Skin Cancer Treatment Just Got More Precise: Advanced IHC-Assisted Mohs Surgery Now Able to Treat Aggressive Melanoma

A St. Louis area surgeon is one of the few locally with fellowship training to treat the most dangerous type of skin cancer with same-day reconstruction

ST. LOUIS, MO, UNITED STATES, April 30, 2026 /EINPresswire.com/ -- For most of the past decade, Mohs micrographic surgery has been recognized as the gold standard for treating basal cell and squamous cell carcinomas, the two most common forms of skin cancer. What has changed, and what most patients across the St. Louis region don’t yet know, is that Mohs is now being used to treat melanoma, historically one of the most difficult skin cancers to remove with surgical precision.

The technique behind that advancement is immunohistochemical (IHC) staining, an antibody-based process that makes melanoma cells visible on frozen tissue slides during surgery. The result: same-day tumor removal, tissue preservation, same-day reconstruction, and published outcomes comparable or superior to more invasive procedures.

May is Skin Cancer Awareness Month. Missouri reports approximately 1,500 new melanoma diagnoses each year, with incidence rising roughly 1.3 percent annually. Basal cell and squamous cell carcinomas together account for more than six million treated cases in the United States every year, with more than 80 percent occurring on the face, scalp, neck, or hands.

Dr. Brandon T. Beal, MD, FAAD, one of the only double board-certified Mohs Micrographic Surgeons and Cosmetic Dermatologists in the region, performs IHC-assisted Mohs at St. Louis Dermatology & Cosmetic Surgery in Troy, Missouri. That means he can perform tumor excision and wound reconstruction in a single visit, in the same office, on the same day. For patients across the greater St. Louis region, it’s a capability previously available only at select academic medical centers.

"The Missouri patients who need Mohs surgery the most, outdoor workers, farmers, people who've spent their lives in the sun, are often the ones least likely to drive an hour to see a specialist," Dr. Beal said. "Bringing this level of care to Troy removes a major barrier to care."

The access gap is documented. Rural patients consistently present with more advanced disease than urban patients, arriving on average 12 to 24 months after first noticing a lesion. In the greater St. Louis region, the traditional referral path for fellowship-level Mohs care has meant appointments at academic medical centers in the city, which has contributed to delays in diagnosis and treatment for patients in Lincoln, Warren, and St. Charles counties. More than half of Dr. Beal’s patients travel fewer than ten miles to reach his office for treatment.

Any licensed physician can legally perform Mohs surgery. However, fellowship training through the American College of Mohs Surgery, the credential Dr. Beal holds, requires a separate year-plus of supervised, high-volume surgical and pathology training beyond standard dermatology residency. Dr. Beal completed his residency at the Cleveland Clinic Dermatology & Plastic Surgery Institute and his Mohs and facial plastic surgery fellowship at Zitelli & Brodland, a program known nationally for training surgeons who go on to lead academic Mohs programs.

“The fellowship distinction matters because Mohs is as much pathology as it is surgery,” Dr. Beal said. “You’re reading your own slides, mapping the tumor, deciding when the margins are clear. That training is a separate discipline, and it directly determines the outcome for the patient.”

Dr. Beal regularly sees patients who say, ‘I'm too young for this' and 'I don't want a scar.'

Patient Profile A — The Young Mom, Wentzville – A woman in her mid-30s who self-referred after noticing a changing mole. She almost didn't come in. "I figured I was too young for skin cancer," she said. Her melanoma was caught at stage 0, treated with IHC-assisted Mohs, and closed the same day. The scar is minimal. She was back to her routine within days.

Patient Profile B — The Veteran, St. Louis region – A man in his '60s who had been putting off checking out a lesion on his face because he didn’t want a big scar. "I was wrong to wait, and wrong about the scar," he said. His basal cell carcinoma was removed and reconstructed in a single visit. He went home the same day.

Dr. Beal is available for media interviews, in-office visits, and on-camera appearances for broadcast. Patient introductions are available with prior coordination. High-resolution before-and-after photography is available for print and digital editorial use. For appointments or additional information, visit cosmeticdermatologystlouis.com or call (314) 834-1400.

About St. Louis Dermatology & Cosmetic Surgery
St. Louis Dermatology & Cosmetic Surgery is a leading provider of advanced surgical, medical, and cosmetic dermatology services. Founded in Troy, Missouri, by Dr. Brandon Beal, MD, FAAD, the practice combines innovative treatments with a compassionate, team-centered approach. As one of the only practices in the greater St. Louis area led by a Mohs surgeon with additional fellowship training in facial plastic and reconstructive surgery, patients benefit from same-day in-office reconstruction and exceptional outcomes. Services include Mohs micrographic surgery, skin cancer screenings, cosmetic dermatology, acne scar treatment, CO₂ laser rejuvenation, and more.

The practice offers same-week appointments and is located at 520 E. Cherry St., Troy, MO 63379. Call (314) 834-1400 or visit cosmeticdermatologystlouis.com to learn more or schedule an appointment.

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Kerry Andersen
1905 New Media
+1 337-292-0725
kerry@1905newmedia.com
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