Mohs Surgery Aftercare

It is normal to have some discomfort for the first 48 to 72 hours after surgery. For most patients, acetaminophen (Tylenol) taken at a dose of 1,000 mg every 4 to 6 hours (two 500 mg tablets or three 325 mg tablets) will achieve adequate pain relief. Do not consume alcohol while taking acetaminophen, and do not take acetaminophen if you have a history of liver disease or have been told by a physician not to take it. Do not exceed 4,000 mg of acetaminophen in a 24-hour period.

If acetaminophen alone does not provide adequate pain control, continue taking acetaminophen and add ibuprofen (Advil, Motrin) at a dose of 400 mg every 4 hours. Do not exceed 3,200 mg of ibuprofen in a 24-hour period.

Cold compresses with a bag of ice or frozen peas help minimize pain, swelling, and bruising, and can be used for 15 minutes out of every hour. Keeping the surgical site elevated also helps — if your surgery was on your head or neck, we recommend sleeping with an extra pillow for a few nights. After surgery on the face, it is not unusual to have substantial swelling or bruising of one or both eyes a few days after surgery.

Keep the original dressing clean and dry (no showering) and leave it in place for 24 to 48 hours. After 24 to 48 hours, you may begin routine wound care as outlined below and get the area wet in the shower. Do not submerge your wound (such as in a pool or tub) for 2 weeks.

At each dressing change (one to two times per day):

1. Wash your hands with soapy water.
2. Remove the bandage and gently wash the area with warm soapy water, rinse, then pat (do not rub) dry with a clean towel. Allow the area to air dry for a few minutes.
3. Using a clean cotton-tipped applicator (Q-Tip), apply a thin film of petroleum jelly (Vaseline) to the surgical site, then apply a non-adherent dressing such as Telfa and secure it with tape or a wrap. If the wound is small, a Band-Aid may be used.
4. Continue this routine until your scheduled suture-removal appointment — or, if no sutures need to be removed, for one to two weeks.

Call the office at 813-867-6200 if you notice any of the following:

• Increasing pain, tenderness, swelling, redness, warmth, or thick yellow or green drainage at the surgical site. A thin pink rim is a normal part of healing.
• A body temperature of 100.4°F or higher.

If your surgical site is bleeding: hold firm, continuous pressure for 30 minutes (no peeking). This stops the overwhelming majority of bleeding. If you are still having trouble with bleeding, pain, or anything else, call the office at 813-867-6200 — or, after hours, use the contact number provided on your printed instruction sheet.