- Days 1–7 involve bandage changes, rest, and ice for swelling — follow your surgeon's specific wound care instructions, keep the dressing clean and moist with petrolatum, and change it once daily
- Stitches come out between day 5–21 depending on location — face heals faster (5–7 days), scalp takes longer (10 days), extremities take longest (10–21 days)
- Swelling and bruising peak at day 3–4, then improve — this is normal; use ice packs (20 minutes on, 20 minutes off) to reduce swelling
- No strenuous exercise for 7 days — light walking is safe after day 2–3, but avoid running, heavy lifting, or swimming until after stitches are out
- Silicone gel and daily sunscreen starting week 3–4 reduce scar thickness by 50–73% — continue sun protection (SPF 30+) for at least 6–12 months
- Scar massage starting after complete healing (week 3–4) makes scars softer and flatter — use light circular motions for 5–10 minutes, 2–3 times daily for at least 6 months
- Anxiety and worry are common after surgery — these feelings usually ease within 3–4 weeks as your wound heals and you return to normal activity
What You Need to Know Right Now
Your Mohs surgery is done. You're probably tired, maybe a little sore, and wondering: "What happens now?" This guide walks you through recovery step by step—from today through the next six months. Everything here is normal healing information. Your surgeon gave you specific instructions for your surgery. Follow those first.
Day 1: The First 24 Hours After Surgery
What Your Wound Looks Like
Your surgical site is wrapped in a bandage. Under that bandage, it's probably oozing a little bit. That's normal. Your body is cleaning out the wound.
What You Should Do
- Keep the bandage dry. Don't shower or get it wet.
- Apply ice if you have swelling. Ice for 20 minutes, then take a break. Repeat while awake.
- Take pain medicine if you need it. Ibuprofen (Advil, Motrin) is commonly used and works well. Acetaminophen (Tylenol) is also a good option. Your surgeon will tell you what's best for your situation.
- Rest. Your body just went through surgery. It's okay to take it easy today.
- Don't bleed on things. Some blood seeping through the bandage is normal. If it keeps flowing after 20 minutes of firm pressure with a clean cloth, call your surgeon.
What's Normal
- Mild to moderate pain (3–5 out of 10)
- Oozing or light bleeding on the bandage
- Swelling and bruising starting to appear
- Mild redness around the wound
Days 2–7: The First Week
Your Wound Care Routine
After 24 hours, your surgeon will tell you how to change your bandage. Here's the basic routine:
Daily bandage change:
- Gently wash your hands.
- Carefully remove the old bandage.
- Gently wash the area with mild soap and lukewarm water. Don't scrub.
- Pat dry with a clean cloth (don't rub).
- Apply a thin layer of petroleum jelly (Vaseline) or antibiotic ointment.
- Cover with a fresh bandage.
Petroleum jelly keeps the wound moist, which helps it heal faster and with less scarring.
Activity Restrictions
- No exercise, sports, or heavy lifting. This includes yard work and moving furniture.
- No bending over or straining. This raises pressure in your head and can cause bleeding.
- No swimming or soaking in bathtubs or hot tubs until stitches come out.
- Stay out of the sun. It will darken your scar.
What to Expect
- Swelling and bruising peak around day 3–4. This is normal. It will get better.
- Pain decreases as the days go on. You may stop needing pain medicine by day 3 or 4.
- The wound starts to close. You'll see the edges getting closer together.
- Light pink or red color around the wound. That's inflammation—it's part of healing.
When to Call Your Surgeon
- Fever (100.4°F or higher)
- Bleeding that won't stop after 20 minutes of pressure
- Pus, yellow or green drainage, or a foul smell
- Pain that gets worse instead of better
- A red streak extending away from the wound
Stitches usually come out between day 5 and day 10, depending on where your surgery was. See the timeline below.
Stitches: When Do They Come Out?
Your surgeon will tell you the exact day. Here are the general guidelines:
| Location | Days Until Removal |
|---|---|
| Face | 5–7 days |
| Scalp | 10 days |
| Chest | 7–14 days |
| Arms and legs | 10–21 days |
Why the difference? Faces heal fast and are cosmetically important, so stitches come out sooner. Legs heal slower and have more tension on the wound, so stitches stay in longer.
Stitch removal feels like a quick pinch. It's usually not painful, though you might feel tugging.
Weeks 2–4: Moving Forward
Bandaging
- You may stop wearing a bandage once your stitches are out (assuming your surgeon says it's okay).
- The wound is still healing, so keep protecting it from the sun.
Wound Care Continues
- Keep washing and moisturizing with Vaseline for at least another week.
- The wound will look pinkish-red. That's normal.
Activity
- Light walking is fine.
- Avoid strenuous exercise for a full 7 days after surgery. After that, check with your surgeon.
- You can shower normally, but don't let the water stream directly on the wound.
Scar Management Begins (Week 3–4)
Once your wound is completely closed, you can start scar massage:
- Gently massage the scar in small circles, 2–3 times a day, for 5–10 minutes each time.
- Use light pressure. It shouldn't hurt.
- This helps the scar become softer and flatter.
- Continue for at least 6 months.
Sun protection is critical. Use broad-spectrum sunscreen (SPF 30 or higher) every single day, even on cloudy days. Reapply every 2 hours if you're outside.
What You'll See
- Pinkish-red color gradually fading
- Mild swelling that comes and goes
- The scar flattening out
- Slight itching or tightness (normal)
Months 1–6: The Longer View
How Healing Works
Your wound closes in about 4–6 weeks. But the scar keeps changing for months. Here's what happens:
- Month 1: The scar is still red and maybe slightly raised.
- Months 2–3: The redness begins to fade. The scar starts to flatten.
- Months 3–6: Continued improvement. The scar becomes softer, flatter, and lighter.
- 6–12 months: The scar reaches its final appearance.
The bottom line: Scars improve a lot in the first 6 months. Be patient.
Scar Care Tools
Three things help scars heal better:
1. Silicone Gel
- Apply silicone gel or use silicone gel sheets on your scar.
- Start once the wound is closed.
- Silicone hydrates the scar tissue and helps it flatten and soften.
- Use for at least 3–6 months for best results.
- Evidence shows this actually works.
2. Massage
- Continue gentle massage 2–3 times daily.
- Use light circular motions.
- 5–10 minutes per session.
- This breaks down stiff collagen and makes scars more supple.
3. Sunscreen Every Day
- SPF 30 or higher, broad-spectrum.
- Use it for at least 6–12 months after surgery.
- Sun exposure can triple the risk of an ugly, dark scar.
- Reapply every 2 hours outdoors.
Activity (After Week 1)
- Return to normal exercise after 7 days (with your surgeon's approval).
- Swimming is okay after stitches are out.
- Protect the scar from sun during outdoor activities.
What's Normal
- Slight color changes (getting lighter)
- Mild itching or tightness
- Swelling that comes and goes, especially in hot weather or after activity
- A small amount of dryness or flaking
Normal Healing vs. Complications: Quick Comparison
| Sign | Normal Healing | Call Your Doctor |
|---|---|---|
| Redness | Fades over days/weeks | Stays bright red, gets worse, or spreads |
| Swelling | Peaks at day 3–4, then decreases | Increases after week 1, or very severe |
| Drainage | Clear or light seepage for 1–2 days | Yellow, green, or thick pus; foul smell |
| Pain | Decreases day to day | Gets worse after day 2; sharp or severe |
| Bleeding | Light oozing for 1–2 days | Continues after pressure; bright red flow |
| Appearance | Pink/red scar, gradually lighter | Dark red, raised, or growing |
| Temperature | Normal body temperature | Fever 100.4°F or higher |
What You Should Call Your Surgeon About
Right Away (Within Hours)
- Fever of 100.4°F or higher
- Bleeding that won't stop after 20 minutes of pressure
- Severe pain not controlled by pain medicine
- Chest pain or trouble breathing
Within 24 Hours
- Yellow, green, or thick pus
- Foul-smelling drainage
- Red streaks extending from the wound
- Very large amount of swelling or bruising
- Signs of an allergic reaction (hives, difficulty breathing)
Within a Few Days
- Pain worsening instead of improving
- Increasing redness or warmth after day 3
- Wound edges pulling apart
- Feeling like something is wrong (trust your instincts)
The Emotional Side of Recovery
You just had surgery to remove cancer. That's a big deal. It's completely normal to feel:
- Anxious or worried. You had skin cancer. Will it come back? That's a real concern.
- Sad or blue. Surgery is stressful. Your body's healing uses energy. You might feel tired or low.
- Frustrated. You can't do your normal activities. You have to think about wound care constantly.
- Relieved. The cancer is out. That's good.
How Long Will These Feelings Last?
For most people, anxiety and worry ease within a few weeks as the wound heals and life goes back to normal. If you're still feeling very down or anxious three weeks after surgery, talk to your doctor or a mental health professional.
What Helps
- Stay connected. See friends and family. Don't isolate.
- Gentle movement. Walk. Stretch. Light yoga. Movement helps mood.
- Sleep. Your body needs rest to heal.
- Realistic expectations. Your scar will improve. It won't be invisible, but it will get much better.
- Follow your surgeon's instructions. Doing the right things helps you heal faster and feel more in control.
Frequently Asked Questions
Q: Can I shower after surgery?
A: Not for 24 hours. After that, you can shower, but keep the wound dry. Don't let water spray directly on it. After stitches are out, you can shower normally.
Q: How much pain is normal?
A: Mild to moderate pain (3–5 out of 10) for the first few days is normal. Pain should decrease each day. If it's getting worse, call your surgeon.
Q: When can I go back to work?
A: Depends on your job and your wound. Desk work? Maybe a few days. Heavy lifting? A full week minimum. Ask your surgeon.
Q: Why is my scar still so red?
A: New scars are red because there's lots of blood flow to the healing area. The redness fades over weeks and months. By 3 months, most scars are much lighter.
Q: Can I use makeup over my scar?
A: After stitches are out and the wound is closed, yes. Use makeup that feels comfortable. Waterproof makeup is easiest to keep clean.
Q: Will the scar be visible forever?
A: Scars always show a little, but they fade a lot. Most scars look 70–80% better by 6 months. Continuing to use sunscreen and silicone gel helps.
Q: What if my scar becomes a raised, thick bump (keloid)?
A: Some people are prone to keloids. If your scar gets thicker or raised instead of flatter, tell your surgeon. There are treatments (steroid injections, lasers) that help.
Q: When can I exercise again?
A: Light walking after a few days is fine. Strenuous exercise, heavy lifting, or anything that makes you sweat and strain: wait 7 days. After that, ask your surgeon.
Q: Is it normal to have anxiety after surgery?
A: Yes. Studies show up to 74% of people feel some depression or anxiety during recovery. It usually gets better as you heal. If it doesn't, talk to your doctor.
Evidence Snapshot
Your recovery care is based on decades of surgical science. Here's what research shows:
✓ Keeping wounds moist (with Vaseline or ointment) speeds healing and reduces scars.
✓ Silicone gel sheets or topical silicone reduce scar thickness, color, and height by 30–50% when used for 3–6 months.
✓ Scar massage (starting after complete healing) makes scars softer and flatter through collagen remodeling.
✓ Sun protection with SPF 30+ is critical—UV exposure can triple scarring risk.
✓ Suture removal timing by location (face earlier, legs later) optimizes both healing and cosmetic outcome.
Medical Disclaimer
This guide provides general wound care information and is not a substitute for professional medical advice. Every patient and every wound is different. Always follow the specific post-operative instructions from your surgeon. If you have questions or concerns about your recovery, contact your dermatologic surgeon immediately. If you experience fever, signs of infection, severe bleeding, or any emergency symptoms, seek immediate medical care.
References
- American College of Mohs Surgery - Post-Operative Care
- Post-Operative Care and Recovery Timeline - SLUCare Dermatology
- Efficacy of Topical Silicone Gel in Scar Management - PMC/NIH
- Update on Postsurgical Scar Management - PMC/NIH
- Wound Infection After Mohs Surgery: Signs and Management - Dermatology and Skin Health
Dr. Thomas L.H. Hocker Triple Board-Certified Dermatologist Harvard Medical School | Mayo Clinic Mohs Fellowship Dedicated to patient education and excellent skin cancer care.
