What is a punch biopsy?
This is a method of removing a small circular piece of skin under a local anaesthetic using an instrument called a punch, which has the appearance of a small apple corer. A small piece of skin will be removed and sent to the pathology laboratory, this will be examined under a microscope to aid diagnosis.
What happens when I come for treatment?
- Punch biopsy is performed under local anaesthetic, which numbs the area we will be operating on. This means that you will be awake during the procedure.
- Local anaesthetic injections cause a stinging discomfort which will last for a few seconds. The local anaesthetic removes pain sensation but you might be aware of touch and pulling sensations.
- The numbness from the anaesthetic will normally last 2 hours. A punch biopsy usually takes around 15 minutes.
- You can eat and drink as normal
- After the local anaesthetic has been injected the lesion will be removed and stitches will be put in place which will need to be removed in around 5-10 days depending in the site of surgery(you will be informed on the day of the operation when to have them removed).
Will there be a scar?
- All skin surgery will leave some form of scar.
- The type of scar often depends on the procedure, your racial background and the body site.
- Sometimes in areas, especially on the upper back, shoulders and chest, scars may become raised, thickened and sore or itchy. These are known as hypertrophic or keloid scars.
- In addition scars can stretch over time so that the scar becomes wider than it was at the end of the procedure. This is most common in areas under tension such as around joints
Will there be any pain?
- This often depends on the operation site but after most punch biopsies there is very little pain.
- Most pain is controlled by simple analgesia (pain relief) such as Paracetamol.
Will I be able to drive?
- You will have a simple dressing in place for 24 hours after your surgery.
- If your procedure is on the face this may interfere with your vision or if your operations is on the leg, it might interfere with your ability to drive.
- Operations around the eye and upper cheek can cause swelling or bruising of the eye which can also affect your vision. In these circumstances you are strongly advised not to drive.
After effects of surgery
- All skin surgery inevitably cuts small nerve fibres, this can result in numbness or pins and needles around the operation site. This change in sensation can last for a few weeks or occasionally months.
- Wound infections are an uncommon but recognised risk of skin surgery. Wound infections should be treated as soon as possible with antibiotics. Heat, pain, redness, swelling or a pus like discharge around the site 4-5 days after surgery could be a sign of wound infection. Please contact the clinic or your GP if you are concerned that you could have a wound infection.
- Overstretching of the scar initially (especially in sites of high tension) can cause the stitches to come out and leave the wound open. Hence, it is vital to avoid strenuous exercise / gym work or heavy manual work for 4 weeks. The healing process continues even after the stitches are removed.
- The may be some bleeding after surgery however, this is usually minor.
Medications
Please bring a copy of your most recent prescription when attending your operation.
Your medication should have been discussed with you at consultation. If you are taking Aspirin, Clopidogrel, Dipyridamole, Warfarin, Rivaroxaban, Dabigatran or Apixaban these can increase your risk of bleeding after surgery however, unless instructed otherwise by your doctor you should continue to take your medication. You should also make your doctor aware if you take Propranolol, this is a drug known as a beta-blocker which can be used for high blood pressure, anxiety or tremors.
Results
Your Dermatologist will contact you by letter regarding the results in approximately 2-4 weeks and you may be asked to come back to clinic for a review.