Moles or melanocytic nevi that appear at birth or are acquired later on are generally benign skin lesions, but due to harmful UV radiation exposure and in some cases, to genetic factors, these nevi can suffer cellular alterations, developing into a malignant melanoma or skin cancer. When such a change is observed in the shape, color and size of the mole, or if itching sensations, reddening of the area or bleeding appear, you should immediately see a specialist who, after a visual examination will be able to determine if a biopsy is required or not to set an accurate diagnosis.

A skin biopsy implies the removal of a certain skin area containing the suspicious naevus together with a small quantity of the adjacent tissues in order to determine if the condition is benign or if it has already spread in which case it is of malignant nature. There are various skin biopsy techniques: shave (surface) biopsy, punch biopsy, excisional biopsy and incisional biopsy. In some cases, the patient may be allowed to choose one biopsy type, but this rarely happens anyway, the specialist being the one deciding in most cases. The type of biopsy is also chosen according to the patient’s individual medical history, the type, shape, size and color of the mole, its location and any other special conditions or situations mentioned prior to the surgery.

Before the shave biopsy, the dermatologist will apply a local anesthetic, after which he/she will gradually shave the mole until skin level using a very fine blade scalpel. This procedure doesn’t usually require stitching, hemostasis being ensured through pressure upon the lesion. The wound is then covered with a bandage for protection and the tissue sample is further sent for pathological analysis in a sterile container with formaldehyde to avoid its contamination.

A punch biopsy is also performed under local anesthetic and implies the introduction of a cylindrical, thin and rather sharp medical tool (with a dimension between 1-8 mm) within the lesion and the extraction of a deeper, circular tissue sample from the dermis and the superficial hypodermis. The more visible the punched zone, the small the incision. In the face, neck and décolletage areas, the punch biopsies will be between 1 and 1,5 mm, so the lesion will not require stitching, scarring being minimal. Nevertheless, not all punch biopsies can be 1 mm in size, because in some cases the extracted tissues samples would be too small to be properly analyzed.

Incisional biopsy very much resembles excision as in some cases the entire lesion is removed with the help of a scalpel, together with a sample of the healthy tissue surrounding it. But in general the incisional biopsy removes only a part of the suspicious mole or dysplastic naevus. The tissue sample extracted during this type of surgery is larger, as the incision is made deeper, through the dermis and the hypodermis entirely, subsequently requiring stitching. There are however cases when these stitches are not actually necessary and the patient is only asked to apply local pressure to stop the bleeding, after which the targeted area is bandaged.

Excisional biopsy requires local anesthetic and in some cases when the mole is situated in a more difficultly accessible area or the excision must be performed delicately, the doctor may suggest a general anesthesia to avoid any sudden moves that may endanger the precision of the surgery. With the help of a scalpel, the surgeon will remove the entire lesion together with the adjacent skin tissues in order to set a clear boundary between the eventual malignant cells and the healthy tissue. The wound is then stitched surgically and protected with a sterile bandage.

Any kind of biopsy is generally painless, the patients feeling only the sting from the needle used to apply the anesthetic, for the rest, the entire procedure is fast and with a minimal discomfort. Risks are also minimized, if the maintenance instructions given by the doctor are followed accordingly; downtime is rather short followed by the removal of the stitches (after 4-14 days), depending on the type of biopsy and the size of the incision.

Results are usually available after 3-10 days, according to the severity of the condition, and can be normal, or in normal parameters or pathological – malignant, benign processes, skin infections or autoimmune diseases with skin outbreaks. Sometimes, a second test is recommended in order to ensure the result accuracy, as there are a series of factors that may interfere with their precision, such as specific treatments administered for other affections.

Biopsies performed at Renew Skin & Health Clinic are of highest accuracy, our specialists, dermatologists and surgeons being very experienced and dedicated to their activity. If you are confronted with such problems, Renew Skin & Health Clinic is the right place for you to find the right solution!