Skin Punch Biopsy

A skin punch biopsy procedure is performed to evaluate diseases such as small fiber neuropathy. This is a simple procedure in which a small circular piece of skin (about 2-3 mm in diameter) is taken from the surface of the skin. The punch biopsies are usually taken from three sites, typically in the lower limb. Your physician will determine the three sites. The entire procedure is performed in the office and takes only a few minutes. 


The biopsy areas are first cleaned, usually with alcohol and betadine, and then a local anesthetic such as lidocaine is injected with a very fine needle to numb the area. The patient will feel a slight pinch of the needle and then a brief burning sensation as the anesthetic is injected. Once the skin is anesthetized, with the help of a circular punch needle, a small punch biopsy is made into the skin, about 2-3mm in diameter and about 3mm deep. Three of these biopsies are obtained and sent to specialized dermatopathology labs for processing. No sutures are needed. The biopsy sites heal by scabbing over.


After your skin biopsy, keep the biopsy site covered with a Band-Aid. You can apply an over the counter antibiotic ointment, such as Neosporin. This will help healing and minimize scarring. A small rim of redness will likely occur at the edge of the biopsy but if you see excessive redness, fever, chills, pus, or significant pain, it may signify infection, in which case, please contact your physician. Most biopsy sites heal within 1-2 weeks.