Wound care after Mohs surgery, day by day

Caring for a Mohs wound is simpler than most patients fear: keep the pressure bandage on for the first day or two, then clean gently, keep the wound moist with petrolatum, and re-cover it daily until your surgeon says otherwise. The details vary with the repair you received, and your surgeon's written instructions always win, but the day-by-day rhythm below describes how recovery typically unfolds after a full Mohs day.

Day 1: leave the pressure bandage alone and take it easy. You will usually go home with a bulky pressure dressing over the repair. Its job is to prevent bleeding, so leave it in place and dry for the time your surgeon specifies, often 24 to 48 hours. Rest with the treated area elevated when you can, skip bending, lifting, and exercise, and expect some soreness as the anesthetic wears off. Most discomfort is managed well with acetaminophen. A small amount of pink drainage on the bandage is normal; steady bleeding that soaks through deserves firm, continuous pressure for 15 to 20 minutes and a call to the office if it does not stop.

Days 2 to 3: begin gentle daily wound care. Once the pressure dressing comes off, most surgeons ask you to clean the wound once or twice a day. The routine is usually the same: wash gently with mild soap and water or a prescribed cleanser, pat dry, apply a thin layer of plain petrolatum, and cover with a fresh non-stick bandage. Keeping the wound moist under ointment is not just for comfort; wounds kept moist heal faster and scar less than wounds left to dry out and crust, a principle the American Academy of Dermatology emphasizes in its wound care guidance. Some bruising and swelling, especially around the eyes after facial surgery, peaks around this point and looks worse than it feels.

Days 4 to 7: the wound settles into a routine. Redness at the edges softens, swelling recedes, and the daily clean-ointment-cover cycle takes a few minutes. Showering is usually fine once your surgeon confirms it; let water run over the area rather than scrubbing. Continue to avoid strenuous activity that stretches the repair, particularly for wounds on the face, scalp, or shin, since tension is the enemy of a fine scar. Watch for the signs of infection worth a call: increasing rather than decreasing pain, spreading redness, warmth, thick drainage, or fever.

Week 2: stitches come out, and the wound looks its worst. Non-dissolving sutures on the face typically come out around day 5 to 7, and on the body around day 10 to 14. It is completely normal for the scar at this stage to look red, firm, and slightly raised. This is the noisy middle of healing, not the finished product, and a Mohs scar keeps improving for a full year after this point.

Weeks 3 and 4: protect the new skin. Once the surface is fully closed, sun protection becomes the most important job, because ultraviolet light can permanently darken a young scar. Cover the area or use a broad-spectrum sunscreen daily. Many surgeons also suggest gentle scar massage beginning around this time to help the scar soften and flatten; ask before you start. If you had a flap or graft reconstruction, your surgeon may add specific steps and a follow-up visit to check how the repair is maturing.

A few rules apply the whole way through. Do not smoke, since smoking measurably impairs skin healing. Do not pick at crusts or trim stray sutures yourself. Take medication questions to the office rather than guessing, especially about blood thinners you may have continued through surgery. And keep your follow-up appointments, which exist to catch small problems while they are still small. The Mayo Clinic notes that most Mohs wounds heal without complication, and the patients who do best are usually the ones who followed the boring instructions faithfully.

The encouraging bottom line: wound care after Mohs is a short season of small daily tasks, and it pays off directly in how the scar matures. A little preparation before the procedure and a few weeks of patience afterward are what turn the highest cure rate in skin cancer treatment into a result you also feel good about seeing in the mirror.

Related reading: How do Mohs surgery scars heal over time?