Your Guide to Mohs Surgery Recovery Time

Mohs surgery is a specialized surgical technique used to treat skin cancer. It involves the precise removal of cancerous skin while preserving as much healthy tissue as possible. Understanding the recovery time associated with Mohs surgery is crucial for patients as it can affect their post-operative care and overall healing process. In this guide, we will explore the typical recovery timeline, factors that influence healing, and tips for a smoother recovery. Whether you are preparing for the procedure or are already in the recovery phase, having a clear understanding of what to expect can help ease any concerns and promote optimal healing.

What You Need to Know About Mohs Surgery Recovery

Going through Mohs surgery is a huge step toward putting skin cancer behind you, but knowing what to expect during the healing process is just as crucial. It’s completely natural for our patients here in St. Louis—from Chesterfield to Frontenac—to have questions about the Mohs surgery recovery time. Recovery isn't just a single event; it's a series of phases, and each one has its own set of rules and milestones.

Simply knowing what to anticipate can make a world of difference, reducing anxiety and letting you focus on what matters most: healing. If you want a refresher on the procedure itself, our detailed guide on understanding Mohs surgery in St. Louis is a great place to start.

The Stages of Healing

Your body is amazing—it gets to work on repairs the moment the surgery is over. This process typically unfolds in a few predictable stages, moving from immediate post-op care all the way to long-term scar management.

• Immediate Post-Op (First 48 Hours): Your main jobs are to rest and protect the surgical site. You'll go home with a pressure dressing designed to keep bleeding and swelling to a minimum.

• Early Healing (First 1-2 Weeks): Once that initial dressing comes off, your focus shifts. You'll be cleaning the wound daily and applying ointment to prevent infection and help healthy new tissue form.

• Maturation Phase (Weeks 2 to Month 12+): This is the long game. The scar tissue spends months remodeling itself, gradually becoming softer, flatter, and less noticeable in color.

To give you an even clearer picture, here's a quick summary of what your recovery journey might look like.

Your Mohs Recovery Journey at a Glance

Timeframe	What to Expect	Key Care Instructions
First 48 Hours	Mild discomfort, swelling, bruising, and possibly some minor oozing. The area will be covered by a pressure dressing.	Rest and avoid strenuous activity. Keep the dressing clean and dry. Use ice packs as directed to manage swelling.
Days 3-14	Redness, scabbing, and itching are common as the wound begins to close. Sutures, if any, are typically removed around day 7-14.	Follow your dermatologist’s instructions for daily wound cleaning. Apply antibiotic ointment and a new bandage as prescribed.
Weeks 2-6	The wound should be fully closed. The scar will likely be pink or red and may feel firm or lumpy to the touch.	Begin gentle scar massage if your doctor approves. Protect the area from the sun with a high-SPF sunscreen.
Month 2 to 1 Year+	The scar will continue to mature, gradually flattening, softening, and fading in color. Final appearance can take a full year or more.	Continue consistent sun protection to prevent scar darkening. Consider silicone sheets or gels to improve texture and color.

This table is just a general guide, but it helps map out the key milestones and care steps you'll encounter along the way.

Factors That Influence Your Recovery Timeline

It's so important to remember that everyone heals at their own pace. Your specific recovery speed will be shaped by a few key factors, and any good St. Louis skin specialist will consider these when giving you your post-op instructions.

"A patient's overall health, the location of the surgery—such as on a high-movement area like the mouth or a delicate area like the eyelid—and the type of reconstruction performed all play a crucial role in the healing timeline." - Dr. Gibstine, Mid-County Dermatology

Here are the main things that can affect your healing:

• Location and Size of the Wound: It makes sense, right? A small spot on your back is going to heal very differently than a larger area on your face.

• Type of Repair: A simple line of stitches will heal much faster than a more complex repair involving a skin graft or flap.

• Your Overall Health: Things like your age, nutrition, and whether you have conditions like diabetes can all impact how quickly your body can repair itself.

• Adherence to Aftercare: This is the big one. Following your St. Louis dermatologist's instructions to the letter is the #1 factor you can control to ensure a smooth and speedy recovery.

If you’re curious about how this compares to other procedures, looking into general surgical recovery timelines can offer some interesting context. Even though the surgeries are different, many of the core healing principles are surprisingly similar.

Navigating the First 48 Hours After Surgery

The initial 48 hours after your Mohs procedure are huge. They really set the tone for your entire recovery. Think of it as laying the groundwork for the rest of your healing. It’s totally normal to feel a little anxious, but knowing what to do can make all the difference.

The single most important rule is to leave that initial pressure dressing alone. We put it on for a reason, and it typically needs to stay in place for the first 24 to 48 hours. This special bandage is your first line of defense—it’s applied perfectly to minimize bleeding and keep swelling down, which are the two biggest things to watch for right after surgery. I know it's tempting, but resist the urge to peek! Letting it do its job undisturbed allows the initial healing to kick off without a hitch.

Managing Discomfort and Swelling

You’re probably going to have some mild to moderate discomfort, swelling, and maybe some bruising. Don't worry, that's just your body's natural response to surgery. The good news? It's all very manageable.

Here are the go-to strategies for those first couple of days:

• Cold Compresses: An ice pack or a bag of frozen peas wrapped in a thin towel is your best friend. Applying it to the bandaged area can work wonders for swelling and discomfort. Just do it for 15-20 minutes at a time, a few times a day. And remember, never put ice directly on your skin or the dressing.

• Pain Relief: For most people, over-the-counter pain relievers like acetaminophen (Tylenol) are all that's needed. It's really important to follow the specific advice we give you, because some medications like ibuprofen or aspirin can actually increase the risk of bleeding.

• Keep Your Head Elevated: If your surgery was on your face, head, or neck, this one is key. Prop your head up on a couple of extra pillows when you sleep. It lets gravity help you out by drawing fluid and swelling away from the area.

Sticking to these steps will make a huge difference in how you feel during this initial healing phase.

Rest and Activity Restrictions

Your body is working overtime to heal, and that requires energy. Rest during the first 48 hours is not optional. This is your official permission to put off errands, chores, and everything else on your to-do list.

Limiting your activity keeps the surgical site stable and protected. Any kind of strain can put pressure on the wound and stitches, which could lead to bleeding or a hematoma (a painful collection of blood under the skin). Just think of it as giving your body the peace and quiet it needs to do its repair work.

Wound Care and Bandage Management

During this initial window, your main task is simply to keep the pressure dressing clean and dry. That means no getting it wet in the shower—your St. Louis skin doctor will give you specific tips on how to bathe safely.

We'll also tell you exactly when and how to start cleaning the wound and applying ointment. Most dermatologists, including us, recommend using a simple, pure ointment to keep the wound moist. This is a proven technique to speed up healing and minimize scarring. If you want to know why this is so critical, you can learn more about the benefits of petrolatum in wound care on our blog. Honestly, following the aftercare plan we provide is the most effective thing you can do to guarantee a smooth recovery.

Your First Week of Healing and Wound Care

Once you’ve made it through the initial 48 hours, your Mohs surgery recovery time shifts into a new, more hands-on phase. This first week is all about moving from simple rest to daily wound care. It's a really important time where what you do directly helps your body's natural healing process along.

You'll start to see your body's repair work in action. It's totally normal to see some mild redness, a bit of swelling, and maybe even some clear or yellowish drainage. These are just signs that the healing has begun. At Mid-County Dermatology, our team makes sure patients from Creve Coeur to Chesterfield feel confident, not worried, about these changes.

This week is dedicated to setting up a routine that keeps the area clean, protects the delicate new tissue, and lowers the risk of infection. Your St. Louis dermatologist will give you a personalized care plan, but knowing the general game plan will help you feel much more in control.

Daily Wound Care Routine

Your Mohs surgeon will tell you exactly when you can take off that first pressure dressing. From there, you’ll start a simple but critical daily cleaning ritual.

1. Gentle Cleansing: The usual instruction is to clean the wound once or twice a day. You'll use a gentle cleanser with water or a specific diluted solution your St. Louis skin doctor recommends. Skip the harsh soaps and definitely don't scrub—that can damage the new skin trying to form.

2. Applying Ointment: After cleaning and gently patting the area dry, you'll put on a thin layer of an approved ointment, like petroleum jelly. This step is key because it keeps the wound moist, which is proven to speed up healing and lead to a better-looking scar.

3. Applying a Fresh Dressing: Cover the wound with a new, clean bandage. This acts as a shield, protecting the area from bacteria and any accidental bumps or friction.

For a more in-depth look at managing the surgical site, from cleaning and dressing to monitoring, check out your guide to home wound care. It’s a great resource to have alongside the specific advice from our team.

What to Expect During This Week

As your body gets to work, you’ll notice a few things happening at the surgery site. The trick is knowing what's a normal part of the process and what might be a red flag.

Itching is incredibly common as the skin heals—it’s actually a sign that nerve fibers are regenerating. Don't be surprised if some mild swelling and bruising are still hanging around; they should start to go down. The most important thing is to resist the urge to scratch to avoid damaging the wound.

Here’s what’s generally considered normal during this period:

• Mild Redness and Swelling: The skin around the wound will likely stay pink or red, and some puffiness is totally expected.

• Itching: This is one of the most common—and annoying—parts of healing. It’s a good sign!

• Tenderness: The area might be sore to the touch, but this should gradually get better each day.

• Scabbing: A scab is your body’s natural bandage. As tempting as it is, do not pick at it.

For most people who've had Mohs surgery, the initial wound healing takes about four to five days for the main discomforts like swelling and bruising to calm down. Recovery typically involves using cold compresses to manage swelling and taking over-the-counter pain relievers. You'll also be told to avoid strenuous activity to give your body the best shot at healing well.

Practical Tips for Daily Life

Making a few small adjustments to your daily routine this week can make a huge difference in your comfort and how well you heal. For our patients in Ladue and Clayton, these simple tweaks can help you cruise through the week.

Think about things like showering. Your St. Louis skin specialist will give you specific advice on how to keep the wound dry while you bathe. You might need to take baths instead of showers for a bit, or use a waterproof dressing. It also helps to wear loose, comfortable clothing that won’t rub against the surgical site—this prevents irritation and keeps your fresh bandage in place.

Beyond Stitches: The Next Stage of Recovery

The day your stitches come out is a big milestone in your Mohs surgery recovery time. That appointment marks a major shift—you're moving from the phase of intensive wound care to the next crucial step: healing and scar management. Your active role in recovery is about to evolve, with a new focus on nurturing that new skin to minimize the final look of your scar.

For many of our patients here at Mid-County Dermatology, whether they're in Ladue or Creve Coeur, this moment brings a mix of relief and a fresh set of questions. What's next? How do I take care of this delicate new skin? This is where your attention turns to long-term healing to get the best cosmetic result possible.

Transitioning to Scar Management

Once your Mohs surgeon gives you the green light after suture removal, your daily routine is going to change. The wound is now closed on the surface, but the healing process is far from over. Underneath, the tissue is still working hard to rebuild and strengthen itself.

This next phase is less about preventing infection and more about creating the perfect environment for your scar to mature. That scar will go through a lot of changes over the next year, and the care you give it now can make a world of difference in how it looks in the end.

Essential Scar Care Strategies

Taking great care of your scar boils down to a few key, evidence-based practices. These simple steps help the scar tissue remodel smoothly, becoming flatter, softer, and less visible over time.

• Gentle Massage: Once the surface is fully healed, your St. Louis skin specialist might suggest a gentle scar massage. Using your fingertips to apply light, steady pressure can help break down any firm scar tissue and improve its flexibility.

• Silicone Products: Silicone gels and sheets are a go-to method for improving a scar's appearance. They work by hydrating the scar tissue and creating a protective barrier, which can help calm redness and flatten raised scars.

• Moisturizing: Keeping the new skin hydrated is absolutely vital. A simple, fragrance-free moisturizer prevents dryness and supports the skin’s natural barrier function as it continues to heal. This is also important for producing collagen, the protein that gives skin its structure. You can learn more about [the role of collagen for healthy skin and hair](https://www.midcountyderm.com/post/collagen-skin-hair-stlouis) in our detailed guide.

A scar can take 12 to 18 months to fully mature. Sticking with your scar care routine, especially during the first few months, is the key to getting the best possible result.

The Critical Role of Sun Protection

If there is one non-negotiable rule during this recovery phase, it’s diligent sun protection. The new, delicate skin of a healing scar is extremely vulnerable to the sun's ultraviolet (UV) rays.

Sun exposure can cause the scar to become permanently darker than the skin around it, a condition known as post-inflammatory hyperpigmentation. This discoloration can make the scar much more obvious. To prevent this, you have to protect the area every single day—no exceptions.

We recommend applying a broad-spectrum sunscreen with an SPF of 30 or higher directly over the scar. For our patients in sunny St. Louis neighborhoods, from Clayton to Chesterfield, this is a step you just can't skip. Reapply it every two hours when you're outside, and think about adding protective clothing or a wide-brimmed hat for extra defense.

Reintroducing Physical Activity Safely

Getting back to your normal exercise routine is another huge part of feeling like yourself again. But it’s crucial to do this gradually to avoid putting any strain on the healing wound. Your St. Louis dermatologist will give you a personalized timeline, but a slow-and-steady approach is always the best bet.

Generally, you can start reintroducing light activities like walking soon after surgery. Most patients should wait at least one to two weeks before jumping back into more strenuous exercises like running, weightlifting, or any activity that stretches or puts tension on the surgical site. Listen to your body—if you feel any pulling or discomfort, that’s your cue to scale it back.

How Surgical Repair Impacts Your Recovery

The size of the skin cancer removed during Mohs surgery is just one piece of the puzzle. How that wound gets closed plays a massive role in your specific Mohs surgery recovery time. After ensuring every last cancerous cell is gone, your Mohs surgeon will decide the best way to repair the area. It’s a crucial decision, as a simple repair heals very differently from a more complex reconstruction.

Knowing which type of repair you have is the key to setting the right expectations for your healing journey. At Mid-County Dermatology, we make sure our patients from Ladue, Clayton, and all over St. Louis understand exactly why we chose a certain method. This knowledge empowers you to follow the right aftercare instructions for your unique situation.

Common Types of Surgical Repairs

The goal is always to restore both function and appearance to the treated area. The best method really depends on the wound's size, depth, and where it’s located. Here are the most common options your St. Louis skin doctor might use.

• Letting the Wound Heal on Its Own (Second Intention Healing): Sometimes, the best move is no move at all. For certain shallow wounds, especially in concave spots like the inner corner of the eye, we let the body’s amazing healing process take the lead. This means simple wound care, but it can be a longer road to full recovery.

• Simple Linear Closure: Think of this as the most straightforward repair. We bring the edges of the wound together and secure them with stitches, kind of like zipping up a jacket. It's perfect for smaller, elliptical wounds and usually leaves a fine-line scar.

• Skin Grafts: When a wound is too large to simply pull the edges together, a skin graft is a great option. We take a thin piece of skin from another spot (like behind the ear) and place it over the wound. This does mean you'll have two sites to care for as they heal—the Mohs site and the donor site.

• Skin Flaps: This is a more advanced reconstruction technique. We move a section of nearby skin and its underlying tissue to cover the wound, all while it stays connected to its original blood supply. This is often our go-to for facial repairs to maintain natural contours and get the best cosmetic result possible.

Each of these repairs changes what your recovery looks like. A simple linear closure might just involve suture care for a week or two. In contrast, a graft or flap will require more delicate handling and a longer period of restricted activity to make sure the new tissue takes hold and thrives.

Delayed vs. Immediate Reconstruction

The timing of your reconstruction can also have a big impact on your recovery. While we perform most repairs at Mid-County Dermatology right after the Mohs procedure, there are times when a delayed reconstruction is the smarter choice. This might be necessary if the wound needs to be monitored for a bit, or if we need to bring in a specialist for a particularly complex repair.

Research has shown that timing matters. One 2024 study in Facial Plastic Surgery & Aesthetic Medicine that looked at over 600 Mohs cases found that putting off reconstruction for more than 48 hours can raise the risk of postoperative complications. Lifestyle factors also play a role; for example, smokers had 2.46 times higher odds of complications. The overall complication rate for Mohs reconstruction is thankfully low—hovering between 1% and 19%—but a timely repair is a key factor in keeping that risk as low as possible. You can [Learn more about these reconstruction findings](https://www.liebertpub.com/doi/10.1089/fpsam.2024.0215) for a deeper dive into the data.

Understanding your specific repair is the first step in a successful recovery. It helps you anticipate your needs, from activity limitations to the type of wound care required, ensuring a smoother healing journey.

At Mid-County Dermatology, our top priority is delivering the best possible functional and cosmetic result. Whether you're coming from Creve Coeur or Chesterfield, our St. Louis skin specialists will craft a personalized plan that accounts for your specific surgical repair, guiding you with expert care every step of the way.

When to Call Your St Louis Dermatologist

Your body is a healing machine, but it’s still important to keep a close eye on things as you recover from Mohs surgery. Think of yourself as the most important member of your recovery team. Knowing the difference between what’s normal and what could be a complication is the key to a smooth, worry-free process.

Knowing when to pick up the phone can stop a minor issue from turning into something more serious. At Mid-County Dermatology, our team, led by Dr. Feigenbaum and Dr. Gibstine, is always here to support our patients. If you feel like something just isn’t right, never hesitate to call our St. Louis office.

Signs of a Possible Infection

An infection is one of the main things we watch out for after any surgery. While it’s not common—studies cited by the American Academy of Dermatology (AAD) show significant side effects happen in less than one in every 100 patients—it’s smart to know what to look for.

Get in touch with your St. Louis dermatologist right away if you notice any of these signs:

• Spreading Redness: A little redness right around the wound is expected. But if you see that redness spreading outwards, if the area feels warm to the touch, or if red streaks start to appear, that could signal a problem.

• Increased Pain or Swelling: Your discomfort should get a little better each day. If your pain suddenly gets worse or the swelling increases after the first 48 hours, that’s a red flag.

• Pus or Drainage: A small amount of clear or slightly yellow fluid can be part of the normal healing process. However, if you see thick, cloudy, or foul-smelling drainage (pus), that's a clear sign of infection.

• Fever: Running a fever of 101°F (38.3°C) or higher is your body's way of saying it might be fighting off an infection, and we need to know about it.

Your intuition is a powerful tool. If you're worried about how your wound looks or feels, it's always better to be safe than sorry. Give your St. Louis skin specialist a call.

Other Important Reasons to Call

Beyond infection, a few other situations need a professional's attention. Our St. Louis dermatology team wants to hear from you if any of these issues pop up.

Call us if you experience:

• Excessive Bleeding: A little bit of oozing in the first 24 hours is perfectly normal. But if the bandage becomes soaked with blood or the bleeding won’t stop after applying firm, continuous pressure for 15 minutes, you need to contact us immediately.

• Wound Separation (Dehiscence): If you notice your stitches have popped or the edges of the wound are pulling apart, please don't try to fix it yourself. This requires a professional look to make sure it heals correctly and to keep scarring to a minimum.

Your Mohs Recovery Questions Answered

It’s completely normal to have questions about your Mohs surgery recovery time. Even after we've talked through the procedure, new concerns often pop up once you're back home and starting to heal. Here at Mid-County Dermatology, our team, including our expert St. Louis dermatologists Dr. Feigenbaum and Dr. Gibstine, have put together answers to the most common questions we hear from our patients across Ladue, Clayton, and the greater St. Louis area.

Think of this as your quick-scan guide for clear, straightforward answers. We want you to feel confident and supported every step of the way.

How Much Pain Should I Expect After Mohs Surgery?

Most of our patients describe the feeling as mild to moderate discomfort—more of a soreness or tenderness right at the surgical site. This is usually managed quite well with over-the-counter pain relievers like Tylenol, but it's essential to follow the specific instructions we give you.

The key is that the pain should get a little better each day. If you notice it suddenly getting worse or becoming severe, that’s your cue to give our office a call.

If you're curious how this compares to other common procedures, you might find it helpful to read our guide that covers [what to expect from a skin biopsy](https://www.midcountyderm.com/post/how-painful-is-a-skin-biopsy-stlouis).

When Can I Start Exercising Again?

Your return to the gym really depends on the location and size of your surgery. As a general rule, we ask patients to avoid any strenuous activities, heavy lifting, or even significant bending for at least one to two weeks.

Why? These movements can spike your blood pressure and put a strain on the wound, which increases the risk of bleeding or popping a stitch. We'll give you a personalized timeline for safely getting back into your routine.

What Will My Scar Look Like and How Can I Improve It?

Right after surgery, every scar will look red and might feel a bit raised or firm. Don't worry—this is a totally normal part of the healing process. Over the next 6 to 12 months, you'll watch that scar mature. It will gradually become flatter, softer, and fade in color.

The single most important thing you can do to minimize a scar’s appearance is diligent sun protection. Using a broad-spectrum sunscreen with an SPF of 30 or higher every day prevents that delicate new skin from darkening and becoming more noticeable.

Once the wound is fully closed and healed, your St. Louis skin specialist might also suggest silicone gels or sheets. These can do wonders for improving the final texture and appearance of the scar.

Is It Normal for the Area to Feel Numb or Itchy?

Yes, both numbness and itching are very common—and actually expected—sensations as you heal. During surgery, tiny nerve endings are unavoidably disrupted. As they slowly regenerate, you might feel some numbness or a tingling sensation.

Itching is also a classic sign that your skin is healing. The most important thing is to resist the urge to scratch, as that can easily damage the delicate new tissue.

The timing of any reconstructive work can also play a role in your overall recovery. A large-scale 2024 study on facial nonmelanoma skin cancer found that performing reconstruction right away (within 24 hours) after Mohs surgery was linked to a lower risk of wound separation after a month and less need for revision surgery a year later when compared to delayed repairs. This suggests that immediate reconstruction can lead to a smoother recovery journey. [Learn more about these reconstruction findings](https://www.liebertpub.com/doi/10.1089/fpsam.2024.0215) to better understand how these decisions can impact your healing.

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At Mid-County Dermatology, your health and peace of mind are our top priorities. If you have any more questions about Mohs surgery or want to schedule a consultation with a leading St. Louis dermatologist, we are here to help.

Contact us today to book your appointment.

This information is for educational purposes only and does not constitute medical advice. Please consult with Dr. Feigenbaum, Dr. Gibstine, or another qualified healthcare provider at Mid-County Dermatology for personalized treatment recommendations. Individual results may vary.