Punch Biopsy

April 2, 2026

This page was reviewed under our medical and editorial policy by Gaurav Singh, M.D., M.P.H., F.A.C.M.S., Mohs Micrographic Surgeon and Dermatologist, City of Hope^® Cancer Center Chicago.

A biopsy is a procedure that removes a sample of tissue from a patient’s body so that it may be examined in a lab for signs of cancer or other diseases. A punch biopsy is a kind of biopsy that uses a small, round, sharp medical instrument to remove a circular tissue sample from the site of a suspected tumor, growth or rash.

What Is Punch Biopsy?

When diagnosing cancer, doctors may perform a biopsy to confirm whether a suspected tumor is cancerous or to find out more information that may help guide treatment. The instrument used to conduct a punch biopsy is called a punch. It is cylindrical, has a plastic or metal handle at one end and a small circular blade at the other end. Doctors use this tool to cut away a small sample of tissue, then close the wound.

Punch Biopsy Versus Shave Biopsy

Punch biopsy and shave biopsy are two types of procedure that may be used to diagnose or treat skin conditions. A shave biopsy uses a sharp medical tool like a scalpel to remove a thin layer of tissue close to the surface of the skin. A punch biopsy removes a full-thickness tissue sample, which means it includes all layers of the skin down to the fatty tissue beneath.

In most cases, shave biopsy is used to remove early-stage skin cancer or precancerous lesions that have not spread to the tissue beneath, while a punch biopsy is used to remove deeper lesions or tumors. A punch biopsy can also evaluate the skin for the presence of inflammation or other rashes or skin conditions.

Punch Biopsy Versus Excisional Biopsy

Punch biopsy and excisional biopsy are procedures that may be used to diagnose a wide range of cancer types. While a punch biopsy takes a small tissue sample for analysis in a lab, excisional biopsy uses a scalpel to remove an entire lesion or tumor and some of the surrounding healthy tissue. Punch biopsy is primarily used to help diagnose cancer.

Common Sites for a Punch Biopsy

Punch biopsy may be used to help diagnose a range of cancers and other conditions, including:

• Skin cancer
• Throat cancer (oropharyngeal or hypopharyngeal cancers)
• Mouth (oral cavity) cancer
• Inflammatory breast cancer
• Vaginal or vulvar cancer

In some cases, the procedure may be used to diagnose other cancer types.

The Procedure

A punch biopsy takes around 15 minutes and is usually performed in a doctor’s office or clinic. During a punch biopsy:

• The biopsy site is cleaned and a doctor uses local anesthetic to numb the area
• The doctor stretches the skin around the biopsy site so that it is taut
• The punch is placed over the skin, then the doctor pushes the punch tool down while twisting it, which allows it to cut through the skin to collect a tissue sample
• The sample is lifted out and cut away using another sharp medical instrument
• The wound is closed with a bandage or, if necessary, a small number of stitches

The sharp cutting tool on a punch may range in size from 1 millimeter (mm) to 12 mm, however, most punch biopsies take a sample that is less than 8 mm across, which is about the same size as a pencil eraser. Patients may return home immediately after a punch biopsy.

Does a Punch Biopsy Hurt?

For most patients, a punch biopsy does not cause much pain. This is in part because the area where the biopsy is performed is numbed beforehand with anesthetic. Some people experience some mild discomfort at the site of the biopsy in the days after the procedure.

Aftercare and Healing

In most cases, punch biopsy does not require significant aftercare. After the procedure, a doctor uses a sterile bandage to cover the wound and, if a larger sample is taken, uses stitches to hold the wound closed. Some of the minor side effects or complications of punch biopsy include:

• Pain or discomfort at the site of the wound
• Minor bleeding during the first few days of healing
• Scarring as the wound heals
• Infection at the site of the wound, which should receive medical treatment promptly

Results

The tissue sample removed during a punch biopsy is sent to a pathologist — a doctor who specializes in examining samples on a cellular level for signs of disease. It may take a couple weeks to receive results from a punch biopsy. If the sample shows signs of abnormal cell behavior, doctors may order other tests to gather more information.