The Role of Tranexamic Acid in Mohs Micrographic Surgery for Nonmelanoma Skin

Mohs micrographic surgery (MMS) already carries a low risk of bleeding, but around 1% of patients experience postoperative bleeding—especially when wounds are left open to heal. Tranexamic acid (TXA), an antifibrinolytic drug that prevents blood clot breakdown, has been shown to reduce bleeding during and after MMS. TXA can be given as a subcutaneous injection, applied topically, or used in combination with local anesthetics. Studies demonstrate that TXA reduces bleeding complications, especially in patients on blood thinners or with larger tumors, while side effects are rare. Because TXA is affordable, safe, and effective, it may be a valuable tool for Mohs surgeons to improve outcomes and patient comfort.

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