type of cancer you had and your own risk.
Our page on skin cancer detection explains what clinicians look for. If your surgery was on your face, our guide to spotting symptoms on the face is also useful.
Do I still need to be careful once the scar has faded?
Yes. The usual slip comes once the first follow-ups are over and the wound looks good: an appointment gets missed, or the daily sunscreen quietly stops. A new or returning skin cancer is easy to miss unless you’re looking for it, so the monthly check matters as much in year three as in month three.
If your wound was repaired with a flap or graft, our page on reconstruction after Mohs surgery explains what to expect over the longer term.
Talking to Miss Nayar
Miss Rakhee Nayar is a Consultant Plastic Surgeon, FRCS (Plast), MD, and one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery. Her training covers both removing the cancer and repairing the wound, which is where healing and scarring begin. You can read about Mohs surgery for BCC or how Mohs surgery works, or contact her clinic to arrange an appointment.
Frequently asked questions
How soon can I wash my face after Mohs surgery?
Usually within the first 24 hours, using water and mild soap, but follow the instructions you were given for your own wound. Don’t soak or scrub the area. The evidence favours gentle cleansing over harsh antiseptics, which can damage new tissue and slow healing.
When can I put sunscreen on the scar?
Once the skin has fully closed, typically after one to two weeks, and your surgeon has said it’s ready. Until then, shade the area with a hat. After that, use a broad-spectrum SPF 30 or higher on the scar every day to help stop it darkening.
What should I look for when I check my skin?
Look for new spots, changes in existing moles or scars, and any area that bleeds, crusts or doesn’t heal. Check once a month, including the skin around your scar. If anything worries you, contact your specialist rather than waiting for your next appointment.
Does diabetes slow healing after Mohs surgery?
It can. Diabetes may slow wound healing by affecting circulation and the immune response, and it can raise the risk of infection. Keeping your blood sugar steady and eating well both help, so make sure your surgeon knows you have diabetes.
Recommended
- How to prepare for Mohs surgery: your step-by-step guide
- Mohs surgery myths vs facts: what patients need to know
- Reconstruction After Mohs Surgery
- How to minimise scarring after skin cancer removal
Filed under Recovery and Aftercare
