How Long Does a Vulvar Biopsy Take to Heal?

What to expect:

• After a vulvar biopsy, you may experience some mild itching or swelling because the area heals over the next one to two weeks.
• Soreness and discomfort at the biopsy site can be managed by painkillers such as paracetamol, ibuprofen, or cold compresses.
• If you have stitches, it will be removed after 5-10 days.
• If you have an absorbable type of stitches, it will take two to three weeks to dissolve or fall off.
• If you have bleeding occasionally, apply direct pressure over the biopsy site with a piece of cotton wool or towel for 15 minutes while resting lying down.

See your doctor or contact emergency care if you have

• Bleeding that does not stop even by direct pressure.
• Severe pain, swelling, and redness that is spreading.
• Malodorous discharge from the biopsy wound or a fever.
• More discomfort, and the site feels hot or starts oozing.

Quicken the duration by:

• Avoid heavy work or prolonged standing after this procedure.
• Wash the vulvar skin with plain warm water after you pass urine to soothe the area and pat dry, or you can wipe the area as normal.
• After passing the bowel, rinse the skin fully gently and make sure you wipe the skin in a direction away from the vulva to keep the biopsy site as clean as possible.
• Take a quick bath but rinse thoroughly after that and dry the area thoroughly after washing.
• Continue to wash the vulvar skin every day as normal with water alone.
• Avoid baths, hot tubs, and swimming pools for the first two to three days until the wound has healed completely.
• Given the difficulty of keeping a dressing in place, most vulvar biopsies are not covered. A panty liner may be useful to protect the area and absorb any ooze or bleeding.
• Avoid sexual intercourse and cycling until your discomfort has resolved, which usually takes three to five days.
• Wear loose cotton underwear and avoid tight pants to reduce friction at the site.

A vulval or vulvar biopsy is a surgical procedure in which your doctor/gynecologist will remove a small piece of tissue from the vulval skin or mucosal membranes for laboratory investigation.

If you have pain, itching, ulcer, or lump or blister or rash in the vulval area, sometimes, it becomes very difficult to judge the disease of the vulva just by looking or taking a blood test or swab test. Therefore, your gynecologist often suggests a vulval biopsy to help make a correct diagnosis and suggest suitable treatment.

Types of a vulvar skin biopsy are as follows:

• Shave or snip biopsy: In this, tissue samples are taken by shaving and sniping the lesion using a scalpel or curved scissors.
• Punch biopsy: In this, tissue samples are taken using a cylindrical dermal punch.
• Incisional biopsy: In this, the lesion is removed by making an incision using a scalpel and closed with sutures.
• Excisional biopsy: In this, the tumor is excised by using a scalpel and the wound is sutured.

Your gynecologist may suggest a vulvar biopsy when

• Cancerous growth is suspected.
• An immune system disorder causing blisters is suspected.
• Lesions have atypical color, texture, or vascular patterns.
• Your disease does not resolve with standard treatment.
• Results have implications for the diagnosis and management of systemic illnesses such as
  • Behcet disease (a rare disorder that causes inflammation in the blood vessels).
  • Crohn's disease (a chronic inflammatory bowel disease that affects the digestive tract lining).
• Removal of a lesion is requested for functional or for better appearance.

Typical vulval conditions that may require a biopsy include:

• Lichen sclerosis (thin, white patches of the skin, usually in the genital area)
• Lichen planus (swelling and irritation of the skin and mucous membranes)
• Abnormal growth of squamous cells on the cervix surface
• Squamous cell carcinoma (cancer of flat, thin cells of the vulva)
• Melanoma (dangerous, spreading cancer)

Complications include:

• Pain
• Swelling
• Redness
• Infection
• Bleeding
• Hematoma (bleeding beneath the skin)
• Bruising 
• Scarring 
• Discoloration of the area
• Darkening of the area
• Skin allergies to topical antiseptic, anesthetic, suture material, or dressings
• Persistence or recurrence of vulvar lesions