Your own instructions come first. This page is general guidance for preparing for Mohs surgery. If your surgeon or the office gave you specific instructions that differ from anything here, such as a medication to hold or a change to your arrival time, follow theirs. When in doubt, call your Belaray office.

Mohs surgery is an outpatient procedure performed in the office under local anesthesia, so there is no hospital stay and no general anesthesia. A little preparation makes the day go smoothly. The most important things to know are that you should plan to spend most of the day with us, and that you should keep taking your regular medications, including blood thinners, unless your surgeon tells you otherwise.

Keep Taking Your Medications

Take all of your regular medications on the day of surgery unless your Mohs surgeon or your regular physician tells you otherwise. This includes prescription blood thinners such as aspirin, Coumadin (warfarin), Plavix, Xarelto, Eliquis, and Pradaxa. Please do not stop them on your own.

Plan for the Whole Day

Please leave the entire day open for surgery. The visit can take up to about six hours. Removing each layer of tissue takes only a few minutes, but our laboratory then needs 1 to 2 hours to process and examine that layer under the microscope while you wait. Most tumors are cleared in one or two layers, but some need three or more, and there is no way to know in advance. The day also includes local anesthesia, any reconstruction of the wound, and bandaging afterward. Because there is waiting time between layers, feel free to bring a book or a device to pass the time. Free Wi-Fi is available in our offices.

Eating

Eat your usual breakfast. If you normally skip breakfast, please have a morning snack. Because it is a long day, you are welcome to bring additional snacks or lunch, and to drink plenty of water.

Shower the Morning of Surgery

Please shower and wash your hair the morning of your surgery. Afterward you will need to keep your bandage clean and dry, and the surgical area may need to stay dry for a day or two, so starting the day freshly washed helps. Leave the surgical area clean and do not apply makeup, lotion, or moisturizer to it. If your surgery is on the scalp or face, washing your hair beforehand is especially helpful.

What to Wear

  • Wear comfortable, loose-fitting clothing that gives the team easy access to the surgical site.
  • Choose something that opens in the front, with buttons or a zipper, and avoid pullover clothing. If needed, we can provide a gown.
  • Please do not wear your nicest clothes. On rare occasions clothing can get stained during surgery, so wear something you can launder easily.
  • If your surgery is in or near a hair-bearing area, bring hair clips or barrettes to help keep your hair away from the surgical site.
  • Bring a sweater. We keep the rooms cool to maintain our specialized equipment.

Bring Someone With You

We encourage you to bring a friend or relative to keep you company between the stages of the procedure. Mohs surgery uses local anesthesia, so most patients can drive themselves home. However, if your surgery is near the eye, please arrange for someone to drive you home.

Plans After Surgery

  • Do not schedule out-of-town trips right after your surgery.
  • You will have a post-operative follow-up and suture removal about 1 to 2 weeks after surgery.
  • Plan to wear a bandage and avoid strenuous activity for one to two weeks. See our wound care and aftercare instructions.

Key Things to Tell Your Mohs Surgeon

A few health conditions and medicines change how we plan your surgery. Please tell us about the following when you call, at your consultation, or on the day of your procedure, even if you think we already have it on file. When in doubt, mention it.

1. You have a weakened immune system

Tell us if you have had an organ transplant, are on chemotherapy, have HIV, or take medicine that suppresses your immune system (for example, for rheumatoid arthritis, lupus, inflammatory bowel disease, or after a transplant).

Why it matters: A weaker immune system can affect healing and the risk of infection, and some skin cancers behave more aggressively. Knowing helps us plan your treatment and follow-up.

2. You may need antibiotics before a procedure

Tell us if you have an artificial (prosthetic) heart valve, a heart transplant, certain heart conditions present from birth (congenital), or you have had an infection of a heart valve (infective endocarditis). Some joint replacements may also be relevant. These histories do not automatically mean you need antibiotics for clean skin surgery; your surgeon will assess the procedure and your individual risk.

Why it matters: These conditions can mean you need to take an antibiotic shortly before surgery to prevent a serious infection. We need to know ahead of time so it can be arranged.

3. You have a pacemaker or defibrillator

Tell us if you have a pacemaker, an implantable defibrillator (ICD), or any other implanted heart device.

Why it matters: During surgery we often use a tool that stops bleeding with a small electrical current (electrocautery). For patients with these devices, we adjust our technique to keep the device working safely.

This list is not complete. Always share your full medical history and a list of all your medicines and supplements, including any blood thinners.

What Happens on the Day

After the area is numbed with local anesthesia, the visible tumor is removed, along with a thin layer of surrounding tissue. That layer is mapped, color-coded, and examined under the microscope while you wait. If any cancer remains at the edges, only those areas are treated with another thin layer. This is repeated until the margins are clear. Once the cancer is fully removed, your surgeon discusses the best way to repair the wound, which is often done the same day. Learn more in What is Mohs surgery?

Quick Checklist

  • Take your regular medications, including blood thinners, unless told otherwise.
  • Take any new medication your Mohs surgeon prescribed for you.
  • Get a good night’s sleep beforehand.
  • Shower and wash your hair that morning; leave the surgical area clean and free of makeup or lotion.
  • Eat breakfast and bring snacks or lunch.
  • Wear loose, front-opening clothing that is easy to launder, and bring a sweater. Bring hair clips or barrettes if the surgery is in a hair-bearing area.
  • Consider bringing someone to keep you company, and a book or device for the waiting time. Free Wi-Fi is available.
  • Arrange a driver if the surgery is near your eye.
  • Keep the whole day open and avoid travel for 1 to 3 weeks.
  • Tell us as soon as possible if you need to change your appointment.

Frequently Asked Questions

Should I stop my blood thinners before Mohs surgery?

Usually no. Take all of your regular medications unless your Mohs surgeon or your regular physician tells you otherwise, including prescription blood thinners such as aspirin, Coumadin (warfarin), Plavix, Xarelto, Eliquis, and Pradaxa. Do not stop these on your own, because stopping them can be more dangerous than the small amount of extra bleeding they cause during surgery. Always confirm with your care team.

How long does Mohs surgery take?

Plan to spend most of the day at the office, up to about six hours. Each layer of tissue takes only minutes to remove, but our laboratory needs 1 to 2 hours to process and examine it under the microscope. Most tumors need one or two layers, and you wait between stages. The visit also includes anesthesia, any reconstruction, and bandaging.

What should I eat and wear on the day of Mohs surgery?

Eat your usual breakfast, or a morning snack if you normally skip it, and bring snacks or lunch because it is a long day. Wear comfortable, loose-fitting clothing that opens in the front (buttons or a zipper) rather than a pullover, so the team can reach the surgical site easily. Bring a sweater, since the rooms are kept cool for the equipment.

Do I need someone to drive me home after Mohs surgery?

Mohs surgery uses local anesthesia, so most patients can drive themselves. However, if your surgery is near the eye, you will need someone to drive you home. We also encourage you to bring a friend or relative to keep you company between the stages of the procedure.

Will I need time off or a follow-up after Mohs surgery?

Plan to keep the whole day of surgery open, and avoid scheduling out-of-town trips right afterward. You will have a post-operative follow-up and suture removal about 1 to 2 weeks after surgery. Plan to wear a bandage and avoid strenuous activity for one to two weeks.

Related reading: What is Mohs surgery?, wound care & aftercare, and the Belaray Skin Cancer Center.

Have Questions Before Your Surgery?

Call the office where your surgery is scheduled, or reach us anytime by text.

📞 Hicksville: (516) 822-SKIN 📞 Stony Brook: (631) 864-MOHS