Understanding your biopsy
A skin biopsy removes a sample of a spot or lesion so a pathologist can examine it under a microscope. It helps your doctor find out what the lesion is and whether further treatment is needed. A changing, unusual, bleeding or non-healing spot may need a biopsy.
Most clinic biopsies use local anaesthetic: you remain awake while the skin is numbed. The technique depends on the lesion and the information needed. A biopsy may remove part or all of the spot.
The main types
- Shave biopsy: a thin layer is removed with a blade; stitches are not usually needed.
- Punch biopsy: a small circular instrument takes a deeper sample; stitches may be used.
- Incisional biopsy: part of a larger lesion is removed with a scalpel.
- Excisional biopsy: the whole lesion and a small surrounding margin are removed, usually with stitches.
Before your appointment
Bring a current list of medicines, vitamins and supplements, and tell us about allergies to medicines, latex, antiseptics or dressings. Let the team know about diabetes, circulation problems, previous healing difficulties or a tendency to develop thick scars.
Do not stop blood thinners or change prescribed medicines without advice from your treating team. This includes prescribed aspirin. Ask about any medicine instructions before your appointment.
For a procedure under local anaesthetic alone, fasting is usually not needed unless you have been told otherwise. If sedation or general anaesthetic is planned, follow the fasting and medicine instructions provided by your hospital or anaesthetic team. Call if these are unclear.
- Bring your Medicare card, relevant referral or test results, and comfortable clothing that gives access to the treatment area.
- Discuss transport home. Arrange a responsible adult after sedation or general anaesthetic. Wound location, pain and movement can affect driving even after local anaesthetic.
- Smoking can slow healing. Ask your GP or the clinic for help stopping before surgery and during recovery.
- Ask about the benefits, risks, alternatives and likely scar before giving consent. You can ask for more time or further explanation.
What happens on the day
Your doctor confirms the site, explains the procedure and checks your consent. The local anaesthetic injection may briefly sting. Once numb, you may feel pressure or movement; tell us if you feel pain so we can pause and give more anaesthetic.
The sample is removed, any bleeding is controlled, and stitches or a dressing are applied as needed. The tissue goes to the pathology laboratory. The nurse explains how to look after the wound and arranges any stitch removal or review.
If you feel faint or unwell afterwards, tell the team and take time to recover before leaving.
Looking after the biopsy site
Follow the dressing and showering instructions given for your particular wound. The clinic may ask you to keep the initial dressing dry for the first 48 hours; the timing can vary. If it gets wet underneath, loose or dirty, follow your dressing plan or call for advice.
When you are allowed to clean the site, wash your hands first, clean gently and avoid scrubbing or picking. Use only the ointment or dressing advised by your clinician. Avoid soaking in a bath, pool or spa until the wound has healed and your team says it is safe.
Keep activities gentle at first. Avoid lifting, vigorous exercise or movements that stretch the wound until advised. Take pain relief as directed; ask before adding an anti-inflammatory such as ibuprofen, particularly if you take blood thinners.
Healing, stitches and possible problems
Mild tenderness, bruising and local swelling can occur early and should gradually settle. Healing varies with the biopsy type and location; lower-leg wounds may take longer. Risks include bleeding, infection, delayed healing, wound opening, scarring and changes in skin colour or sensation.
If you have external stitches, the clinic commonly reviews facial wounds at about one week and body or limb wounds at about two weeks. Your own removal date takes priority. Do not remove stitches yourself.
All skin surgery leaves a scar. The early pink, firm or raised appearance can change over many months; scars may continue to mature for 12–18 months. Wound location, skin type, healing and the procedure all affect the final result.
Only start scar massage or silicone products once the wound is fully closed and your clinician says it is ready. Protect healed skin from the sun and let us know if a scar becomes increasingly raised, tight or uncomfortable.
Your results and next steps
A clinician will call you if your results require urgent action. Otherwise, your results will be discussed with you at your follow-up appointment.
Confirm your review appointment before leaving. If it has not been arranged, or your results are taking longer than expected, call the clinic. No contact does not mean a result is clear.
When to seek help
- Increasing or spreading redness, warmth or swelling.
- Pain that is getting worse rather than settling, pus, a new unpleasant smell, fever or feeling unwell.
- A wound that opens, a rapidly growing swelling, or a dressing that is repeatedly soaked.
- An unexpected change in the colour or appearance of a graft, flap or BTM wound.
Call 07 7520 8580 promptly. If the clinic is closed and the problem is urgent, seek an urgent medical assessment. Do not wait for a routine review.
For bleeding, apply firm, continuous pressure with a clean dressing. If bleeding persists despite pressure, seek urgent care. For severe bleeding, collapse or another medical emergency, call 000.
Further reading: American Academy of Dermatology: biopsy wound care.
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