Understanding skin checks and biopsies

We can’t tell just by looking at a spot whether it is cancerous or not, so a skin check and then a biopsy may be necessary to get a correct diagnosis.

You should get a skin check every year.

What is a biopsy?

During a biopsy at ENRICH Clinic, your doctor will numb the area then take a small piece of skin from the spot with a special biopsy tool. Where possible, we try to take just a tiny sample of the spot if we can, to avoid cutting the whole spot out and risk a scar.

However, some spots need to be removed entirely on the spot, making sure to go far enough from the margins of the spot in case it is cancerous.

Removing the full spot means it can be sent off to the lab, but meanwhile, you know at least the spot, cancerous or not, is gone. Stitches will be applied to close the wound.

The biopsy results go to the lab for checking under a microscope, with the test results back usually in about a week. If the spot is cancerous, your skin and blood is then checked to make sure it hasn’t spread to any other areas of your body.

If you’re all clear, there is nothing more to be done.

Using phone apps to detect skin cancer

Some smartphone apps can record a mole map for you to monitor changes. These apps can help you record your skin and moles, but it is worth noting that these apps can’t – at least at this stage – detect skin cancer.

An app cannot replace your doctor’s eye and experience, so don’t rely solely on your app to detect changes. Perhaps at some point, these apps will be more useful, but we are not there yet.

Types of skin cancer – what is the doctor checking for?

Your doctor will do a skin check first since different biopsies are useful for different types of skin cancer. Your spot will dictate the type of biopsy used.

There are three main types of skin cancer:

1. Squamous cell skin cancer
2. Basal cell carcinoma of the skin
3. Melanoma

Non-melanoma cancers rarely spread to other parts of the body so that regular biopsy procedures are the go. The same cannot be said for melanomas. Having an expert looking at your skin spots can make a big difference in how your skin issues are managed.

Types of skin biopsies

Shave biopsy

A shave biopsy is more or less what it sounds like – skin is shaved off in much the same way as you might shave your face or legs, but deeper. Shave biopsies work best with raised spots, removing the top two layers of skin, the epidermis and the upper part of the dermis.

If melanoma is suspected or the spot shows pigmentation, a shave biopsy should be switched out for another type of biopsy.

Punch biopsy

A punch biopsy is like a hole punch, removing a round section of tissue. There are many different sized punch biopsy tools, with your doctor opting for the one that best suits the size of your spot, will produce the least scarring and will get the best sample. A punch biopsy tool is applied to the chosen area of skin and then rotated.

Punch biopsies can remove just a portion of a spot or the full lesion if it’s small enough. A deeper sample can be obtained using this type of biopsy, with the sample containing the epidermis, dermis, and some subcutaneous tissue. You may need a stitch after being biopsied.

If a melanoma is suspected, a punch biopsy is not appropriate.

Incisional and excisional biopsies

Incisional and excisional biopsies are performed using a scalpel (a surgical knife) and are appropriate if a melanoma is suspected. The incisional biopsy removes just a portion of the spot, while an excisional biopsy removes the whole lesion.

How your doctor chooses the right biopsy

If your doctor thinks you may have a basal cell or squamous cell skin cancer, typically a shave biopsy or punch biopsy will be used, however, if there is any chance it could be a melanoma, then a wide excisional biopsy should be performed. ‘Wide’ means leaving a margin around the spot when it is cut out.

Frequently asked questions about skin biopsies

1. Do skin biopsies hurt?
   Before the biopsy, the skin is numbed via injection. The pain will be minimal or nonexistent past the injection prick.
2. Will a biopsy scar?
   It’s hard to know if you’ll be left with a biopsy scar – it will depend on how well you heal, what size the cut was, and how well you tend to the wound. You can expect a small, insignificant scar that will fade over time, but sometimes a biopsy leaves no marks at all.
3. What is the complication rate for biopsies?
   You may have some bleeding after a biopsy, and in rare cases, infection. If you have a bleeding disorder or are on medication or herbal supplements, make sure you talk to your doctor about possible added risks.
4. How long until I get my results?
   Lab result timeframes vary depending on where you are – if you are in a remote area, it’s likely to take much longer, but in a town or city with good access to labs with qualified technicians, you can expect to wait a few days or a week. You will need to reschedule an appointment with your doctor to discuss your results. If you have a melanoma, further tests will be required.

It’s ok to feel nervous! Just remember that even if you do have skin cancer – even melanoma – early detection and treatment usually means a great outcome.

We do skin checks!

And we treat skin cancer!

Contact us for an appointment

ENRICH Clinic