Types and Procedures of Skin Biopsy | Dermatology

skin biopsy

What is a skin biopsy?

A skin biopsy removes samples of cells or skin from the surface of your body. The example taken from a skin biopsy is analyzed to give data about your ailment. A specialist utilizes a skin biopsy to analyze or preclude certain skin conditions and maladies.

What is it used for?

A skin biopsy is utilized to help analyze an assortment of skin conditions including:

  • Skin disorders such as psoriasis and eczema
  • Bacterial or fungal infections of the skin
  • Skin cancer: A biopsy can confirm or rule out whether a suspicious mole or any other growth is cancerous.

Skin cancer is the most well-known sort of disease in the United States. The most common types of skin cancer are basal cell carcinomas and squamous cell carcinomas. These cancers rarely spread to other parts of the body and are usually treatable. The third type of skin cancer is called melanoma. Melanoma is less common than the other two types but is more dangerous because it is more likely to spread. Most skin cancer deaths are caused by skin cancer. Skin biopsy can help diagnose melanoma in the early stages when treatment is easiest.

What are the types of skin biopsies?

Three types of skin biopsies are:

  • Shave biopsy: The doctor uses a tool similar to a razor to remove a small portion of the upper layers of skin (the epidermis and part of the dermis).
  • Punch biopsy: The doctor uses a circular tool to remove a small portion of the skin, including the deeper layers (epidermis, dermis, and superficial fat).
  • Excisional biopsy: The doctor uses a small knife (scalpel) to remove an entire lump or abnormal area of skin, including a portion of normal skin below or through the oily layer of the skin.

Why has a skin biopsy done?

Skin biopsy is used to exclude various skin diseases and also to remove skin lesions. This procedure is recommended by a doctor to diagnose some of the following problems:

  • Actinic keratosis
  • Skin tags
  • Warts
  • Psoriasis and other inflammatory skin diseases
  • Dermatitis
  • Eczema
  • Bullous pemphigoid and other skin disorders consisting of blisters
  • Skin cancers such as melanoma, squamous cell carcinoma, and basal cell carcinoma.
  • Suspicious moles and other abnormal small growth on the skin
  • Abnormal and persistent skin rashes
  • Skin infections bacterial or fungal
  • Keloids
  • Open sores
  • Rough or scaly skin
  • Any abnormal change in the colour of the skin

The biopsy is very helpful in diagnosing melanoma at a very early stage and thus preventing its spread. A skin biopsy is usually a small, minimally invasive procedure performed on an outpatient basis (doctor’s room).

How to prepare for the skin biopsy procedure?

It is important to inform the doctor if:

  • Bleeding disorders
  • If the patient is taking blood-thinning medications such as aspirin, warfarin, or heparin
  • Previous experience of excessive bleeding from any medical procedures
  • History of skin infections such as impetigo
  • If the patient has diabetes, it is important to inform the doctor before the procedure
  • Inform the doctor of any allergies or previous surgeries, if any
  • If there are any medications after an organ transplant

The specialist takes a total clinical history and physical assessment test before playing out the method. The patient may be asked about any previous surgeries, allergies to any medications, past personal history, and family history of skin conditions. On a physical examination, the doctor examines the patient very carefully for any other signs and symptoms related to it.

The patient is asked to avoid smoking before the procedure, and he is asked to wear a hospital gown or take off part of his clothes, depending on the area to be treated, during the operation.

How is a skin biopsy done?

A skin biopsy is an extremely straightforward outpatient methodology that takes around 10 to 15 minutes. This type of skin biopsy that examines the nerves is usually performed in three locations on the leg: above the outer ankle, above the outer knee, and the outer thigh.

  • First, the areas are well cleaned with an antiseptic solution.
  • A small injection of a local anaesthetic (lidocaine) is used to numb the area where the biopsy will be taken. This may sound like a bee sting and only last a few seconds. Then the skin is examined for numbness.
  • An instrument called a punch biopsy is used to remove a small sample of skin.
  • Finally, bandages are used to cover the biopsy sites. Generally, the skin heals easily within 1-2 weeks without the need for stitches. The risk of bleeding or infection is very low.

The biopsy itself does not hurt but taking an injection of a local anaesthetic before the biopsy usually causes a slight stinging sensation that lasts for a few seconds. After a biopsy, the skin heals quickly in a few days and the healing site is nearly uncomfortable or painful.

What to do after a skin biopsy?

  1. Keep dressings at the biopsy sites for 24 hours. After 24 hours, you can shower with the bandages, then remove them. Cover the biopsy sites with an adhesive pad daily until a crust forms, then leave the areas open for air. Do not remove the crust that forms.
  2. You may shower, but please don’t take bathtubs, go in hot tubs, or swim for 7 days after the procedure.
  3. If bleeding occurs, apply firm pressure for two minutes with a clean piece of gauze.
  4. An initial slight redness may appear around the skin biopsy sites. If an area becomes red, you can use bacitracin or polysporin (bacitracin and polymyxin b) on the wounds as needed.

What Is done with a skin biopsy sample?

The tissue is prepared, and a pathologist analyzes the skin biopsy test under a magnifying instrument to decide whether any illness is available. Results usually appear within 1-2 weeks.

When should I call the specialist after a skin biopsy?

Call your PCP if you have draining that can’t be halted by pressure, or any indications of disease, for example, redness, warmth, delicacy, discharge, or red streaks. Likewise, call if you have any inquiries or worries after a skin biopsy.


Skin biopsy is usually minor and an uncommon complication. As a general rule, the more skin sample removed, the greater the chance of complications. The following complications may occur.


Bleeding can occur during surgery or after surgery for anyone, but it can be especially troublesome in those who have a tendency to bleed, or who are taking blood-thinning medications such as warfarin or aspirin.


Bacterial wound infection affects approximately 1-5% of excisional biopsies. However, it is extremely uncommon on small, shave, or section biopsies. Ulcerative or scaly skin lesions, the biopsy site, or patient characteristics such as diabetes, aging, or the use of immunosuppressive drugs may increase the risk.

Nerve injury

The blade may sever the superficial sensory nerve, causing pain or numbness. This is most likely to happen when the skin is thin, for example on the face or the back of the hand. The risk of developing motor nerve dysfunction is extremely rare, but it can occur during melanoma surgery in risk areas of the face. These include the temporal, marginal, and zygomatic branches of the facial nerve and the spinal accessory nerve (at the IRB point).


It is usual for the biopsy site to form a large permanent scar. Certain body sites such as the centre of the chest are prone to excessive scarring or enlargement. This is also more common in Afro-Caribbean skin types.

Persistence or recurrence of the skin lesion

Many biopsies are intentionally partial and are only intended for diagnostic purposes. In excisional biopsies, there is a risk of not removing the complete lesion, which may recur later.

Anaesthetic problems

Allergy from local anaesthetics may be possible but are also rare. The vagal reaction is more common, which can cause the patient to faint and self-harm. Palpitations are another adrenaline-related side effect commonly found in local anaesthesia.

Wound breakdown

This is an uncommon complication of stitches. It is more likely to occur in sites of the body where there is a lot of tension to the scar (such as the chest and back), immediately after removal of a suture, or as a result of an infection. Avoiding exercise and using soluble straps and strings may help prevent this.

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