A biopsy is an investigation that allows your dermatologist to get diagnostic information by removing a small sample of skin, and sending it to a specialist laboratory for analysis, called histopathology.
What Is a Skin Biopsy?
After the analysis has been completed, the results are sent to the clinic and interpreted by the dermatologist, who will use them either to confirm a suspected diagnosis or to make a diagnosis, in the event that the symptoms of your skin condition could be the result of multiple conditions. There are many different conditions that can present similarly, and so the dermatologist would need to take a skin biopsy to rule things out.
While some treatments, like excisions, may involve the removal of skin, and may also be sent off to a lab, they are not the same as a biopsy, which is often less invasive, depending on the size of the growth being tested.
Sometimes the dermatologist may require a patient to undergo more than one diagnostic test in order to confirm a particular diagnosis. This is because while essential information may be obtained by testing the skin tissue, it may be vital to also evaluate other factors – such as the presence, or levels, of biomarkers (naturally-occurring chemicals and other indicators). These biomarkers sometimes need to be assessed and/or confirmed through other means, such as blood tests, which would supply an amount of blood (usually a vial) for testing.
What is the Benefit of a Skin Biopsy?
A skin biopsy allows the dermatologist to obtain further diagnostic information with which to make a diagnosis of a skin condition, and thus determine the course of treatment – for example a biopsy of a suspicious growth could determine it is benign (harmless), or it may indicate skin cancer.
Through analysing the result of a biopsy, the dermatologist is more efficiently able to treat a patient with a suspected skin condition, rather than waiting to assess changes (which may or may not present) over time. In some cases, a biopsy is the only means of confirming a diagnosis, so it is only done when necessary.
Accurately identifying and treating medical conditions sooner, rather than later, is always beneficial for the patient’s health.
Who is a Skin Biopsy Suitable For?
A skin biopsy is suitable for patients who have undergone a consultation with the dermatologist, and are subsequently needing the diagnosis of a particular skin condition confirmed, so that they can undergo treatment.
There are several reasons a dermatologist might need to get additional diagnostic information from a skin biopsy, and these could include diagnosing patients who have;
What is the Process of a Skin Biopsy?
Most people don’t need to prepare to have a skin biopsy, but if you are taking certain medications, or have underlying medical conditions, your dermatologist will advise you of any special considerations prior to your appointment. It is important to follow any instructions you are given.
Before a biopsy, your skin will be numbed with a local anaesthetic. You are awake during the procedure, and the dermatologist will check to ensure you do not feel anything.
Once the skin is numb, the area to be excised (removed) is disinfected, then cut out with a sterile surgical knife.
When the dermatologist has finished removing the tissue, the skin may be stitched back together, and the wound will be dressed with the appropriate dressings, and the skin sample will be sent to a specialist laboratory for testing.
You will be able to go home the same day and will receive information on follow-up care, which may include applying cream or taking antibiotic tablets.
It is essential that you adhere to the instructions of the dermatologist to ensure proper healing – even if you feel well, you must follow this guidance to the letter. There are also some over-the-counter medications that need to be avoided following a biopsy, as taking them can cause complications.
You will be given all the information from the dermatologist on the day. You may have to return to the clinic to have your dressings changed, or stitches removed, unless the dermatologist has used stitches that dissolve. Once the results of the histopathology have been received and checked by the dermatologist, you may need to have a follow-up appointment so that the dermatologist can inform you of the outcome and let you know the next steps.
What are the Risks and Complications of a Skin Biopsy?
As taking a biopsy results in a small wound, there is a risk of infection, bleeding and soreness as the wound is healing, however your dermatologist will provide instructions on how to prepare for the biopsy, as well as follow-up care advice to minimise complications.
Depending on the location of the skin needing a biopsy, and/or the patient’s mobility, it might be more difficult to keep a healing wound clean and dry – this may elevate the risk of complications. Your dermatologist can advise if this is likely to be the case with your biopsy.
A biopsy will commonly leave a scar, however depending on your age, the location, and how your skin usually scars, it may be more or less visible. Most scars take time to fully heal and blend in with the surrounding skin.
Very occasionally, if scarring is abnormal, it can result in large, raised scars - for example, a hypertrophic scar, which is caused by the body overproducing collagen during the healing process; or a keloid scar, which is the result of the overgrowth of scar tissue. Once the wound is fully healed, the appearance of keloid scarring can be treated by the dermatologist, but they are harmless.
Some lifestyle factors, such as smoking, can affect wound healing, and can even cause irregular scarring or more serious complications, so while it is best for your health not to smoke at all, it is essential that you heed the advice of your dermatologist in the weeks prior to, and after a biopsy.
As with all surgery, there is a small risk of complications, such as nerve damage or an allergic reaction to the anaesthetic or sutures. These risks will be explained by the dermatologist, who is the best trained and qualified person to avoid these events.
Following the biopsy, it is possible that you may experience complications such as bleeding, infection, swelling, or reopening of the incision.
It is important to contact the clinic if you are experiencing any of these complications or unexpected pain or discomfort, whether they present immediately in the days following the operation, or weeks on from the biopsy. In the rare event that you need care urgently and cannot contact the clinic, you should go to hospital, and if necessary, dial 999.
What is the Recovery Time and Outcome for a Skin Biopsy
The wound left from a skin biopsy can take between 10-14 days to heal, but depending on the individual, complete healing can take up to three weeks. Most people heal quite quickly if they are in generally good health and haven’t had any complications.
The follow-up care instructions provided by the clinic will let you know how long you’ll need to recover before you resume normal activities, or when you can resume taking certain over-the-counter medications. If there are any special considerations, your dermatologist will advise you, and if you have any questions during your recovery, you can email our team, who will endeavour to reply as quickly as possible.
If the biopsy reveals that a suspicious growth is benign, you may not need a further appointment with a dermatologist following the surgery, but may need to come into the clinic to have stitches removed.
However, if the results indicate you have a confirmed skin cancer, or another skin condition, you will likely require further appointments with a dermatologist, and regular follow up appointments may be advised. For more information, or to book an appointment for a skin biopsy with Derma, please call the clinic or contact us via email here.