Beliefs and attitudes toward skin biopsy as a diagnostic tool: a cross-sectional survey among US patients

Skin biopsy remains the diagnostic gold standard for assessing melanocytic lesions, yet its use is influenced by provider experience and scope of practice. This study evaluated patient attitudes toward biopsy, barriers such as discomfort and needle phobia, and interest in noninvasive alternatives. A cross-sectional survey of 506 adults assessed prior biopsy experience, biopsy-related discomfort, recovery time, anesthesia pain, needle fear and willingness to pay for noninvasive tools. Twenty-eight percent of respondents had undergone biopsy. Of these, two-thirds reported discomfort and 28% rated it moderate to high. Recovery lasted ≥1 week for 59%, ≥2 weeks for 18%, and ≥1 month for 7%. Anesthesia was moderately to very painful for 33%. Common concerns included pain, scarring, infection risk and prolonged healing. Among those with biopsy experience, 53% expressed strong interest in noninvasive diagnostics, and 82% were willing to pay out-of-pocket. Patient-reported pain, needle fear and prolonged recovery contribute to hesitancy toward biopsy. Strong interest in noninvasive methods underscores the need to advance alternatives such as reflective confocal microscopy, tape stripping and electrical impedance spectroscopy, while future studies should examine socioeconomic and access-related influences.