Skin Biopsy: How It Is Done

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How It Is Done

Several different methods may be used to obtain a skin sample, depending on the size and location of the skin lesion. The skin sample is placed in a solution, such as formaldehyde, or in a sterile container if infection is suspected. In each of these procedures, the tissue is then examined under a microscope.

• Shave biopsy. After a local anesthetic is injected, a surgical knife (scalpel) is used to shave off the growth. Stitches are not needed. Any bleeding can usually be controlled with a chemical that stops bleeding and by applying pressure. The biopsy site is then covered with a bandage or sterile dressing. See an illustration of a shave skin biopsy .
• Punch biopsy. After a local anesthetic is injected, a small, sharp tool that looks like a cookie cutter (punch) is placed over the lesion, pushed down, and slowly rotated to remove a circular piece of skin. The skin sample is lifted up with a tool called a forceps or a needle and is cut from the tissue below. Stitches may not be needed for a small skin sample. If a large skin sample is taken, one or two stitches may be needed. Pressure is applied to the site until the bleeding stops. The wound is then covered with a bandage or sterile dressing. See an illustration of a punch biopsy .
• Incision. After a local anesthetic is injected, a piece of the lesion is removed with a scalpel. Stitches are used to close the wound. Pressure is applied to the site until the bleeding stops. The wound is then covered with a bandage or sterile dressing.
• Excision. After a local anesthetic is injected, the entire lesion is removed with a scalpel. Stitches are used to close the wound. Pressure is applied to the site until the bleeding stops. The wound is then covered with a bandage or sterile dressing. If the excision is large, a skin graft may be needed. See an illustration of an excisional biopsy . If cancer is discovered, more surgery will be needed.

Last updated:	April 26, 2007
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Kathleen Romito, MD - Family Medicine, Alexander H. Murray, MD, FRCPC - Dermatology
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer