It’s natural to feel anxious or fearful when your doctor informs you that they want to perform a skin biopsy to get a closer look at an area of concern. In addition to the stress of undergoing this outpatient procedure, you’re also faced with the possibility of discovering a more serious medical condition lurking in the layers of your skin. 

For many, understanding when and why a biopsy is needed can help calm these uneasy feelings. This article will detail the must-knows about the procedure, including the most common types, the basic process, and how to provide appropriate aftercare. 

Types of Skin Biopsies

Incision Biopsy

Used for: removing only a portion of a larger tumor, skin ulcers

The process for an incision biopsy is identical to an excision biopsy, but the doctor will only remove part of the lesion for testing. This procedure is standard in cases where the dermatologist cannot safely remove an entire skin lesion, but the doctor requires more information about what the spot is. 

Punch Biopsy

Used for: mouth cancer, throat cancer, cervical cancer

If your doctor requires a full-depth sample or attempts to remove an entire lesion, they may utilize a punch biopsy. The punch is a small, circular tool that pierces through all layers of skin and the superficial layer of fat below. 

Shave Biopsy

Used for: warts, superficial carcinomas, skin tags, keratoses, raised moles

The most common way for dermatologists to collect skin tissue samples is the shave biopsy. Your doctor will use a sterilized razor blade to shave off a small sample of the epidermis and upper layers of the dermis. 

Excision

Used for: removing larger tumors and lesions

An excision is typically employed when your doctor needs to remove an entire melanoma lesion and a certain margin of healthy skin to avoid unintentionally leaving behind cancerous cells. Your doctor will use a surgical scalpel to complete the procedure and layered sutures are used for repair.

The Biopsy Process

From start to finish, most biopsies will only take around 15 minutes and have a very short recovery time similar to that of an everyday cut or abrasion. Still, knowing what to expect on the day of the procedure may help ease some of your fears before your appointment.

  1. Depending on the lesion or infection location, your doctor might require you to change into a gown for easy access to the site. 
  2. Your dermatologist will prepare the biopsy site by disinfecting the area thoroughly. Then, they circle the area of concern with a marker to ensure they collect the entire sample.
  3. The biopsy site receives a dose of local anesthetic delivered via a sterile sharp. This will quickly numb the area, making the procedure much more comfortable. 
  4. Once the anesthetic has numbed your skin, the doctor will remove the skin sample or lesion using one of the four methods outlined above. After removing the tissue, it is packaged and sent away for further testing. 
  5. Depending on the depth and size of the wound, your doctor will dress the site to facilitate healing and prevent infection. Shave biopsies typically require nothing more than cautery to stop the bleeding and a pressure dressing. Excision, incision, and punch biopsies often require stitches, followed by a sterile bandage. 
  6. Your doctor will follow up with your biopsy results once the lab has analyzed the sample. While this timeline varies based on many factors, you can usually expect to hear back from your dermatologist within a week to let you know if the area of concern is benign or requires more investigation. If, after further investigation, the site is cancerous, your doctor will follow up with a treatment plan. 

Post-Biopsy Care Tips

As with any surgery, proper aftercare is necessary to prevent complications, excessive scarring, or infection. You can expect the site to fully heal over the next 2-3 weeks, so long as you follow your doctor’s instructions. 

  • Wash your hands before cleaning the wound to prevent introducing foreign bacteria or debris. It would be best if you kept the area as sterile as possible. 
  • Clean the wound with antibacterial soap and warm water twice a day. Pat, rather than rub, the area dry, then apply a very thin layer of Aquaphor with a cotton swab to moisten the area. This helps minimize scarring. Apply a clean bandage or dressing until the wound has completely closed. 
  • Avoid stressing, bumping, or stretching the surgical site, as it can cause the skin to reopen. This may require you to take a break from tasks like working out or lifting heavy objects. 
  • Don’t go swimming or take baths in the first 24 hours, as excessive moisture can impede healing. 
  • Attend your follow-up appointment if you have sutures. Waiting too long can cause your skin to grow over the stitches, complicating the healing process and creating more scar tissue. 
  • If you experience discomfort at the wound site, take acetaminophen or other OTC pain relievers. Contact your doctor if the pain seems excessive, the area becomes increasingly inflamed, or you feel feverish. These are signs of infection, which are very rare. 

Put Your Mind at Ease with Advanced Dermatology & Cosmetic Institute

There’s no denying that skin cancer is scary, but it’s also one of the easiest to treat. Melanoma, when detected in its earliest stages, has a 97% 5-year survival rate, as removing the cancerous cells typically requires nothing more than an additional excision procedure. 

Dr. Elizabeth Briden has more than 35 years of experience providing comprehensive skin care to her patients. With that experience comes a long history of accolades, awards, and success stories for this globally-celebrated professional. If you are concerned about a spot on your skin or would like to get on the right track for preventative dermatological care, we encourage you to schedule an appointment. We accept new patients at all of our locations!