A Skin Biopsy With The Specialists

A skin biopsy involves taking a small sample of skin tissue and sending this sample to the laboratory for histological analysis.

It is undertaken when required, to confirm the diagnosis of a skin lesion or condition. Local anaesthetic will normally be administered to numb the area before taking the skin sample.

There are different types of biopsies that can be taken. Your dermatologist will select which option is most suitable to confirm the diagnosis while minimising the impact on you. If you have a preference for the type of skin biopsy you would like, you are more than welcome to let your dermatologist know about this.

Punch biopsy

A punch biopsy involves taking a cylindrical piece of skin and is normally followed by placing stitches to close the wound. If stitches are placed, you will need to return to the clinic approximately one week later to have these removed.

The main advantage of this procedure is that it can sample deeper layers of skin. However, you will need to look after the wound to minimise the risk of stitches popping (coming apart).

There will normally be a residual small scar once the small wound has healed.

For very small lesions we may end up removing the whole lesion as part of the sample. This is sometimes referred to as a punch excision.

Illustration of punch biopsy before and after.

Shave biopsy

A shave biopsy involves taking a superficial shave of skin to confirm the diagnosis. It is used when a deeper assessment of the lesion is unnecessary.

The main advantage is that because the sample of tissue is taken superficially, stitches are not usually required so you won’t need to return to the clinic.

The wound heals like a graze and has a minimal impact on your normal activities. In many cases, a shave wound heals without scarring.

Curettage (or scrape) biopsy

A curettage is very similar to a shave but it uses a different instrument. Like a shave, it only provides a superficial assessment and heals like a graze. It is particularly useful in concave areas where it is difficult to use a shave biopsy blade.

Diagram of a curettage skin biopsy.

Incisional biopsy

An incisional biopsy takes a thin, but deep and long sliver of a lesion to sample the full cross-section of a lesion. It is particularly used for pigmented lesions in cosmetically sensitive or difficult areas. This provides a reliable assessment while avoiding the full removal of the lesion in case this later proves to be unnecessary.

An incisional biopsy can be thought of as a mini-excision. Ordinary stitches will be placed to close the wound.

This requires you to look after the wound and you will need to return to the clinic about a week later to have these removed.

Diagram of an incisional skin biopsy.