The skin is delicate due to its multi-layered surface, constant exposure to environmental factors and the presence of numerous nerve endings that make it sensitive to damage. Its outer layer, the epidermis, is thin and regularly renews, making it vulnerable to injury and wear. Additionally, factors like moisture balance, cellular turnover and the gradual weakening of collagen and elastin fibers contribute to the fragility of the skin. While the delicate nature of the skin is essential for its protective and sensory functions, it is also susceptible to damage, even of the permanent variety by way of a scar.
“If I come into THE CENTER for Advanced Dermatology for a skin assessment, will a biopsy leave a scar?” It depends. After a skin biopsy, you may have swelling, redness, bruising or discomfort around the wound site, but symptoms should dissipate within a few days, if not sooner. Whether a scar results depends on several factors including type of biopsy, size & depth affecting multiple layers of skin, location on the body, individual healing factors and follow-up care after the biopsy.
Skin biopsies are procedures where a small sample of skin is removed for examination to diagnose various skin conditions, including infections, inflammatory diseases and cancers. Each type of biopsy is chosen based on location, size and depth of lesion, as well as the suspected diagnosis. Your dermatologist’s selection of biopsy method is crucial for ensuring accurate detection while minimizing complications and scarring. Types of biopsies are as follows:
- Shave Biopsy:
- Procedure: After numbing the area, a razor-like tool is used to scrape or shave off a thin layer of the surface of the skin
- Use: A skin sample is used to evaluate superficial lesions (such as moles or warts) and skin growths
- Healing and Scarring: Because it does not go very deep into the skin or require stitches or sutures, it has a very low risk of scarring. Any scarring is minimal and will likely blend in with skin tone and fade over time
- Punch Biopsy
- Procedure: Using a circular tool, similar to a tiny cookie cutter, this biopsy type removes a deep yet small sample containing round piece of tissues from multiple layers of skin including the epidermis, dermis and sometimes subcutaneous fat
- Use: Diagnoses skin conditions such as rashes as well as skin cancers
- Healing and Scarring: The skin will be closed with a suture or left open to heal with an antibiotic ointment and dressing, often leaving a small scar
- Excisional Biopsy
- Procedure: Performed with a scalpel, a lump or abnormal tissue mass is removed along with a small amount of healthy issue around it
- Use: Option for patients requiring removing of the whole lesion when melanoma or large skin tumors are suspected
- Healing and Scarring: To fully excise a skin lesion, a long, think, linear scar will be left behind following the contour of the skin; some people develop keloid (raised) scars
- Incisional Biopsy
- Procedure: Like excisional biopsy except it is a partial removal of the lesion versus a full removal
- Use: This option is necessary when either a lesion is too large to be removed in its entirety or only a limited sample is sufficient for diagnosis
- Healing and Scarring: The skin will experience scarring as stitches will likely be required
- Curettage:
- Procedure: Involves scarping off a lesion with a curette (a sharp, ring-shaped instrument) and is often combined with cauterization to stop bleeding
- Use: To treat skin cancer, warts and noncancerous growths
- Healing and Scarring: Scars from curettage typically cause some degree of scarring, similar in size to that of the original skin lesion
Skin biopsy scars are generally minimal. Proper aftercare such as cleaning the wound, moisturizing and protecting it from the sun aid in minimizing scarring. Over time, most biopsy scars fade and become less noticeable.
To schedule your skin assessment, contact THE CENTER for Advanced Dermatology at 602-867-7546 or WEBSITE.