Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

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Am Fam Physician. 2002;65(6):1167-1168

What is punch biopsy?

Punch biopsy is a commonly performed diagnostic procedure on abnormal skin growths or skin tumors. It is performed using a local anesthetic (numbing medicine). A pencil-like instrument is used to remove a small, thin cylinder of tissue. The small hole in the skin then may be sutured (stitched) closed.

What happens to the biopsy specimen once it is removed?

After removal, the biopsy specimen is sent to the laboratory for further evaluation. The specimen is examined under a microscope by a subspecialist doctor known as a pathologist. The pathologist is trained to correctly identify the cells of various skin growths, which will assist your doctor in selecting the proper treatment.

Are there any complications after punch biopsy?

Complications are uncommon following this simple procedure but can occur with any surgical procedure. Some of the complications associated with punch biopsy include local bleeding and bruising, pain, infection, allergic reaction to the numbing medicine used in the procedure, or damage to the structures beneath the skin site (such as an artery or a nerve). Your doctor will take care to reduce the likelihood of these rare problems.

What happens to the site where the piece of skin was removed?

The biopsy site may be sutured (stitched) closed, depending on the size of the skin defect. The area often heals with a small scar. Your doctor may ask you to return in 5 to 14 days for removal of the stitches. You will be given instructions on how to help the biopsy site heal. The results of the biopsy evaluation will determine if further treatment of the skin site will be needed.

How long before I will receive the results of the biopsy evaluation?

The biopsy results usually are available in one to two weeks. Your doctor?s office will notify you of the results. You do not need to call the office in the first two weeks after the procedure. Sometimes the doctor will review the results with you at the follow-up (stitch removal) visit. If 1 month goes by and you have not heard from your doctor, call the office for the results of the biopsy.

Following Punch Biopsy of the Skin

  1. Immediately after removal of the skin biopsy specimen and closure of the biopsy site, your doctor will apply antibiotic ointment and a bandage to the site. Continue to apply antibiotic ointment to the wound until it is completely healed. The antibiotic ointment Mycitracin Plus is recommended because it contains numbing medicine in addition to the antibiotic.

  2. You can remove the bandage at any time, but you may prefer to keep the wound covered. Keeping the site covered with a bandage may prevent rubbing at the site and will also keep the antibiotic ointment off your clothing.

  3. If the biopsy site begins to bleed, apply direct pressure for 10 minutes. If it continues to bleed, call your doctor.

  4. If you experience discomfort at the biopsy site, you can take ibuprofen (brand names: Advil, Motrin, Nuprin), three 200-mg tablets 3 times a day with food, or acetaminophen (brand name: Tylenol), two 325-mg tablets every 6 hours.

  5. Skin infection can follow any surgical procedure. If you develop increased pain, redness, pus or swelling at the biopsy site, call your doctor.

  6. Your doctor will notify you of the time for suture (stitch) removal, usually about 5 to 14 days following the procedure. Sometimes your doctor may have used only one stitch to to close a punch biopsy site. If the stitch falls out and the wound is not gaping open, you can call and cancel your follow-up visit.

  7. Most doctors use the suture removal visit to discuss with you the pathology results of the biopsy, if they are available. It usually takes 1 to 2 weeks for your doctor to receive the results of your biopsy. The doctor?s office will contact you with the results. If 1 month goes by and you have not heard from your doctor?s office, call to check on the biopsy results.

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