Mohs Surgery Recovery: What to Expect Week by Week

Mohs surgery is the most precise skin cancer removal technique available, and the procedure itself is only half the story. The recovery — how you care for your wound in the days and weeks that follow — directly affects your cosmetic outcome. Here's exactly what to expect.

Days 1–3: The first 72 hours

You'll leave the office with a pressure dressing in place. Keep it on, dry, and undisturbed for the first 24 hours unless your surgeon instructs otherwise.

What's normal:

• Mild throbbing or aching — take acetaminophen (Tylenol), not ibuprofen or aspirin, which thin the blood
• Small amount of ooze or slight bleeding underneath the dressing
• Bruising and swelling, especially around the eyes or nose

What to avoid:

• Strenuous exercise or anything that raises your heart rate significantly
• Bending below the waist (increases pressure in the head and face)
• Alcohol for at least 48 hours
• Getting the wound wet (no showering over the site)

Call our office if: you soak through the dressing with bright red blood that doesn't slow with 20 minutes of firm pressure, you develop fever over 101°F, or the wound edges pull apart.

Week 1: Gentle wound care begins

After the first 24 hours (or when instructed), you'll begin daily wound care:

1. Gently clean the wound once or twice daily with mild soap and water or diluted hydrogen peroxide if instructed
2. Pat — never rub — completely dry
3. Apply a thin layer of plain petroleum jelly (Vaseline) or antibiotic ointment per your surgeon's instructions
4. Cover with a non-stick dressing

Moist wound healing is the goal. Letting a wound dry out and form a thick scab actually slows healing and worsens scarring. Keep it moist with ointment.

Sutures (if present) are typically removed at 7–14 days depending on the location. Facial sutures come out earlier; wounds on the trunk or scalp may stay in longer.

Weeks 2–4: Early scar management

Once your wound has fully closed and crusting has resolved, you transition into scar management:

• Sun protection is critical — Miami's UV index is among the highest in the continental United States year-round. A healing scar exposed to sunlight can permanently hyperpigment (darken). Apply SPF 50+ mineral sunscreen to the healed area every morning, and wear a hat if outdoors.
• Silicone gel or sheets — the most evidence-backed scar treatment available without a prescription. Apply once or twice daily to the closed wound for 2–3 months.
• Gentle massage — once the wound is fully healed (no open areas), circular massage with a moisturizer for 5 minutes twice daily helps soften and flatten the scar.

Months 1–12: Full scar maturation

Scars are dynamic. They typically look their worst at 4–8 weeks — red, raised, firm — and improve significantly over the following months. Final appearance isn't assessed until 12 months post-surgery.

Options to accelerate scar improvement (discussed at your follow-up):

• Pulsed dye laser for redness
• Fractionated laser resurfacing for texture
• Intralesional corticosteroid injections for raised scars

When to call us

• Fever above 101°F
• Increasing redness, warmth, or swelling spreading from the wound
• Pus or foul odor
• Wound edges separating after suture removal
• Pain significantly worsening after day 3 (it should be improving)

Bottom line

Mohs surgery gives you the best chance of cancer-free margins. Your wound care gives you the best chance of a beautiful outcome. Follow the instructions, protect the site from Miami's relentless sun, and don't hesitate to call us with questions — that's what we're here for.