Understanding Skin Biopsies: What You Need to Know

A Skin Biopsies is a medical procedure that involves removing a small piece of skin for examination. Learn more about the process and what to expect.

By Dr. Heba hegzy Last updated Mar 31, 2023

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Skin Biopsies is a medical procedure that may sound scary or intimidating, but it’s actually a routine test that can provide valuable information about your skin health. In this article, we will guide you through the skin biopsy procedure step by step, explaining what to expect and how to prepare for the test. We’ll also discuss the different types of skin biopsies and their risks and benefits. Whether you’re curious about skin biopsy or are scheduled for one soon, keep reading to learn more about this common procedure.

What is a Skin Biopsies?

A skin biopsy is a procedure that involves extracting a small portion of skin in order to conduct tests. This procedure assists in the identification of unusual areas on the skin known as skin lesions. By studying the extracted sample under a microscope, doctors can detect skin cancer, various types of skin disorders, or infections. It is not mandatory to get a biopsy for all types of skin lesions, as some can be diagnosed through observation alone by your medical practitioner.

There are 4 primary methods for conducting a skin biopsy, and which one is utilized hinges on variables such as where the lesion is located, its size, and how deep it extends into the skin:

Punch: A punch biopsies is the most common type of skin biopsy and it involves using a cylindrical tool to remove a small circular section of skin.
Shave: A shave biopsy can help with superficial skin problems and involves scraping off skin for examination.
An excisional biopsy is used to remove the entire area of suspicious skin, which is then sent to the laboratory for testing.
An incisional biopsy is similar, but only a small sample of skin tissue is removed.

Each type of biopsy has its benefits and produces different data. Your dermatologist will determine which type of biopsy is best based on the location and type of skin issue.

Other names: Basal cell biopsy, squamous cell biopsy, and melanoma biopsy.

What is it used for?

A skin biopsy is used to assist in the diagnosis of a number of skin disorders, such as:

Psoriasis
Eczema
Actinic keratosis (also known as “precancers”)
Warts
Bacterial or fungal infections of the skin.
carcinoma of the skin. A biopsy can determine if a suspicious lesion or other growth is cancerous or not. The biopsy can identify the specific type of skin cancer if the test is positive for malignancy.

Performing a skin biopsy is useful for identifying skin cancer in its early stages, which allows for simpler treatment.

Why do I need a Skin Biopsies?

If you have specific skin symptoms, such as those listed below, it may be necessary for you to undergo a skin biopsy:

A persistent skin irritation that does not disappear.
Skin that has scales or a textured surface
Non-healing wounds or ulcers
A skin rash or growth that has altered its shape, hue or dimensions.
A new growth or mole which exhibits the characteristics of melanoma using the A-B-C-D-Es
- Asymmetrical: The form is irregular
- Border: The border is rough
- Color: The color is not consistent throughout
- Diameter: The size is bigger than that of a pea
- Evolving: Over time, developing and changing the growth in the past few weeks or months.
Blistering skin, which may be a sign of pemphigus, an autoimmune disease.

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What happens during a skin biopsy?

A provider will clean the site and give you an injection (shot) in order to numbing your skin so you won’t feel any pain.

punch biopsy procedures

A particular tool with a hollow, rounded blade is used by a provider.
A little piece of skin the size of a pencil rubber is removed by rotating the blade across the aberrant skin area (lesion).
With the use of another tool, the sample is removed.
If a bigger sample of skin is obtained, the incision may require one or two stitches to seal it.
The wound will be compressed until the bleeding stops.
A bandage will be applied to the wound.

Shaving biopsy procedures

A medical professional will cut a sample from the epidermis of your skin using a scalpel or a razor.
Pressure will be applied to the wound or medicine may be applied to it to help stop the bleeding.
A bandage will be applied to the wound.

Excisional, and Incisional biopsy

The entire skin lesion will be removed by a clinician using a knife, typically with “a margin” of healthy skin surrounding it.
In the case of a huge skin lesion, your doctor might merely remove a portion of it. It’s referred to as an incisional biopsy.
The wound will be stitched up by the physician, the stitches will be taken out 3-14 days after the biopsy.
The wound will be compressed until the bleeding stops.
A bandage will be applied to the wound.

An excisional biopsy is often used if your provider thinks you may have melanoma, the most serious type of skin cancer. It may also be used for basal cell and squamous cell skin cancer.

How Long Does a Skin Biopsy Take?

A skin biopsy is generally a quick and straightforward procedure that usually takes around 15-30 minutes to complete. However, the exact time may depend on the size and location of the tissue sample required, as well as the method of biopsy used. Shave biopsies are typically faster, often taking just a few minutes to perform, whereas punch and excisional biopsies may take longer. Patients should expect to spend some time at the doctor’s office before and after the procedure for consultation and aftercare. While a skin biopsy may cause some mild discomfort or pain, the procedure is generally well-tolerated and complications are rare. Patients will typically receive instructions on how to care for the biopsy site and when to follow up with their doctor for results.

Preparation for a Skin Biopsies

Before getting a skin biopsy, there are a few things that one needs to do to prepare. The doctor or nurse will provide specific instructions to follow, but generally, it is best to avoid wearing any makeup, moisturizer, or lotion on the area being biopsied. This is because these products can interfere with the results of the biopsy. It is also important to let the doctor know if you are taking any medications or have any allergies. Some medications, such as blood thinners, may need to be paused or stopped to prevent excessive bleeding during the biopsy.

Risks and Complications of Skin Biopsies

Skin biopsies, like any medical procedure, come with their own set of risks and complications. The most common complications are bleeding at the biopsy site, hematoma, or infection. Patients may experience soreness, swelling, redness, or bruising around the wound, and some discomfort is expected. More serious complications such as excessive bleeding, nausea, vomiting, dizziness, confusion, seizures, and blurred vision are rare, but can occur. To avoid these complications, pressure dressings and ice can be applied post-procedure. It is important to follow aftercare instructions carefully to promote proper healing and prevent infection. Patients should also monitor their biopsy site for any changes and contact a doctor should they experience excessive swelling, redness, or drainage from the site. Overall, while potential complications exist, skin biopsies remain an important diagnostic tool for identifying various skin issues and disorders.You may have a little bruising, bleeding, or soreness at the biopsy site. If these symptoms last longer than a few days or they get worse, tell your provider.

Results meaning

Patients must wait several days for the results of a skin biopsy. When the biopsy was done to look for potentially dangerous skin lesions, the waiting period might be anxious-inducing.

A normal biopsy result means there was no evidence of cancer or skin diseases. A particular skin ailment may be diagnosed based on an aberrant biopsy result. But, if aberrant results aren’t apparent, you might require additional testing to determine your particular issue.

What your results signify can be explained by your provider.

In some cases, a Skin Biopsies may be recommended to diagnose and treat the underlying condition. Early detection and treatment of skin conditions can help to prevent more serious or life-threatening complications. It is important to communicate any concerns with a healthcare provider and to follow up with any recommended screenings or tests.