The time before Mohs micrographic surgery, as with any surgery, is important for ensuring a successful outcome. To know how you should prepare for your procedure, you will need to discuss details about your health and medical history with your surgeon. Whether you are undergoing Mohs surgery for basal cell carcinoma, squamous cell carcinoma, or melanoma, it is essential that you communicate the following areas of your health with your health care team.
Details About Your Skin Cancer
When your Mohs surgeon has a full understanding of your skin cancer, they are able to provide the most effective care possible. This is why it is essential for you to relay as many details as you can, ensuring they have all the necessary information. If you had a biopsy taken, they will need a copy of the pathology report. Any imaging results from lab tests will also be needed. In addition, your Mohs surgeon may require further diagnostic tests, such as blood work.
Current Medications You Are Taking
The medications you take can affect whether you are eligible for Mohs surgery and how soon you are able to schedule your procedure. This is because certain types, like blood thinners, can increase your risk of experiencing complications from Mohs surgery. Local anesthesia can also interact with certain medications or other medical problems you may have. While many people think this only means prescription medications, even over-the-counter medicines (like herbal supplements) can cause problems during and after surgery. Make sure your doctor is aware of all the medications you are taking, so they can help you create a safe regimen.
Any Allergies You Have
All of your allergies and potential intolerance to medications will need to be relayed to your doctor, even those that may seem irrelevant. During office-based surgical procedures, you may be given certain medications, such as pain medication, antibiotics, and anxiolytics. To prep for your Mohs surgery, the area may be cleansed and prepped with iodine, which patients with a shellfish allergy may react to. Since you may not always realize what will interact with your allergies, it can help to carry a list with you at all times, so your doctor is fully aware and can plan accordingly.
Other Medical Conditions
In addition to the medications you take, your doctor will need to know any other health problems and conditions you suffer from. This includes bleeding disorders, respiratory issues, immunosuppression, heart disease, vascular disease, and past organ transplants. If you have a pacemaker or implantable defibrillator, this is also important to share with your surgeon. Always tell your Mohs surgeon about any medical conditions you have, even if you think your diagnosing doctor informed them. It is always better to confirm your surgeon is aware.
Your Medical History
When planning your Mohs procedure, your surgeon will need a thorough understanding of your health history. You will need to share previous medical records, including instances of past skin cancer, circulatory issues, or heart attack. Always voice any questions or concerns you may have, as this can help your doctor customize your surgical plan. Patients may have different needs, including varying medications and treatment details. “I am always happy to help ensure that each patient’s questions, concerns, and information is heard,” says Dr. Adam Mamelak, a board-certified dermatologist and Mohs micrographic surgeon.
History of Alcohol & Tobacco Use
Your surgeon will need to know your history of smoking, as tobacco use can complicate your body’s ability to heal properly. In addition, you should avoid alcohol for at least 3 to 4 days before your Mohs procedure, as it can cause blood thinning and lead to bleeding after your skin surgery.
Some patients may require special care to accommodate their specific needs. For instance, patients with a motorized wheelchair, service dog, or interpreter may need special arrangements made to ensure a comfortable procedure. Unique situations like these can affect where and when Mohs surgery can be performed. Guardians or those making one’s medical decisions should be available when possible or provide special instructions, as needed.
If you have received a skin cancer diagnosis and have questions about Mohs micrographic surgery, please contact our office to schedule an appointment with Dr. Mamelak.