Skin Biopsy

(Skin Lesion Biopsy; Shave Biopsy; Punch Biopsy; Excision Biopsy)

by Editorial Staff and Contributors

Definition

A skin biopsy is a procedure where a small piece of abnormal skin is removed for testing. There are 3 main types of skin biopsies:

Shave biopsy—outer part of affected area is removed
Punch biopsy—a small cylinder of skin is removed using a punch tool
Excisional biopsy—an entire area of abnormal skin is removed

Punch Biopsy

Reasons for Procedure TOP

A skin biopsy is used to test an area of abnormal skin. If possible, the entire area will be removed during the biopsy. A skin biopsy may be done to diagnose:

Bacterial, viral, or fungal infections
Inflammatory skin disorders, such as psoriasis
Skin cancer or benign skin growths

Skin biopsy may also be done to:

Make sure a tumor was completely removed—by testing remaining skin
Monitor the effect of a treatment

Possible Complications TOP

Problems from the procedure are rare, but all procedures have some risk. The doctor will review potential problems, like:

Bleeding
Infection
Poor wound healing
Scarring
Nerve damage

Factors that may increase the risk of complications include:

Smoking
Suppressed immune system
Bleeding disorders
Circulatory problems

What to Expect TOP

Prior to Procedure

No special preparation is needed for this procedure.

Anesthesia

Local anesthesia may be used. It will numb the area being treated.

Description of the Procedure TOP

The involved area will be prepared. The skin will be cleaned. Medication will be applied to the skin or injected to numb the area. The exact steps will depend on the type of biopsy:

Shave biopsy—A thin slice of the skin will be removed. It is done with a special razor that shaves off a piece of skin.
Punch biopsy—A special tool is used. The tip of the tool is pushed into your skin. As it is pushed down, the tool will be rotated into the skin. A circular sample of skin will then be cut free. This biopsy provides a sample from all of the layers of the skin. Stitches may be needed to close the hole.
Excision biopsy—The entire area of abnormal skin will be removed with a scalpel. This biopsy will make a larger and deeper hole in the skin. Stitches will be placed to close the hole left in the skin.

After the procedure, a clean dressing will be placed over the area.

How Long Will It Take? TOP

5-20 minutes

Will It Hurt? TOP

There may be some pain and discomfort after the procedure. Medication may be advised to reduce discomfort. .

Post-procedure Care TOP

Keep the biopsy area clean and dry. Keep it covered with a sterile bandage for 1-2 days. Stitches will be left in the skin for 3-14 days, depending on where they are located. The area will need to be cleaned to prevent infection. Do not get the area wet unless the doctor says it is okay to do so.

Call Your Doctor TOP

After arriving home, contact the doctor if any of the following occur:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
Pain that you cannot control with the medications you were given
New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Society for Dermatologic Surgery
http://www.asds.net

National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Canadian Dermatology Association
http://www.dermatology.ca

References:

Pickett H. Shave and punch biopsy for skin lesions. Am Fam Physician. 2011;84(9):995-1002.

Skin biopsy. Nemours Kids Health website. Available at:
...(Click grey area to select URL)
Updated July 2012. Accessed February 25, 2015.

Skin biopsy. DermNet NZ website. Available at:
...(Click grey area to select URL)
Updated December 13, 2014. Accessed February 25, 2015.

6/3/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Last reviewed March 2016 by James Cornell, MD
Last Updated: 6/24/2013

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