Is It Bad To Put Retinol on Skin After Mohs Surgery?

Learn When and How to Reintegrate Retinol After Your Procedure

It's generally not recommended to use retinol on skin after Mohs surgery, especially in the early stages of healing. The skin is very sensitive and prone to irritation after the procedure, and retinol can cause dryness, redness, and further irritation.

First, The Golden Rule: Always Follow Your Provider's Instructions

Before anything else, the most critical rule is to adhere strictly to the post-operative care instructions given to you by your Mohs surgeon and/or dermatologist. They performed the procedure, know the details of your wound, your skin type, and your medical history. 

Their guidance is tailored to your specific healing process and is paramount for a safe and successful recovery. Any general advice, including what's in this article, should be secondary to their direct instructions.

Understanding Wound Healing After Mohs Surgery

Mohs micrographic surgery is a precise technique for removing skin cancer, layer by layer, while sparing healthy tissue. After the cancer is removed, you will have a surgical wound. The healing process involves several phases:

1. Inflammation: Initial redness, swelling, and tenderness as your body begins the repair process.
2. Proliferation: New tissue, including collagen and new skin cells (epithelialization), begins to form to close the wound. This phase is crucial for rebuilding the skin barrier.
3. Remodeling/Maturation: The newly formed tissue strengthens and reorganizes. Scars may fade and flatten over months or even longer.

During these vulnerable stages, the skin is highly sensitive and susceptible to irritation and complications.

The Role of Retinol in Skincare (and Why Caution is Needed Post-Surgery)

Retinol, a derivative of Vitamin A, is a popular and effective skincare ingredient known for:

• Increasing cell turnover
• Stimulating collagen production
• Improving skin texture and tone
• Reducing the appearance of fine lines and hyperpigmentation

However, these powerful effects can also lead to irritation, redness, dryness, and peeling, especially when first starting or on sensitive skin. After Mohs surgery, your skin barrier is compromised, making it much more susceptible to these side effects.

Key Consideration: Topical retinoids, including retinol, should generally not be used on a fresh surgical wound after skin cancer surgery until epithelialization (the process of new skin covering the wound) is complete. Applying retinol too soon could:

• Cause significant irritation and inflammation
• Delay wound healing
• Potentially worsen scarring

While some research indicates that oral retinoids (like acitretin) did not significantly impair wound healing in patients who underwent Mohs surgery for skin cancer (among other procedures), this finding pertains to systemic medication and doesn't directly translate to the safety of applying topical retinol directly onto a healing Mohs wound. The mechanisms and concentrations at the skin surface are very different.

Studies have also explored using topical retinoids before certain skin resurfacing procedures to potentially enhance healing, but this involves a specific pre-treatment regimen on intact skin, not application to an open or freshly healing surgical site.

When Might Retinol Be Reintroduced After Mohs Surgery?

The timeline for safely reintroducing retinol to the area treated by Mohs surgery is highly individual and must be determined by your surgeon or dermatologist.

• Complete Healing is Key: Generally, the wound must be fully closed, with the skin surface completely re-epithelialized, and no signs of scabbing, oozing, or significant tenderness. This can take several weeks to months.
• Scar Maturation: Your provider may advise waiting even longer, until the scar has started to mature, to minimize any risk of irritation that could affect the scar's appearance.
• Gradual Reintroduction: When your provider gives the green light, they will likely recommend reintroducing retinol very slowly and cautiously, starting with a low concentration and infrequent application, monitoring closely for any signs of irritation.

What to Use Instead: Supporting Healing After Mohs Surgery

While retinol is on hold, focus on a gentle skincare routine designed to protect and support the healing wound, as advised by your doctor:

• Gentle Cleansing: Use a mild, fragrance-free cleanser and lukewarm water as directed. Avoid harsh scrubbing.
• Moisturize to Support the Skin Barrier: Apply a bland, hydrating, and occlusive moisturizer to keep the wound environment moist, which aids healing and can help minimize scarring. Ingredients like ceramides, hyaluronic acid, and panthenol can be beneficial. Petroleum jelly is often recommended for its occlusive properties.
• Protect Diligently with Sunscreen: Once your provider says it's okay to apply sunscreen to the healed area, use a broad-spectrum, mineral-based sunscreen (zinc oxide, titanium dioxide) with an SPF of 30 or higher daily. This is crucial to prevent post-inflammatory hyperpigmentation (darkening of the scar) and protect the delicate new skin.

Your Post-Mohs Skincare Ingredient Guide: What to Use and What to Avoid (General Guidance)

Always confirm with your provider, but general principles for early post-Mohs skincare often include:

Focus On (as directed by your provider):

• Petrolatum: Creates an occlusive barrier to protect the wound and retain moisture.
• Simple, fragrance-free moisturizers: To hydrate and support barrier repair.
• Mineral Sunscreen (once approved for application): To protect against UV damage.

Generally Avoid on the Healing Wound (until cleared by your provider):

• Retinoids (Retinol, Tretinoin, Adapalene, etc.)
• Exfoliating Acids (AHAs like glycolic acid, BHAs like salicylic acid)
• Vitamin C (Ascorbic Acid) serums (can be irritating on compromised skin)
• Physical Scrubs or Exfoliants
• Fragrance and Essential Oils
• Alcohol-based toners

Post-Mohs Aftercare: Frequently Asked Questions (FAQ)

• How long until I can use retinol on my Mohs scar? This is entirely dependent on your individual healing and your surgeon's specific advice. It could be many weeks to several months after the surgery. Do not resume without their explicit approval.
• What are signs that my Mohs wound is healed enough to consider asking my doctor about retinol? The skin should be fully closed with no scabs, no oozing, minimal to no redness or tenderness, and the scar should be starting to mature. However, only your doctor can make the final determination.
• Can retinol help my Mohs scar look better eventually? Once healing is complete and your doctor approves, retinol may be incorporated to help with scar texture and discoloration over the long term, as it promotes collagen production and cell turnover. However, this must be approached cautiously.

Patience and Professional Guidance are Key

Healing from Mohs surgery takes time and patience. While retinol is a powerful tool in a regular skincare arsenal, it's generally best avoided on a healing Mohs surgical site until your surgeon or dermatologist confirms it's safe to reintroduce. 

Prioritizing gentle care and sun protection, and strictly following your provider’s instructions, are the most important steps you can take to ensure optimal healing and the best possible outcome for your skin.