Sending Your Skin Out for a Check-Up

A biopsy is a surgical procedure where a small piece of skin is removed and sent to a pathology laboratory for microscopic examination.

After cleaning the skin, I inject a local anesthetic to numb the area to be biopsied. The local anesthetic is similar to the type used by your dentist.

If you know you are allergic to local anesthetics, please inform my medical assistant or me. Other types of local injections can be used. You will feel a very brief needle prick and a slight burning sensation for a few seconds. The local injection works very fast in the skin.

I will then remove a specimen using a small round knife (a "punch") or a small, curved, cutting instrument.

Bleeding is controlled with a hemostatic chemical and cautery (electric needle). A small Band-Aid or dressing is applied and you may leave the office and return to your usual activities.

The following simple, post-biopsy instructions will help the biopsy site heal with as little scar as possible:

Remove the Band-Aid or dressing at night.

Cleanse the area with warm water and 3% Hydrogen Peroxide or rubbing alcohol two or three times daily for 5 to 7 days.

When a crust or scab forms, it should be left intact. If it becomes thick and underlying infection is evident, apply warm water compresses and call the office.

Normal healing takes one to two weeks.

If possible, leave the biopsy site uncovered. It will heal faster. You may cover it during the day, but try to leave it uncovered at night.

There may be a difference in the color of the skin at the biopsy site, it may be darker or lighter than the surrounding skin. This is usually temporary, but will vary according to your skin type, past and present sun exposures and other factors.

Depending on the condition being biopsied, I may choose to burn and scrape ("desiccate and curette") the areas right after I perform the biopsy.

Sometimes I wait until I get the report from the pathologist who reads the slide. It may take two to five days to get this report.

If I do not ask you to make a follow-up appointment when I do the biopsy, I will write to you or call you to discuss the pathology report with my further recommendations.

Most insurance companies pay for part or all of the surgical biopsy procedure. The charge for the biopsy, and any future surgery, is determined by the diagnosis. Benign lesions are usually less expensive than malignant lesions because malignant lesions require more attention, deeper or wider removals, and regular follow-ups.

There may be an additional Pathology Charge from the pathologist who slices stains and prepares the biopsy tissue, examines the tissue under the microscope and then sends me the report.

The pathologists I usually work with are The Clinical Laboratories of Hawaii, Inc. They participate with HMSA, Medicare, Medicaid, HDS, Hawaii Laborers, Pacific Healthcare, and Aetna-Partners. Some of these plans have deductibles or co-payment requirements. If you have any questions about your Pathology Laboratory bill, please call 599-5585.