Skin Cancers & MOHS Surgery
Skin cancer is the most common cancer in the United States — and the good news is that when caught early, it's also one of the most treatable. At MDI, Dr. Jeff brings exceptional expertise to the diagnosis and treatment of skin cancer, including advanced surgical techniques like MOHS micrographic surgery. If you've noticed a new or changing spot on your skin, don't wait. Early detection makes all the difference.
Types of skin Cancer
Basal Cell Carcinoma (BCC)
Basal cell carcinoma is the most common form of skin cancer. It develops in the basal cells — the deepest layer of the epidermis — and most commonly appears on sun-exposed areas like the face, neck, and hands. BCC rarely spreads to other parts of the body but can cause significant local damage if left untreated. It often looks like a pearly or waxy bump, a flat flesh-colored lesion, or a bleeding or scabbing sore that heals and returns.
Squamous Cell Carcinoma (SCC)
Squamous cell carcinoma is the second most common skin cancer and develops in the squamous cells that make up the outer layers of the skin. It can appear as a firm red nodule, a flat lesion with a scaly surface, or a new sore or raised area on an old scar. SCC is more likely than BCC to spread to other tissues and organs if not treated promptly, making early diagnosis especially important.
Melanoma
Melanoma is the most serious form of skin cancer. It develops in the cells that give skin its color and can appear anywhere on the body — even in areas that rarely see the sun. Melanoma can spread quickly to other organs if not caught early, which is why regular skin checks and prompt attention to changing moles or new growths are so critical. Warning signs include asymmetry, irregular borders, multiple colors, a diameter larger than a pencil eraser, and any lesion that is evolving or changing.
Merkel Cell Carcinoma
Merkel cell carcinoma is a rare but aggressive form of skin cancer that develops in Merkel cells near the surface of the skin. It typically appears as a flesh-colored or bluish-red nodule, often on the face, head, or neck. Because it tends to grow and spread quickly, prompt diagnosis and treatment are essential.
Other Skin Cancers
Skin cancer comes in many forms beyond the most well-known types. Dr. Messenger is trained and experienced in diagnosing and treating the full spectrum of skin cancers, including less common but equally serious conditions. If something doesn't look right, we want to see it.
MOHS Micrographic Surgery
MOHS micrographic surgery is the gold standard for treating many types of skin cancer — and Dr. Messenger is fellowship-trained and highly experienced in performing it at all three MDI locations.
MOHS is a precise, tissue-sparing surgical technique in which the cancer is removed one thin layer at a time. Each layer is examined under a microscope in real time before the next is removed. This process continues until no cancer cells remain, allowing Dr. Messenger to remove the entirety of the cancer while preserving as much healthy surrounding tissue as possible. The result is the highest cure rate of any skin cancer treatment — up to 99% for many cancers — with minimal impact on the surrounding skin.
Why MOHS?
Highest cure rate available — The real-time microscopic examination ensures complete cancer removal before the procedure is finished
Tissue sparing — Because only cancerous tissue is removed layer by layer, MOHS preserves the maximum amount of healthy skin — especially important for cancers on the face, ears, nose, hands, and other cosmetically or functionally sensitive areas
Same-day results — The entire procedure, from removal to confirmation that margins are clear, is typically completed in a single appointment
Ideal for high-risk or complex cancers — MOHS is particularly well-suited for cancers with poorly defined borders, recurrent cancers, and cancers in areas where preserving tissue is critical
What to Expect
MOHS surgery is performed in-office under local anesthesia. After the cancer is fully removed and clear margins are confirmed, Dr. Messenger will repair the wound whenever possible. For more complex repairs, he works closely with a trusted plastic surgery team to ensure the best possible cosmetic outcome. You'll leave the same day with a clear understanding of your results and your next steps.
Skin Cancer Mimickers — When It's Not What It Looks Like
Not every suspicious spot is skin cancer — but every suspicious spot deserves a proper evaluation. Some lesions are precancerous and need to be treated proactively. Others are completely benign but look alarming. The only way to know for certain is to have it evaluated by a dermatologist.
Precancerous & "Not Quite Cancer Yet" Lesions
These aren't cancer — but they shouldn't be ignored either. Left untreated, some of these can progress.
Actinic Keratoses (AKs) Rough, scaly patches caused by cumulative sun damage — most commonly on the face, scalp, ears, forearms, and hands. AKs are precancerous and a small percentage can progress to squamous cell carcinoma if left untreated. We take them seriously and treat them proactively with cryotherapy, ED&C, topical treatments like Efudex, or a combination approach depending on how many you have and where they are.
Atypical Moles (Dysplastic Nevi) Atypical or dysplastic moles aren't skin cancer — but they can look remarkably similar to early melanoma, and they carry a higher risk of developing into one over time. They often have irregular borders, uneven color, and are larger than a typical mole. Any mole that is new, changing, asymmetrical, or just doesn't look like your other moles should be evaluated promptly. We may recommend monitoring, biopsy, or removal depending on what we see. Regular skin checks are especially important if you have a history of atypical moles or a family history of melanoma.
Benign Lesions That Can Look Concerning
These are completely harmless — but their appearance can cause understandable alarm. Getting the right diagnosis means you can stop worrying and move on.
Seborrheic Keratoses (SKs) Waxy, stuck-on looking brown or black growths that are one of the most frequently mistaken lesions for skin cancer. They have nothing to do with sun exposure or cancer and require no treatment — but can be removed in office if they're bothersome.
Other Common Benign Lesions:
Dermatofibromas
Cherry angiomas
Sebaceous hyperplasia
Pyogenic granulomas
Skin Cancer Prevention & Early Detection
The best treatment for skin cancer is catching it early — or preventing it altogether. We recommend:
Annual full-body skin exams, especially if you have a history of skin cancer, significant sun exposure, or a family history of melanoma
Monthly self-checks at home — know your skin and know what's normal for you
Daily broad-spectrum SPF 30 or higher, even on cloudy days
Protective clothing, hats, and avoiding peak sun hours when possible
Never using tanning beds
If you notice anything new, changing, or unusual on your skin — a spot that bleeds, itches, won't heal, or just doesn't look right — call us. We'd always rather take a look and reassure you than have something go undetected.