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Skin Biopsy Procedure - What to Expect

A skin biopsy is a procedure in which a dermatologist cuts and removes a small sample of skin to have it tested. This sample may help your dermatologist diagnose diseases such as skin cancer, rashes, infection, or other skin disorders. Done under local anesthesia in the office, the procedure is quick and relatively painless.

First, the skin is sanitized with alcohol or another antiseptic. Then a small amount of numbing medicine is injected into the skin surrounding the spot to be biopsied. At most, you’ll feel a minor burning sensation for 10 seconds as the anesthesia is injected. Then, the biopsy procedure will be performed.

There are several types of skin biopsies including:

Shave biopsy: The top layer of skin is shaved off with a small blade. This procedure is generally used to diagnose nonmelanoma skin conditions such as actinic keratosis and basal and squamous cell carcinoma. A deeper shave biopsy called a "scoop" or "saucer" shave biopsy is sometimes used to rule out a melanoma. Stitches are not required and bleeding is minimal.

Punch biopsy: The doctor uses a tool that looks like a tiny round cookie cutter to remove a deeper layer of the skin. If a large sample is taken, one or two stitches may be needed.

Incisional vs. excisional biopsy: An incisional biopsy involves removing a small sample of a lesion with a scalpel. An excisional biopsy removes the entire lesion with a scalpel. Stitches are used to close the wound.

During these procedures, there is usually a small amount of bleeding. This is stopped using cautery, a small electrical current that closes the wound or sometimes aluminum chloride is applied to the wound to stop bleeding. Then a layer of Vaseline is applied and a bandage. Some biopsies require sutures but most do not. Healing occurs in 1 to 2 weeks.

Biopsies are mainly performed to determine whether a lesion is cancerous, precancerous, or benign. By examining the biopsied specimen under a microscope and using special stains, the dermatopathologist can give a more exact diagnosis than is possible with physical examination alone.

What to Expect After a Skin Biopsy

After the skin biopsy is done you may have some soreness around the biopsied site for a few days. Tylenol is usually sufficient to relieve any discomfort. If you had stitches after the procedure, keep the area as clean and as dry as possible. Your doctor will tell you when the stitches should be removed. You should expect a small scar from the biopsy.

What Is Done With a Skin Biopsy Sample?

The tissue is processed, and a dermatopathologist examines the skin biopsy sample under a microscope to determine if there is any disease. The results usually come back within one to two weeks.

When Should I Call the Doctor After a Skin Biopsy?

Call your doctor if you have bleeding that can't be stopped by applying pressure or any signs of infection such as redness, warmth, pus, or red streaks. Also call if you have any questions or concerns after a skin biopsy.


Is Dermatology Covered By Insurance
Dermatology is a mainstream medical specialty. Thousands of people visit a dermatologist every day for common and uncommon skin issues. Like traditional health care, most services a dermatologist offers are covered by insurance. However, medications, procedures, and some conditions won’t be payable by health insurance.
The guideline insurance companies use to determine whether they will pay for a service or not is medical necessity. Medical necessity has been a controversial topic for decades, so it’s always a good idea to read your policy and refer to it several times a year.
To be considered medically necessary, the visit must be to evaluate, diagnose, or continue treating a medical condition. Dermatologists spend most of their time treating more serious skin conditions. Most of the conditions and procedures listed below are considered medically necessary. A list of the most commonly covered conditions is listed below.
  • Skin cancer
  • Rashes
  • Psoriasis
  • Port wine stain removal
  • Hemangioma excision
  • Acne
  • Skin or fungal infections
  • Eczema
  • Warts
  • Hives
  • Skin allergies
  • Keloid scars
  • Shingles
In most situations, an elective or cosmetic procedure is not covered by health insurance because it is not medically necessary, which means a person’s overall health is not affected if the person does not receive the treatment. There may be exceptions, but it is very unlikely.

Even if you are convinced that your insurance will cover your dermatology visit, you still need to make sure you have a referral, if needed. Some insurance companies require their subscribers to receive a referral from a primary care physician before seeing a specialist. If a referral is not secured before a specialist visit, the dermatology appointment may not be covered or paid at a lower rate.

If you are referred to a dermatologist and already have insurance, you need to make sure the physician is covered under your plan before you make an appointment. If you can’t find a dermatologist in your area, you can contact the insurance company directly for a referral.
Skincare Ingredients Perfect for Sensitive Skin

If you have sensitive skin purchasing skincare products can seem overwhelming and scary. Knowing what to look for and what to avoid is important. Using treatments and products that focus on improving the skin barrier, moisture, and nutrients can be very beneficial for sensitive skin. In order to keep the skin healthy and still get results with other concerns like wrinkles, dryness, and blemishes you need to know what ingredients are safe to use. Here are a few that you should look for when reading labels on products.

Chamomile is probably one of the first things that comes to mind when you think of ingredients that soothe. A natural anti-inflammatory and antiseptic, chamomile can prevent infection by neutralizing germs on the skin which in turn helps reduce the severity of inflammatory conditions like eczema and acne.

Aloe Vera is one of nature’s purest moisturizers. On contact with the skin it instantly cools and soothes irritation, reduces redness and hydrates even the driest skins. I It is lightweight enough to be used on all skin types and can be found in many lotions, not just in the traditional gel form.

Oatmeal is a great skin soother and natural exfoliator. Oatmeal can gently buff away dead skin cells while also hydrating the skin to leave you with a smoother, softer complexion. It also helps to reduce inflammation caused by acne and eczema, making it a multi-tasking sensitive skin must-have.

Vitamin E is a very versatile ingredient, powerful antioxidant that protects and heals sensitive skin types. The antioxidant properties defend the skin against harmful free- radicals which can cause wrinkles so that skin stays looking younger for longer. Vitamin E will also regulate the moisture levels in the skin to reduce inflammation.

Glycolic acid is effective on all skin types. Found naturally in sugarcane and fruits including grapes, glycolic acid is a popular ingredient found in cleansers designed for dry skin. Glycolic acid exfoliates and helps to attract moisture to your skin and keep your face hydrated throughout the day.

Urea is a little-known ingredient used to dramatically soften the skin. Urea is humectant- it draws moisture from the air to hydrate the skin. It is a great additive to your skin in improving the appearance of KP or Keratosis Pilaris.

Please keep in mind, as sensitive skin comes in many forms, always be careful when trying out new skincare products. While the ingredients mentioned here may be low risk, you should still be careful when using any new products for the first time, even if they have been created for sensitive skin. Finally, remember to avoid anything that contains harsh chemicals, fragrances, and artificial colors as these are the biggest irritators for sensitive skin. If you are still feeling unsure call our office for a complimentary consultation with our Medical aesthetician, Lily. She will work with you to come up with a regimen that works best for you and your skin.

What to Look For in a Good Sunblock

Hyperpigmentation such as age spots, acne scars, and melasma are darkened spots or patches on the skin. It is caused by an overproduction of melanin. Sun exposure is the main cause of overproduction of melanin in the skin. It can also occur after damage to the skin by conditions such as acne and eczema or injury such as a burn and after picking at the skin. Although no one likes to hear it, aging skin is also more prone to hyperpigmentation in the form of "age spots."

Prevention is key! All causes of hyperpigmentation are affected and worsened by sun exposure, therefore a good sunblock is essential. The American Academy of Dermatology recommends looking for 3 essential traits when shopping for sunblock.
1. SPF 30 or higher
2. Broad spectrum protection (UVA/UVB)
3. Water resistance
In general mineral based sunblocks offer superior protection with less sensitivity. These sunblocks contain zinc oxide and titanium dioxide. The EltaMD brand of sunblock offered at Paradise Dermatology contain these ingredients and offer sun protection without clogging your pores. For acne prone skin or for the active person concerned about sweat, the ColorScience mineral powdered sunblock is a favorite at Paradise Dermatology.
To help minimize the appearance of hyperpigmented spots one of the many options is the Sciton BBL photofacial. With fast results and minimal downtime the BBL treatment can help reduce the appearance of hyperpigmentation and also redness on the face.
As always, ask your specialist at Paradise Dermatology what you can do to keep your skin healthy and youthful!

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