
Surgery of the skin or dermatological surgery deals with the diagnosis and treatment of medically necessary and cosmetic conditions of the skin, hair, nails, veins, mucous membranes and adjacent tissues by various surgical, reconstructive, cosmetic and non-surgical methods. The purpose of skin surgery is to repair and/or improve the function and cosmetic appearance of skin tissue.
Examples of dermatological surgery procedures include treatment of skin cancers, mole removal, anti-aging treatments, injectable and implantable soft tissue fillers, botulinum toxin (Botox™) treatments, correction of acne scarring, chemical peeling, vein therapy, hair restoration, and laser surgery.
Mohs Micrographic Surgery, an advanced treatment procedure for skin cancer, offers the highest potential for recovery, even if the skin cancer has been previously treated. This procedure is a state-of-the-art treatment in which the physician serves as surgeon, pathologist and reconstructive surgeon. It relies on the accuracy of a microscope to trace and ensure removal of skin cancer down to its roots. This procedure allows dermatologists, trained in Mohs Surgery, to see beyond the visible disease, and to precisely identify and remove the entire tumor, leaving healthy tissue unharmed. This procedure is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma.
The cure rate for Mohs Micrographic Surgery is the highest of all treatments for skin cancer, and is useful even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement.
Additional Information
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Mohs micrographic surgery, often referred to simply as Mohs surgery, is a specialized surgical technique used to treat skin cancer, particularly non-melanoma types like basal cell carcinoma and squamous cell carcinoma. The procedure is named after Dr. Frederic Mohs, who developed it in the 1930s.
How it works…
Advantages over wide local excision:
– Maximizes Skin Preservation: Mohs allows for the precise removal of cancer with minimal damage to surrounding healthy skin, which is especially important in cosmetically sensitive areas like the face.
– High Cure Rate: Mohs surgery has one of the highest cure rates for skin cancer, often exceeding 99% for basal cell carcinoma and squamous cell carcinoma.
– Immediate Results: Because the tissue is examined on the spot, patients receive immediate feedback on the status of their cancer.
Recovery: Mohs surgery varies depending on the size and location of the cancer removed. Patients might experience some swelling, redness, or discomfort, which usually subsides over time. The surgical site will heal, and Dr. Aerlyn Dawn will provide post-operative care instructions, which may include how to care for the wound and when to return for follow-up visits.
Ideal Candidates:
Considerations: While Mohs surgery is highly effective, it requires a Board Certified Mohs surgeon. While Dr. Dawn is extensively trained to make the surgical scar almost invisible, there is no scarless surgery.
To that end, Frederick Dermatology Associates has added in Gentle Cure in 2025 in order to allow patients a non-surgical option to treat basal cell and squamous cell without surgery and possibly less scarring for removal of basal cell and squamous cell skin cancers. While Gentle Cure requires more treatments, there is no surgery, less potential for scarring, but it does require more treatments
In summary, Mohs micrographic surgery is a precise and effective method for treating skin cancer, allowing for complete removal while preserving healthy tissue. If you or someone you know is facing skin cancer, this surgery may be something worth considering and Dr. Aerlyn Dawn is one of the best Mohs surgeons available.
At Frederick Dermatology Associates, we offer both GentleCure and Mohs surgery because each method has specific strengths. The right treatment depends on the type of skin cancer, its location, and your individual medical needs. Here’s a straightforward comparison to help you understand how they differ.
GentleCure (Image-Guided Superficial Radiotherapy)
GentleCure is a non-surgical treatment that uses image-guided, low-energy radiotherapy to treat certain types of basal cell and squamous cell skin cancers.
• No cutting or stitches
• Non-invasive and generally well tolerated
• Often chosen for areas where minimizing disruption to the skin is desired
• Completed over a series of short visits
• Does not require anesthesia
• Appropriate for select skin cancers based on depth, location, and tumor type
Mohs Micrographic Surgery
Mohs surgery is a precise, tissue-sparing surgical technique performed by a fellowship-trained Mohs surgeon. Cancer is removed in layers, and each layer is examined under a microscope in real time.
• Considered the gold standard for many high-risk or aggressive tumors
• Offers the highest level of margin control
• Typically recommended for cancers on the face, ears, scalp, and other sensitive areas
• Performed in a single visit
• May require stitches or reconstructive repair depending on the size of the surgical area
Which Treatment Is Right for Me?
There is no single “best” treatment for every skin cancer. Both GentleCure and Mohs surgery are effective and well-established, but they are used in different situations. Factors we consider include:
• Tumor type (basal cell vs squamous cell)
• Tumor behavior (low-risk vs high-risk)
• Depth and size
• Location on the body
• Your health, preferences, and lifestyle
• Cosmetic and functional considerations
| Feature | GentleCure (Image-Guided Superficial Radiotherapy) | Mohs Surgery |
|---|---|---|
| Type of Treatment | Non-surgical, non-invasive radiotherapy | Surgical procedure removing thin layers of tissue |
| How It Works | Uses ultrasound imaging to map the cancer, then delivers low-energy radiotherapy to target cancer cells | Removes tissue layer by layer and examines each layer under a microscope until clear margins are achieved |
| Ideal For | Select basal cell and squamous cell skin cancers, especially when a non-surgical approach is preferred | Many high-risk, aggressive, or recurrent tumors; areas where precise margin control is essential |
| Anesthesia Needed? | No anesthesia required | Local anesthesia used |
| Number of Visits | Series of short visits over several weeks | Typically completed in a single visit |
| Recovery | No wound care; minimal disruption to daily activities | Surgical wound care required; downtime varies |
| Scarring | No cutting or stitches; minimal cosmetic impact | May leave a scar depending on tumor size and reconstruction |
| Pain/Comfort | Generally well-tolerated and comfortable | Involves injections and tissue removal; discomfort varies |
| Margin Control | Guided by imaging and clinical judgment | Real-time microscopic margin evaluation (gold standard for certain cancers) |
| Best For Patients Who | Prefer a non-surgical option, have certain medical conditions, or wish to avoid surgical wounds | Require precise cancer margin control or have cancers in high-risk locations |
| Effectiveness | Highly effective for appropriate tumor types | Highest cure rates for many aggressive or complex tumors |
| Insurance Coverage | Covered by most insurance plans and Medicare | Covered by most insurance plans and Medicare |
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Frederick Dermatology Associates has put Frederick, MD on the map as a regional authority on skin health and wellness. With an emphasis on building a natural, refreshed look in our patients, we focus on innovations in cosmetic, medical and aesthetic dermatology, backed by experience and supervision by our board-certified dermatologists. Whether you’re local or out of town, consider Frederick, MD as your destination for excellence in dermatology.
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