Skin Biopsies Explained: When & Why They’re Needed

Hearing the word “biopsy” can make an otherwise routine dermatology appointment suddenly feel much more serious. If your dermatologist recommends taking a closer look at a mole, growth, or unusual patch of skin, it’s natural to wonder what they found and what happens next.

Skin biopsies help diagnose many different skin conditions, including skin cancer. In fact, when skin cancer is suspected, examining biopsied tissue under a microscope is how an accurate diagnosis is made.

At Lone Pine Dermatology, our goal is to help patients throughout Logan, Providence, Cache Valley, and surrounding communities understand what is happening with their skin and what their next steps may be. In this blog, you’ll learn what there is to know about a skin biopsy.

A skin biopsy is a procedure in which a dermatologist removes all or part of an area of skin so it can be examined under a microscope. Having a biopsy doesn't automatically mean you have skin cancer, though. Dermatologists use biopsies to diagnose a variety of skin conditions, including infections, inflammatory rashes, and immune system disorders. However, if a spot looks suspicious for skin cancer, a biopsy provides information that can't be gathered simply by looking at the skin.

The tissue is examined, and a pathology report is created with findings. Those results can help your provider make a diagnosis and determine if treatment is needed.

Your provider may recommend a biopsy when a mole, lesion, rash, or growth seems suspicious or needs more testing. When it comes to possible skin cancer, changes in your skin are particularly important to watch for. The American Academy of Dermatology recommends seeing a dermatologist for:

• New spots
• Spots that change
• Spots that are different from your other spots
• Itching 
• Bleeding

• A – Asymmetry: One half looks different from the other.
• B – Border: The edges are irregular or poorly defined.
• C – Color: The color varies within the spot.
• D – Diameter: Melanomas are often larger than 6 mm when diagnosed, although they can be smaller.
• E – Evolving: The spot is changing in size, shape, or color, or looks different from your other spots.

Not every unusual mole or changing spot is cancerous. The important thing is to have concerning changes evaluated rather than trying to diagnose them yourself. Learn more from our ABCDEs of Melanoma blog post.

For most patients, the procedure itself is quick and straightforward.

First, the area is cleaned and numbed with a local anesthetic. You may briefly feel burning or stinging during the numbing injection. It usually only lasts a few seconds. Then, a sample of the skin is removed for testing.

Two common techniques are shave biopsies and punch biopsies. During a shave biopsy, a provider uses a blade to shave a sample from the upper layers of skin. A punch biopsy uses a small, circular tool to remove a deeper sample containing multiple layers of skin. The type of biopsy your provider chooses depends on things like the size and location of the skin needed, and how much tissue is needed for an accurate diagnosis.

Afterward, the area is bandaged. Some types of biopsies may require stitches. Your provider will give you instructions for caring for the biopsy site at home.

The numbing injection can sting with a little poke or burning sensation. After the anesthetic takes effect, the area should be numb while the sample is taken. Once the anesthetic wears off, some tenderness around the biopsy site can be expected. Your provider will explain how to care for the area and what to watch for while it heals. 

Biopsy results are not usually available immediately because the tissue needs to be processed and examined under a microscope. Depending on the sample and whether additional testing is needed, timing can vary.

Once the pathology report is available, your provider can explain what was found and whether any additional care or treatment is recommended. Waiting for results can understandably be stressful. Try to remember that a biopsy is being performed to get an accurate answer, not because cancer has already been confirmed.

The next step depends on the type of skin cancer, its location, and other characteristics. Skin cancer treatment isn't one-size-fits-all.

Some skin cancers can be treated with surgical excision. In certain situations, Mohs surgery may be recommended. During Mohs surgery, thin layers of tissue are removed and examined under a microscope until no more cancer cells are seen at the edges. This technique allows the surgeon to identify where the cancer stops while preserving as much healthy skin as possible.

At Lone Pine Dermatology, Dr. Cory Maughan provides Mohs surgery for appropriate skin cancers. Heather Allred and Phillip Stevenson also provide dermatologic care and evaluate patients with a variety of skin concerns, including suspicious spots and growths.

You don't need to wait until you're certain something is wrong.

Schedule a skin evaluation if you notice a spot that is new, changing, itching, bleeding, growing quickly, or simply looks different from the others on your body.

Regular skin cancer screenings can also give your dermatologist an opportunity to examine areas that are difficult for you to see yourself, including your scalp and back.

Most importantly, don't let fear of a possible biopsy keep you from having a concerning spot checked out. A biopsy is a diagnostic tool designed to give answers. If treatment is needed, identifying skin cancer early can make a meaningful difference in your treatment moving forward.

If you've noticed a changing mole, unusual growth, or spot that doesn't seem to heal, schedule a skin cancer screening with Lone Pine Dermatology.

We provide dermatologic care for patients in Logan, Providence, Brigham City, Smithfield, Hyrum, Cache Valley, and surrounding Northern Utah communities, as well as Preston and Southern Idaho.

Contact Lone Pine Dermatology online today to schedule a skin cancer screening, or give our offices a call at (435) 554-8442.

Want to learn more before your appointment? Visit our blog for more information about skin cancer screening, warning signs, diagnosis, and treatment.