Punch Biopsy of the Skin Make an Appointment Ask a Question Refer Patient What is a punch biopsy of the skin? Your doctor has suggested you have a punch biopsy of the skin as part of the evaluation at National Jewish Health. A punch biopsy is a minimally invasive method of sampling the skin in order to make a diagnosis. A punch biopsy removes all or part of a skin lesion. How do you get ready for the test? Inform your doctor of all the medicines you take, especially blood thinners such as Coumadin, Plavix or Lovenox. What is done during the test? When you arrive we will explain what will be done before, during and after the biopsy. If you have questions, please ask. During the test the area of skin where the biopsy will be done is identified and cleaned well. You will be given a local anesthetic with a shot near the area. You may feel a prick from the shot. Once the area is numb a pencil-eraser sized piece of skin is removed. The area may need to be closed with sutures. The sutures will need to be removed in 7-10 days. How do you care for the site after the biopsy? Daily wound care Gently remove your dressing the morning after your procedure. Change the dressing at least once a day and if it becomes wet. Please follow these guidelines for daily wound care: Wash your hands with soap and water. Gently clean the area with soap and water using a cotton-tipped swab or gauze. (If you cannot easily remove the crust, soak the area with a wet piece of gauze for 15-20 minutes.) After removing crusty material, gently pat the area dry with clean gauze. Use a clean cotton-tipped swab to apply a thick layer of petroleum jelly. Cover the area with clean gauze and tape or a bandage. Continue this process daily until you have your sutures removed. Additional Instructions Avoid soaking in water until 14 days after your biopsy. You may shower as normal the morning after the biopsy. Pain at the biopsy site is typically minimal, but you may take over-the-counter pain relievers if needed. A minor amount of blood from the biopsy site is normal for a few days after the biopsy. If your wound bleeds enough to soak the gauze follow these instructions: Place clean gauze on top of the bloody bandage and do not remove the bandage. Apply firm, continuous pressure with the gauze for 20 minutes. If bleeding continues, apply pressure for another 20 minutes. Firm pressure should be slightly painful. If bleeding stops wait a few hours then gently replace the bandage with a clean one. If the bleeding continues after 40 minutes of pressure contact your doctor right away. Watch for Signs of Infection Infections are very rare with punch biopsies. If you develop the following symptoms or feel that your wound may be infected please contact our office: Increasing pain, soreness, tenderness, redness, or warmth around the area after the second day; worsening pain is frequently the first sign, A temperature of 100.4 degrees or greater, Chills Drainage from the wound that looks white, yellow-green or foul smelling. Suture Removal Depending on the type of suture used on your wound you may need to come back for suture removal in 7-10 days. If you would prefer to have your sutures removed by one of our team members please schedule the appointment the same day as the procedure. You may also have the sutures removed by your primary care doctor. How long will the test take? You will be at National Jewish Health for about 1-2 hours. If sutures are placed, you will need to have them removed in 5 days. The sutures can be removed at National Jewish Health or by your Primary Care Provider. How do you get to your test? On the day of your scheduled test, check in at the Front Desk. If you have questions before or during your test please call 303.398.1355. Also, if you need to cancel the appointment or change the time please call. This information has been approved by Ann Hefel, FNP, MS, RN (March 2013).