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Skin Biopsy (video)
What is a biopsy?
A biopsy is the removal of a sample of tissue from the skin for examination. The tissue will be examined under a microscope by a pathologist to make the diagnosis. Therefore, only very small samples are needed.
Occasionally a growth on the skin must be biopsied to determine if it is malignant (basal cell carcinomas, squamous cell carcinomas, warts, moles or melanomas). In other situations, a skin rash develops and the dermatologist must distinguish between several different causes.
How is a biopsy performed?
There are three procedures for taking a skin biopsy, a shave biopsy, a punch biopsy and an excisional biopsy. First, a local anesthetic is injected with a tiny needle around the growth or the sample to be taken.
A shave biopsy is simply slicing the growth off at the skin level and no stitches are required. Bleeding is stopped with application of a chemical in just a few seconds.
A punch biopsy involves the use of a sharp round instrument that takes a core sample of the lesion or the rash. Then the skin is sewn together again with a couple of stitches. This leaves a very small, almost invisible, scar.
An excisional biopsy is performed when it's important to remove the entire lesion, for instance, in the case of a suspected melanoma. This procedure is outlined in detail in skin cancer surgery. The scar may be larger than the diameter of the growth in order to close up the incision.
After any of these biopsies, the area will be dressed by the assistant with a sterile dressing. These should be kept over the site until it is healed or until the stitches are removed by the physician or assistant. Please do not remove your own stitches. If they are removed too soon, the skin edges will open up, possibly leading to bleeding, infection or a large unattractive scar.
What about scarring?
Scars can be kept to a minimum with proper post-biopsy care and taking Vitamin C in doses of 3,000 to 5,000 mg per day for 3-6 months. Scars generally remain red-purple for several months, so this should not be of concern unless the scar begins to enlarge or thicken. This could indicate formation of a keloid and should be brought to your physician's attention.
Any redness, pus, oozing or pain at the biopsy site should be reported immediately to your physician since these may signal the onset of an infection.
When will I know the results of the biopsy?
You will be given instructions about when to return to the office for removal of the stitches if any were placed and generally, the biopsy result will be available within 1-2 weeks. It's preferable to return for a follow up visit so the physician can inspect the area for infection or scarring and for you to be able to ask questions about the diagnosis and for the physician to review treatment options.
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