Hearing the words 'skin cancer' can be frightening, but the good news is that the most common types of skin cancer are highly treatable, especially when detected early.
Two of the most frequently diagnosed skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). While these cancers share some similarities, they behave differently and may require different treatment approaches depending on their location, size, and characteristics.
For many patients, Mohs surgery offers the highest cure rates available while preserving as much healthy tissue as possible.
If you've been diagnosed with skin cancer or have a concerning lesion that needs evaluation, the team at Mt. Lebanon Dermatology Associates and Dermeve is here to help. Dr. Jeremy Udkoff is a fellowship-trained Mohs surgeon who specializes in the treatment of skin cancer using advanced tissue-sparing techniques.
Understanding Basal Cell Carcinoma
Basal cell carcinoma is the most common cancer diagnosed in the United States.
It develops from cells located in the deepest layer of the epidermis and is most often caused by cumulative ultraviolet (UV) exposure over time.
Basal cell carcinomas commonly appear as:
- Pearly or shiny bumps
- Pink patches
- Non-healing sores
- Areas that bleed easily
- Scar-like lesions
While basal cell carcinoma rarely spreads to distant parts of the body, it can continue growing locally and cause significant tissue destruction if left untreated.
Understanding Squamous Cell Carcinoma
Squamous cell carcinoma is the second most common form of skin cancer.
Like basal cell carcinoma, it is strongly associated with cumulative sun exposure and often develops in areas that receive frequent sunlight.
Squamous cell carcinomas may appear as:
- Scaly red patches
- Crusty or wart-like growths
- Non-healing sores
- Tender or painful lesions
- Thickened rough spots
Squamous cell carcinoma is generally more aggressive than basal cell carcinoma and carries a greater risk of spreading to nearby lymph nodes or other parts of the body if not treated promptly.
How Are Basal and Squamous Cell Carcinomas Different?
Both cancers arise from sun-damaged skin, but there are important differences.
Basal Cell Carcinoma
- Most common skin cancer
- Usually slow growing
- Rarely spreads
- Can cause significant local tissue damage if untreated
Squamous Cell Carcinoma
- Second most common skin cancer
- Often grows more quickly
- Greater risk of recurrence
- Small but meaningful risk of spreading beyond the skin
Because of these differences, treatment recommendations may vary depending on the type of cancer and its specific features.
What Is Mohs Surgery?
Mohs surgery is a specialized procedure used to remove certain skin cancers while preserving the maximum amount of healthy tissue.
Unlike traditional excision, where a predetermined margin of tissue is removed and sent to a laboratory for later evaluation, Mohs surgery allows the surgeon to examine 100% of the surgical margin during the procedure itself.
The process involves:
- Removing a thin layer of tissue.
- Mapping and processing the specimen.
- Examining the tissue under a microscope.
- Identifying any remaining cancer cells.
- Removing additional tissue only where cancer remains.
This process is repeated until all cancer cells have been removed.
Why Is Mohs Surgery Often Recommended?
Mohs surgery offers several advantages:
Highest Cure Rates
Mohs surgery provides some of the highest cure rates available for skin cancer treatment.
For many basal and squamous cell carcinomas, cure rates exceed 99% for newly diagnosed cancers.
Tissue Preservation
Because only tissue containing cancer is removed, Mohs surgery preserves as much healthy skin as possible.
This is particularly important in cosmetically and functionally sensitive areas such as:
- Nose
- Eyelids
- Lips
- Ears
- Scalp
- Cheeks
- Hands
Immediate Margin Evaluation
Patients leave knowing whether the cancer has been completely removed, rather than waiting days for pathology results.
When Is Mohs Surgery Recommended?
Not every skin cancer requires Mohs surgery.
However, Mohs is commonly recommended for:
- Skin cancers on the face
- Recurrent tumors
- Large tumors
- Aggressive subtypes
- Poorly defined borders
- Tumors in high-risk locations
- Certain squamous cell carcinomas with higher-risk features
The providers at Mt. Lebanon Dermatology Associates and Dermeve evaluate each patient's individual situation to determine the most appropriate treatment approach.
What Happens After the Cancer Is Removed?
Once the skin cancer has been completely removed, attention turns to reconstruction and healing.
Depending on the size and location of the surgical site, options may include:
- Natural healing
- Stitches
- Local skin flaps
- Skin grafts
Dr. Udkoff performs reconstructive repairs immediately following Mohs surgery whenever appropriate, helping patients achieve both optimal cancer treatment and excellent cosmetic outcomes.
What Is Recovery Like?
Most patients are pleasantly surprised by how manageable recovery is.
After surgery, patients typically experience:
- Mild soreness
- Temporary swelling
- Bruising in some locations
- Activity restrictions for a short period
Detailed wound care instructions are provided, and follow-up appointments help ensure proper healing.
If you have been diagnosed with skin cancer or have a concerning spot that won't heal, contact Mt. Lebanon Dermatology Associates and Dermeve to schedule an evaluation and learn whether Mohs surgery may be right for you.
