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You Need a Skin Biopsy, Now What?

During a yearly skin check, your dermatologist may suggest a biopsy on any spots or moles that don’t look quite right. Or, you may make an appointment to have a suspicious mole checked out, which leads your dermatologist to suggest a biopsy. Either way, the word biopsy sounds scary, and having to undergo one can leave you with tons of questions: Does getting a biopsy hurt? How long will it take to get the results? What will the site look like as it heals? What does “precancerous” really mean? Have no fear. Skin biopsies are a very common procedure and we have your answers.

What is a skin biopsy?

A skin biopsy removes an area of skin tissue so it can be tested for abnormalities. They’re typically done to determine if the skin is diseased (usually with cancerous cells) but can also be used to discover skin conditions or infections. The entire process usually takes about fifteen minutes and is done under local anesthesia. Before the procedure, your dermatologist should ask you if you have a bleeding disorder, or of you have any allergies to anesthesia or topical antibiotics. There is a quick pinch from the initial prick of the needle, and then it’s a completely painless procedure.

There are three common types of skin biopsies:

Shave biopsy: During a shave biopsy, a dermatologist shaves off a mole or lesion with an extremely sharp razor blade.

Punch biopsy: For this type of biopsy, a tool is used to take a small, circular sample of the skin. This technique is used to access a deeper layer of skin, or to get a small sample of skin conditions such as psoriasis, rashes or fungal infections.

Excision biopsy: During an excisional biopsy, a doctor removes an entire lesion or mole by using a scalpel to cut around the entire area. Since it’s removing a larger area of skin, this procedure typically requires stitches.

looking at a biposy under a microscope

So, you had the biopsy, now what?

After the numbness wears off, the area will be a little sore for a few days, and may continue to bleed a little. Be careful not to bump or scratch the site, and you will need to keep it clean and dry. Your dermatologist will give you specific instructions based on the location and type of biopsy, and whether you had stitches. Usually the directions involve keeping the site covered with a bandage, cleaning it twice a day with soap and water, and using an antibiotic ointment.

Complications with skin biopsies are rare, but you should look out for abnormal bleeding, bruising, allergic reactions, and signs of infection.

The initial healing of a shave biopsy takes about a week, then a scab will form and heal more fully in two to three weeks. Initial healing can take up to two weeks after an excision biopsy, and you will most likely need to return to the office to have the stitches removed.

Will the procedure cause a scar? Shave and punch biopsies usually leave a small, circular shaped mark that will fade over time and become barely noticeable. A typical line scar is likely to form after an excision biopsy. Healing and resulting scar tissue are highly variable based on your skin and the location of the biopsy.

What about the results?

After the biopsy, your tissue sample is put into a small container with solution and sent to a lab for analysis under a microscope. It usually takes about a week to get the results, so sit tight. Once your dermatologist has the results, they’ll call you or schedule an appointment.

Most skin biopsies come back normal or benign. Occasionally, results will be “atypical” or “precancerous”. These terms are synonymous and indicate that there is an abnormality, but this doesn’t necessarily mean it’s skin cancer.

“Atypical” moles (also known as dysplastic nevi) are noncancerous and rarely turn into melanoma. The concern with atypical mole is that their presence slightly increases your risk of developing melanoma. Atypical moles are classified as having mild, moderate, or severe atypia.

The term “precancerous” is slightly misleading, because it doesn’t necessarily mean the lesion would’ve turned into cancer if it wasn’t removed. But there’s no way to tell for sure, which is why preventative measures, such as removing suspicious moles, yearly skin checks, and protecting yourself from the sun, are so important.

Your dermatologist will let you know if the mole or lesion was completely removed during the biopsy, or if there is a need for further excision. If this is the case, you will have to go back for another appointment.

Skin biopsies are a common procedure and an important precaution. Remember, peace of mind is worth a small scar.

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