Medications and Mohs Surgery: What You Need to Tell Your Surgeon Before Your Procedure

Given that 1 in 5 adults in the United States will develop skin cancer by the age of 70, it should come as no surprise that 876,000 Mohs surgery procedures are performed each year. And this number is on the rise, thanks to an aging population with a good deal of cumulative sun exposure.

Also driving the rise in the number of Mohs procedures are these two key benefits: 1) Mohs surgery offers an unprecedented cure rate of 99%; and 2) Mohs surgery is specifically designed to spare as much tissue as possible.

That said, the Mohs procedure is still surgery, which means you need to take a few pre-operative steps to ensure a successful outcome, such as managing medications and supplements beforehand. 

Here, our team of fellowship-trained and certified Mohs surgeons at Vivida Dermatology reviews which medications are potentially problematic for Mohs surgery and how you may need to modify your intake.

Medications that thin your blood

When we perform Mohs surgery, we methodically remove very thin layers of your skin until there are no more signs of cancer. This approach allows us to contain the margins and spare a good deal of your tissue, minimizing collateral damage.

Because it is a surgical procedure, bleeding will occur and needs to be managed carefully. So, if you’re taking any medications that thin your blood, such as anticoagulants or antiplatelets, we need to know ahead of time so we can plan accordingly.

Examples of medications that can potentially encourage more bleeding include:

• Aspirin
• Eliquis® (apixaban), 
• Xarelto® (rivaroxaban) 
• Pradaxa® (dabigatran)
• Coumadin® and Jantoven® (warfarin)
• Plavix® (clopidogrel)
• Heparin injections

While not a direct blood thinner, non-steroidal anti-inflammatory medications like ibuprofen (Advil®) can also have some influence over clotting.

If you’re taking any of the medications on this list, let us know. Please don’t stop any of these medications, especially if you’re taking them under a doctor’s instructions. 

Instead, once you tell us which medication(s) you’re taking, we’ll likely ask you to contact your doctor directly to determine whether you can skip a few doses or lower them for a few days before your Mohs surgery.

Don’t forget certain supplements

Remembering to alert us to which medications you're taking is relatively easy, but many people forget about their supplements, some of which can interfere with clotting, making you bleed more easily.

Given that 75% of Americans take supplements, it’s a good bet that you might be, too. Let us know if you're taking any of the following:

• Garlic
• Vitamin E
• St. John’s Wort
• Ginger
• Omega-3 fatty acids (fish oil)
• Ginkgo biloba
• Ginseng

You should also check any multivitamins for high levels of any of the above supplements.

If you are taking any supplements on this list, tell us. You may need to stop them about a week before your Mohs surgery. You can start taking them again once the surgical site is well on its way to healing.

Rest assured, supplements are just that — they supplement your health — so skipping a couple of weeks shouldn't affect your health in any significant way.

If you have more questions about medications and your upcoming Mohs surgery, please don’t hesitate to contact one of our offices, located in Las Vegas and Henderson, Nevada, as well as St. George, Utah.