When dealing with alopecic or sparsely haired skin, even experienced clinicians worry about one thing:
Will the biopsy be oriented correctly in the lab?
Proper orientation is key to getting clear follicular sections, and therefore, a confident diagnosis. Fortunately, there’s a simple trick that can make all the difference.
The Trick: A Sharpie Line in the Direction of Hair Growth
Before taking your punch biopsy, draw a line with a Sharpie in the direction of normal hair growth and center your punch directly over it.
This quick step gives your pathologist a clear visual cue for how to bisect the tissue, even when there’s no visible hair left to guide them.
Why It Matters
- Prevents orientation errors in alopecic or thinning areas
- Ensures follicles are viewed in profile, improving diagnostic accuracy
- Leads to better biopsy quality and clearer interpretations—every time
This technique is especially helpful in cases of:
- Alopecia
- Thinning coats
- Subtle or patchy dermatitis
The Bottom Line
A simple Sharpie line takes only seconds but can dramatically improve your biopsy outcomes. It’s a small step that helps your pathologist, and ultimately your patient, by ensuring the sample is processed exactly as intended.