For a skin biopsy, the physician may remove part or all of the skin in the area of concern, so it can be thoroughly examined under a microscope by a physician called a pathologist. The skin around the area being biopsied will be numbed using a local anesthetic before the biopsy. The anesthetic may sting slightly as it enters the body, but you should feel no pain during the biopsy itself.
There are several types of skin biopsies.
Shave biopsy
A sharp, thin blade is used to shave off the abnormal growth. To stop the biopsied site from bleeding, the physician applies an ointment or cauterizes the wound with a small electric current. Physicians use shave biopsies to diagnose a multitude of skin diseases and for sampling moles. Physicians generally do not perform shave biopsies if there is a strong suspicion of melanoma. If the blade cannot cut deep enough to get under the area of concern, it may not be thick enough to assess the extent of the melanoma.
Excisional biopsy
A scalpel is used to remove the growth in its entirety and some of the surrounding tissue. Excisional biopsies are generally performed on growths that appear to be melanomas.
Incisional biopsy
A scalpel is used to remove part of the growth.
Punch biopsy
The physician uses a sharp, hollow, round tool to remove a circle of tissue from the area of concern. The physician rotates the tool on the surface of the skin until it cuts through all of the different layers of skin and removes a tissue sample. This allows for better sampling of the depth of the lesion. The edges of the skin are typically stitched together following the biopsy.