Mohs surgery and other forms of micrographic surgery are being carried out in an unregulated way in many parts of the world. The ESMS is devoted at setting high standards for these procedures to ensure that patients are treated by appopriately qualified professionals and get the highest quality of care.
Mohs and other forms of skin cancer micrographic surgery are always best carried out by a board-certified dermatologist with additional training in these techniques (also called dermatological surgeons). Pathologists and other surgeons are highly valued colleagues whom we work with very closely. They may be an important part of your care but if you are having Mohs micrographic surgery then your dermatological suregeon should be leading it.
This is because board-certified dermatologists learn about skin cancer, the ultrastructure of the skin and its pathology throughout their post-graduate training. It is core to their training and not just a peripheral part of it, as it is in other specialties. They practice skin surgery throughout their training and dermatological surgeons concentrate purely on reconstructing the skin and its underlying structures and this is what makes them expert in it. They do not operate on other organs unlike many other surgical specialties. This combined with the specialised training in Mohs allows them to accurately remove the tumour, examine it under a microscope and then map it to your face or body so that we can remove the tumur with the greatest accuracy
With the diffferent array of doctors treating skin we are increasingly seeing skin cancers that have been inappropriately treated. Some have been overtreated therefore leading to unnecessary scars whilst others have been undertreated leading to higher than average recurrence rates and tumour enalrgment. Dermatologists have a deep understanding of skin structure and will have had had experience in multiple non-surgical treatments for skin cancer such as cream treatments, and photodynamic therapy. They can therefore choose the most appropriate treatment for your particular skin cancer and your particular skin.