Punch Biopsy Vs. Shave Biopsy

Hey everyone! Just wondering your opinions and thoughts about the different types of biopsies. I have had 4 shave biopsies and 1 punch biopsy since April 2017. I just got the punch biopsy 5 days ago so I’m not quite sure the results etc. How do you all think one heals up vs the other? My derm mentioned that the punch heals with a smaller scar. But I think it’s kind of a pain in the butt since you have to go back a second time to get the sutures removed.

Thoughts on the procedure anyone? :)

10 Replies

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  • I have never had a punch biopsy. So I guess I don't have an opinion, but the shave ones seem like they do the job and you're right. There is no return visit.

  • My dermatologist said that there are different reasons to use a punch Vs a shave. I don't totally under stand it but it was something about they want to get deeper into the skin tissue and not risk leaving any material behind. I have had both and yes the punches do scar a bit. I tend to develop Keloid scars so mine look way worse than average.

  • Yeah I could see how the punch would get deeper into the tissue. My derm gave me either option for one of my smaller spots I was getting removed and I figured what the heck I might as well try a punch biopsy since I hadn’t gotten one before, just to see how it heals in comparison to my various shave biopsies.

  • I preferred the punch biopsy. My shave biopsies take longer to heal and leave a burning sensation for several weeks. The punch biopsy, once the one or two stitches are out, I have not felt anything. I'm not sure why my derm has done one or the other. I think I'll ask him next time!

  • I heard once that punch biopsies are better/more accurate but I truly do not know the answer to this.

  • I heard that punch biopsies are more accurate. Also shaving can cause issues with staging. This is just what I have heard.

  • I've only ever had punch biopsies (other than the big one once for the actual melanoma, boo!) so I can't completely compare. I live 2 1/2 hours from my dermatologist in the middle of nowhere, Montana so I just take my own stitches out. If your Dr isn't opposed to this (it really is way simpler than it seems) and it is healing nicely, it would save you the extra appointment! My derm understands that I can't take an entire day off work just to get a stitch or two out so she usually ties them so that I can just clip the knot with nail clippers or scissors and then pull it out with tweezers.

  • Oh totally understandable, yikes you’re way out there. That’s one heck of a trip just to get to the derm! I only had to travel 20 minutes to mine (luckily) but still I should’ve just taken those 2 stitches out myself and saved some driving time.

  • I’m going back to my derm for a full body check so I’ll be sure to ask her about this and what differences there are :)

  • My derms at Mayo say due to a history of melanoma, I need to have punches for staging if one was possibly a melanoma again. They go into the subcutaneous fat with the punch. I have had two shaves and found they are more painful, the burning from the chemicals they use to stop the bleeding. Scars are large too. Also, you can ask for a suture removal kit. My scissors have a great little hook on them. Really not too bad to do yourself if you can reach the area.

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