Mohs surgery removes skin cancer layer by layer, allowing for the precise examination of tissue until no cancer cells remain. This technique maximizes the preservation of healthy skin, but the resulting surgical wound requires careful management to ensure optimal healing and cosmetic outcomes. Physical activity restrictions are placed on patients because early exertion increases the risk of complications. Recovery requires a phased approach to returning to exercise, moving from complete rest to light activity and eventually back to a full routine.
Immediate Post-Operative Restrictions
The initial 24 to 72 hours following the procedure represent the most critical period for the surgical repair. During this time, the primary concern is the formation of a hematoma, a collection of blood under the skin caused by bleeding at the wound site. Any strenuous physical activity that elevates the heart rate and blood pressure can increase blood flow to the wound, potentially dislodging the newly formed clot and causing a bleed.
Total rest is mandatory during this acute phase to prevent this immediate risk. Even simple movements like bending over or straining can cause an abrupt rise in pressure at the surgical site. Patients with a facial or head surgery site should sleep with their head elevated on two pillows to minimize swelling and bruising, which peak around 48 hours post-surgery. Minimizing movement of the treated area prevents tension on the fresh sutures, which could lead to pain or wound disruption.
The Phased Return to Activity
Once the acute risk of immediate bleeding has passed, typically after 72 hours, a gradual reintroduction of low-impact movement can begin. This transition period lasts until the sutures are removed, which usually occurs between 7 to 14 days post-surgery. Gentle walking is generally the only permitted activity, as it does not significantly raise the heart rate or strain the wound.
The rule of thumb during this phase is to keep activity levels below the threshold that causes throbbing or pulsing sensations in the wound area. Throbbing is a direct sign that the heart rate and blood pressure are too high for the delicate healing tissues. If the wound is located on a limb, movement should be slow and deliberate to avoid bumping or stretching the site. Any activity that causes significant sweating should also be avoided to maintain a sterile, dry environment for the wound dressing.
Specific Exercise Limitations and Risks
Activities that place tension on the wound or introduce a high risk of infection are restricted for a much longer duration, often extending up to four to six weeks. Heavy lifting and straining must be avoided because the sudden increase in intra-abdominal pressure can place extreme tension on the internal and external sutures. This tension risks wound dehiscence, which is the separation of the wound edges, or the widening of the resulting scar.
The definition of “heavy” lifting is typically anything weighing more than 5 to 10 pounds, roughly equivalent to a gallon of milk. Similarly, submerging the wound in water must be avoided for at least two to four weeks, or until the surgeon confirms the site is fully closed and sealed.
Exposure to water from pools, lakes, or even baths introduces bacteria that can cause a severe infection, which can lead to complications and a poor cosmetic outcome. High-impact activities or exercises that cause excessive stretching, such as yoga or intense cardio, are also limited for several weeks to prevent undue stress on the fragile, newly formed collagen fibers.