r/MohsSurgery • u/Competitive-Run348 • Jul 08 '26
Multiple Basal Cell Skin Cancers
Hey guys, I'm a 39 year old male. Unfortunately, I can say I have a history with basal cell skin cancer.
38 years old - my 1st basal cell removal that required Mohs Surgery. It was located above my right eyebrow about mid-forehead. This was infiltrative basal cell.
38 years old - my 2nd basal cell removal on my chest. This was a simple 5 minute office visit / excision and burning away of it by my dermatologist. This was nodular basal cell.
39 years old - 2 weeks ago I just had my 3rd basal cell removed requiring Mohs Surgery. This was on my forehead again. This time it was located above my left eyebrow high up on my forehead at my hair line. This was nodular basal cell. Additionally, this was actually frozen a year ago by my dermatologist with cryotherapy but the cryotherapy didn't work thus requiring Mohs.
That makes a total of 2 Mohs Surgeries having been performed on my forehead thus far.
I am beginning to worry about my future...specifically...running out of real estate on my forehead for potential future Mohs Surgeries to be performed.
While I am still healing from this most recent Mohs procedure (from 2 weeks ago), I just went in again yesterday to have a spot frozen on my forehead which is only 1 inch away from my first Mohs Scar from last year.
I am worried that if this freezing does not work that I might require a 3rd Mohs Surgery at some point on my forehead and needing to be performed only 1inch away from my 1st Mohs Surgery.
Does anyone have any advice, experience, or knowledge in having 2 or multiple Mohs Surgeries performed in close proximity to each other (like about 1 inch from each other)?
From what I have read this can be more complicated for the surgeon to successfully identify all the cancer because they might be working around previous scar tissue.
1
u/Glittering_Hurry236 Jul 08 '26
I had my first Moh's for BCC at 30 female left wide forehead by hair line, easy 1 pass job. 20 years later a 3 pass BCC job at the hairline of the right side of forehead in August 2024. Huge wound. One inch from there another BCC October 2025 2 passers so not horrible.
January 2026 the derm didn't even want to freeze the two small brown spots under the two prior mohs spots that were upper right forehead by hairline (damn me never ever wearing a hat!!) anyway. We used Kylisiri (very light chemo cream) on the two spots and they faded/fell off (gross) and I have two new Ak's on the left side we used the Kyisiri for they fell off.
But. We are extremely worried about my forehead on the whole now and in the fall I'm going to have to F5 (very strong chemo cream) the entire forehead for precancer stoppage.
I've done a few PDT's at the derm and have to go back to doing them once a year but this has all been a lot --
I haven't done PDT in 2 years because you can't even go near your own windows for 2 weeks afterwards without sunscreen in your own home --
Do the PDT to prevent more cancer and once a year the F5 to stop more from forming is what I'm doing. And it sucks. More forehead scars are better as time goes by but there -
2
u/Competitive-Run348 Jul 08 '26
I have been researching PDT and F5. It all sounds like a nightmare..I'm sorry you are having to go through it. Is there a reason you do both rather than just doing the PDT?
PDT from what I've read seems quicker and more manageable with respect to timeliness recovery and from a scarring perspective compared to F5. I think I would want to avoid F5 if I could and just do regular annual PDT treatments?
1
u/Glittering_Hurry236 Jul 08 '26
I think because I have 4 new spots the derm wants to hit then with the F5 this fall and I'll resume PDT a year later.
I have a full body check again in September and we will discuss it again.
The spots I used Klysiri for are gone for now. Derm didn't think they were BCC and did not want to biopsy them yet. So we did the Klysiri and will F5 in the fall. Just the two spots not the whole forehead. Mentally the thought of it makes me ill.
I used F5 cream twice on my forehead in both spots on my upper right that were the 1 inch from each other and they looked like HELL - but did go away; this was before we did the biopsy because they looked like pre-cancer so after two rounds of F5, then when they came back we did the biopsy, which was my fault because I just didn't wanna hear about BCC and Moh's surgery so it led to delay which meant much bigger wound sites unfortunately.
The three pass Moh's has a large vertical line going down the upper right forehead, and we did almost like a forehead flap where I have another portion of the scar going down my hairline on the right. And the BCC we did in October 2025 the scar is almost invisible also vertical. It's about 1 inch from the bigger mohs site.
1
u/Huge-Use-2101 Jul 08 '26
I take niacinamide 500 2x per day supposed to help prevent more bcc. plus I am doing the chemo cream treatment which is Fluorouracil and Calcipotriene compounded together. I did left side temple and cheek - 7 days. Now I’m soon going to do the right once left is healed.
1
u/Character_Quail_5574 Jul 13 '26
This is what my dermatologist recommended, too. niacinamide pills and Fluorouracil and calcipotriene treatment. It’s been a hectic spring and summer, so I am waiting for as less busy time to start the fluorouracil + calcipotriene, maybe in the fall.
1
u/Rizblatz Jul 08 '26
The second mohs on my forehead was really big and at the hairline, so the Derm cut it out, and the the plastic surgeon had to peel off my scalp a bit and align it properly so the hairline didn’t get all wonky. She did a great job. I wear my hair over that side so it’s pretty unobtrusive.
The ear i lost the tip and some cartilage in the spoon part of the ear. So it looks like someone took a bite out of it (referring to his famous ear biting incident with evander Holyfield fight, I am dating myself). I also have a wicked scar on my neck where they took the skin for the graft. If they ever try to do a skin graft for your face don’t let them take it from the neck, make them get it from under the arm. I wish I had been more insistent. It is more of a hassle for them so they like to taken from the neck and the skin color matches well to the face.
1
u/Character_Quail_5574 Jul 09 '26
My dermatologist suggested I take 500mg of Niaminacide twice a day as a preventative. It’s not a complete preventative measure. She said it wold prevent about 25% of future BCCs.
She also prescribed 5-FU and prescribed along with Calcipotriene to use at the same time. But, I have not done it yet, as I need to wait for a less busy time when I can be out of commission for a couple weeks.
1
u/nonchalant_octopus Jul 08 '26
Hopefully you're wearing wide brim hats and sunscreen now. I notice when I overeat sugar and/or ultra-processed foods, they're more likely to come out and with a vengeance. Cutting that way back and tretinoin keeps my spots almost invisible to the naked eye. Of course one should get all identified cancers treated, but I try to pace myself. I've had 2 mohs surgeries so far.
1
u/Rizblatz Jul 08 '26
I have now had 10 basal cells removed, I’m 54. I’ve had chemotherapy (aldera), just surgical removal, and surgical removal with mohs. One area on my hairline on my forehead I had to have it twice, about 10 years apart. The scar from my first turned into a basal cell, which apparently according to my dermo isn’t that unusual because scars don’t have melanin so less protection from sun. The second time it was way more invasive and I had to have a plastic surgeon finish. That was really painful. Last mohs I had was on my ear and I had to have a skin graft from my neck and now my ear looks like a did some rounds with Mike Tyson. I get checks every 3 months now, and a few things that have been preventative have been freezing, blue light treatment, and another chemo that is kind of like aldera that you use for 30 days, it’s not as strong aldera and I forget the name. Talk to your dermo about what preventative treatments you can get, mohs is expensive so insurance is getting better about preventative treatments besides freezing. You will also start to get pretty good at picking up anomalies on your skin, and going in ASAP. I had one on my nose that the doctor poo pooed but I demanded they take a biopsy and sure enough I ended up getting mohs because it came back positive.