A venous lake is a common benign vascular lesion, a type of venous malformation characterized by dilated blood vessels. It typically appears as a soft, compressible, dark blue to purple spot, most frequently on the lower lip. While often a cosmetic concern, these lesions are generally harmless.
Understanding Venous Lakes
Venous lakes are dilated veins, appearing as soft, compressible papules or macules, typically dark blue or violaceous. They range from 2 to 10 millimeters and can be flat or dome-shaped. Pressure causes them to flatten as blood drains, refilling when released. While most commonly found on the lips, they can also appear on other sun-exposed areas like the ears, face, and neck.
The precise cause of venous lakes is not fully known, but chronic sun exposure and ultraviolet (UV) damage are contributing factors. Aging and weakening blood vessel walls also play a role, making them more common in individuals over 50. Trauma, injury, and smoking have also been associated with their development. Venous lakes are benign and do not pose a cancer risk, distinguishing them from more serious lesions.
Professional Removal Methods
Professional treatment options are available for removing venous lakes, primarily for cosmetic reasons or if they cause symptoms like bleeding.
Laser therapy is a common and effective treatment. Pulsed dye laser (PDL) and Nd:YAG laser target blood in the enlarged vein, heating it to shrink and fade the vessel. This treatment is precise and often results in minimal scarring or side effects, though multiple sessions may be needed. Patients might experience slight swelling and pain for a few days, with the lesion gradually disappearing over several weeks.
Sclerotherapy involves injecting a specialized solution, such as 1% polidocanol, directly into the venous lake. This solution irritates the vessel lining, causing it to swell, clot, and eventually form scar tissue that fades over time. Complete resolution can be observed after one or two sessions.
Cryotherapy uses liquid nitrogen to freeze the venous lake, leading to its shrinkage and destruction. The treated area typically heals with a pale scar but can cause temporary swelling, blistering, and crusting for 10-14 days. Excisional surgery involves the surgical removal of the lesion but is less common due to potential scarring, especially on the lip. Infrared coagulation uses heat to coagulate the vessel, often resulting in complete clearance with minimal scarring.
What to Consider Before Treatment
Before pursuing treatment, obtain a diagnosis from a medical professional, such as a dermatologist. This ensures the lesion is a venous lake and not another condition, including more serious ones like melanoma, which can have a similar dark appearance. A dermatologist may use a dermoscope for examination or recommend a biopsy if uncertain.
During a consultation, discuss all available treatment options, potential side effects, and risks with the doctor. Possible risks include temporary discoloration, recurrence, or scarring. Understand the expected recovery time for each procedure. Since venous lakes are benign and typically asymptomatic, treatment is usually for cosmetic reasons or if the lesion causes issues like bleeding. Do not attempt home remedies or self-removal due to risks of infection, uncontrolled bleeding, scarring, and misdiagnosis.