Venous Lake

Overview

A venous lake is a bluish soft macule or papule caused by vascular dilation. It is most commonly found on the lower lip, though it may also appear on the earlobe, face, neck, and other areas of the upper body.

The lesion appears as a soft, compressible macule or papule with a colour that ranges from blue to purple. The diameter typically measures between 0.2 and 1 cm. Venous lake most commonly occurs in middle-aged and older individuals.

Causes and Risk Factors

The precise causes of venous lake are not fully understood. The condition is associated with the dilation of superficial venules and is observed more frequently in middle-aged and older adults. Chronic sun exposure is considered a potential contributing factor, which may account for the predilection for sun-exposed areas such as the lower lip, ears, and face.

Signs and Symptoms

Venous lake presents with the following characteristics:

• Soft, compressible macule or papule.
• Colour ranging from blue to purple.
• Diameter typically between 0.2 and 1 cm.
• Most frequently located on the lower lip, earlobe, face, and neck.
• Generally asymptomatic and considered benign.

Diagnosis

Venous lake possesses distinctive visible features that allow it to be diagnosed readily through clinical assessment. When pressure is applied to the lesion, the blue-purple colour disappears as blood is displaced from the dilated venule. This phenomenon can be observed using a glass slide or a dermatoscope. Under dermoscopic examination, venous lake appears as a structureless blue-purple lesion, which aids in confirming the diagnosis.

Treatment Options

Venous lake is considered harmless and does not require medical intervention in most cases. However, the lesion may be removed through several treatment methods. A temporary scab may form following treatment and may subsequently develop into a scar.

Laser Therapy

Laser therapy is a non-ablative and non-invasive treatment method that uses monochromatic coherent light to reduce the visibility of or completely remove a venous lake. Further information on laser treatment is available through the Centre for Medical and Surgical Dermatology.

Electrosurgery

Electrosurgery involves the use of alternating electric current at varying voltages to generate heat that destroys the site of the venous lake and removes the lesion. Further information on surgical dermatology is available through the Centre for Medical and Surgical Dermatology.

Cryosurgery

Cryosurgery is a treatment that incorporates a cold substance, typically liquid nitrogen, to destroy the superficial layer of the venous lake. Further information on cryotherapy is available through the Centre for Medical and Surgical Dermatology.

Surgical Excision

Surgical excision is a rarely employed treatment method, reserved for cases where other approaches are not appropriate. The lesion is removed through excision; however, scarring at the treatment site is an expected outcome.

When to Seek Medical Attention

Although venous lake is benign and typically does not require treatment, a dermatologist should be consulted if the lesion changes in size, colour, or shape, if it bleeds, or if there is any uncertainty about the diagnosis. A dermatologist can assess the lesion and recommend an appropriate course of action.