At Preston Dermatology, our priority is empowering patients with clear diagnoses, tailored treatment plans, and complete confidence in their skin cancer care. When dealing with common skin cancers such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), selecting the right treatment depends on the lesion’s type, location, depth, and your personal health goals.

For cancers in cosmetically and functionally sensitive areas—such as the nose, eyelids, lips, ears, scalp, or fingers—Mohs micrographic surgery is widely recognized as the gold standard.

Below, learn how Mohs surgery works, how we partner with top surgical specialists across the Triangle, and how our in-office Superficial Radiation Therapy (SRT) offers a non-surgical alternative for qualifying patients.

What Is Mohs Surgery?

Mohs micrographic surgery is an advanced, tissue-sparing surgical technique designed to remove skin cancer while preserving as much healthy surrounding tissue as possible.

Unlike traditional excision, where a wide margin of healthy skin is removed and tissue analysis is sent to an outside lab days later, Mohs surgery evaluates 100% of the surgical margins in real time.

How the Procedure Works:

1. Targeted Layer Removal: The surgeon numbs the area with local anesthesia and excises the visible tumor along with a very thin border of adjacent tissue.
2. Immediate Microscopic Mapping: The excised tissue is color-coded, mapped, and processed in an on-site laboratory. The surgeon examines the edges under a microscope to pinpoint any remaining cancer cells.
3. Precise Re-Excision (If Needed): If microscopic cancer roots are found, the surgeon removes tissue only from the exact section where cancer cells were detected, sparing surrounding healthy skin.
4. Wound Reconstruction: Steps 1 through 3 repeat until the margins are completely clear. Once cancer-free, the surgeon repairs the wound using cosmetic closure techniques (flaps, grafts, or side-by-side stitches) for optimal aesthetic outcomes.

Because tissue is examined layer by layer, Mohs surgery achieves cure rates up to 99% for new skin cancers and 95% for recurrent cancers, while leaving the smallest possible scar.

How Preston Dermatology Supports Your Mohs Care

While we do not perform Mohs surgery inside our offices, our clinical team serves as your primary partner and advocate throughout the treatment journey:

• Comprehensive Screening & Biopsy: We perform thorough full-body skin checks, identify suspicious lesions, and handle prompt, accurate diagnostic biopsies.
• Trusted Specialty Referrals: We partner with leading fellowship-trained Mohs surgeons throughout Cary, Raleigh, Wake Forest, and the greater Research Triangle to ensure you receive seamless, top-tier surgical care.
• Post-Operative Care & Ongoing Monitoring: Following your procedure, our dermatologists provide continued follow-up, suture site checks, scar evaluation, and long-term surveillance to protect your skin health.

Frequently Asked Questions (FAQs)

What types of skin cancer are treated with Mohs surgery?

Mohs surgery is primarily indicated for non-melanoma skin cancers, specifically basal cell carcinoma and squamous cell carcinoma. It is especially beneficial for lesions located on delicate areas (face, neck, ears, hands, genitals), cancers with ill-defined borders, large or aggressive tumors, or skin cancers that have recurred after previous treatments.

Does Preston Dermatology perform Mohs surgery on-site?

No. Mohs surgery is a specialized surgical procedure that requires specialized frozen-section laboratory equipment. Instead, we coordinate direct referrals to vetted, fellowship-trained Mohs surgeons across our regional network, while handling your preliminary biopsy and all long-term post-treatment surveillance.

How do I know if I qualify for Superficial Radiation Therapy (SRT) instead of surgery?

SRT is FDA-cleared and proven to treat non-melanoma skin cancers (BCC and SCC) with cure rates comparable to surgery (over 95%). It is ideal for patients who want to avoid surgical scars, those with lesions in cosmetically sensitive areas, or individuals who are not good surgical candidates due to medical conditions. Your provider will assess your biopsy report to confirm if SRT is right for your tumor type and stage.

How long does a Mohs procedure take?

Because each tissue layer must be processed and examined under a microscope while you wait, the procedure typically takes between two and four hours. In most cases, patients remain comfortable under local anesthesia in the surgeon’s waiting area between stages.

How can I schedule an evaluation for a suspicious spot?

If you have noticed a new, changing, bleeding, or non-healing spot on your skin, early detection is critical. Contact Preston Dermatology at any of our convenient Triangle locations—Cary / Raleigh, Wake Forest, or Holly Springs—to schedule a skin cancer screening or biopsy consultation.