A Detailed Look at Mohs Surgery for Skin Cancer

Blog Post - A Detailed Look at Mohs Surgery

What is Mohs Surgery?

Mohs micrographic surgery is an outpatient procedure used to treat skin cancer. Mohs is minimally invasive, allowing patients to be alert during the entire process. Mohs micrographic surgery requires extensive training and should only be performed by surgeons that specialize in dermatology and pathology.

At Houston Dermatology Specialists, Dr. Christopher Downing performs Mohs surgery to treat skin cancer in patients of all ages throughout the greater Houston and Cypress area.

If you have any concerns that you may have skin cancer or an irregular mole, please call (713) 487-8233 or request a consultation online to schedule an examination.

Dr. Downing’s Training1

Upon completion of his dermatology residency at UT Houston and MD Anderson Cancer Center, Dr. Downing obtained fellowship training in Mohs micrographic surgery at Florida State University. While at his fellowship, he worked alongside experienced Mohs surgeons, plastic surgeons, and dermatopathologists.

It is important to seek a fellowship trained Mohs surgeon as they are required to complete at least 500 cases under the supervision of an experienced Mohs surgeon. Fellows are also selected from a pool of competitive applicants after an extensive review.

After his fellowship training, Dr. Downing became a proud member of the American College of Mohs Surgery. He is certified by the American Board of Dermatology in both Dermatology and Mohs micrographic surgery. He has performed over 4000 cases.

Who Is Eligible for Treatment?

Mohs surgery is used to treat specific types of skin cancer. Patients with squamous cell carcinoma and basal cell carcinoma may be eligible for Mohs surgery.

In order to be a Mohs skin cancer surgery candidate, a pathology report must identify a treatable skin cancer.

Types of Skin Cancer 2:

  • Basal Cell Carcinoma is the most common type of skin cancer and typically appears as a flesh-colored growth or pink patch of skin.
  • Squamous Cell Carcinoma often appears as a red raised bump or scaly patch of skin.
  • Melanomas are the most harmful because they can spread to local and distal regions of the body.
    • Melanomas appear as dark spots anywhere on the skin.

To learn more about melanomas, check out our The ABCDEs of Melanoma blog.

The Mohs Surgery Process3

Upon arrival for surgery, our staff will escort you to a room where Dr. Downing will greet you before surgery. The skin cancer will be marked and numbed with local anesthesia prior to the procedure.

Once your skin has been prepped, Dr. Downing will begin the first stage and remove a layer of tissue. The tissue will be transported to our in-house lab and examined under a microscope. Dr. Downing analyzes the sample to ensure the surrounding tissue is cancer free.

You will wait in the waiting room until we have the results of the stage.

If cancer is still present, a second stage is performed, and more tissue is removed. This continues until clear margins are observed.

After the tumor is removed, Dr. Downing will counsel you on the best options for closure that minimize scarring.

Illustration of the steps followed for Mohs surgery for skin cancer
The Mohs surgery process

Why Mohs Surgery?

Mohs surgery enables Dr. Downing to stop after each layer is removed and see how much cancer is left, where it is located, and if any is still present at the site. This allows him to spare as much healthy tissue as possible, making Mohs surgery a minimally invasive yet highly effective treatment. For basal cell carcinoma and squamous cell carcinoma. It has a cure rate of 98-99%.4

Please contact Houston Dermatology Specialists in Cypress at (713) 487-8233 or request a consultation online to schedule an examination with Dr. Downing if you are concerned about skin cancer or an irregular mole.


1. www.tricitiesderm.com/mohs-micrographic-surgery/american-college-of-mohs-surgery/. Accessed 8 Nov. 2023.

2 “Types of Skin Cancer.” American Academy of Dermatology, www.aad.org/public/diseases/skin-cancer/types/common. Accessed 26 Oct. 2023.

3 “What Is Mohs Surgery?” American Academy of Dermatology, www.aad.org/public/diseases/skin-cancer/types/common/melanoma/mohs-surgery. Accessed 26 Oct. 2023. “Home.” Dermatology Associates.

4 “American College of Mohs Surgery.” American College of Mohs Surgery (ACMS), www.mohscollege.org/for-patients. Accessed 8 Nov. 2023.

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