Venous Lake Treatment

Venous lakes are small veins located in the skin that become larger and more visible with the passage of time. Venous lakes are much more common in older age groups and are more often seen in men than women. They most commonly on the lower lip and are vascular in origin. The causes of venous lake formation is not completely understood. Venous lakes are completely benign lesions and are not infectious. This means they cannot be spread from person to person. Venous lakes are seldom a source of problems, however discomfort may be felt if they are knocked or caught in clothing. On occasion, venous lakes can start to bleed with no clear underlying cause.

Typical appearance of venous lakes

A venous lake has an appearance resembling a small bluish lump with a soft consistency and can be up to 1 cm wide. Venous lakes may either completely flat or be raised from the surrounding skin. Venous lakes are most commonly found at areas of chronic sun exposure, most commonly the lower lip or the rim of the ear. When finger pressure is applied to a venous lake, the blood inside the venous lake will be forced outwards which causes the venous lake to flatten and even almost disappear. Once the pressure is released, the venous lake will return to its original appearance. The photo above represents the typical appearance of a venous lake.

Venous lake treatment

The optimal treatment for treating venous lakes involves the use of a long pulse Nd:YAG laser. A pulsed dye laser is an alternative but less effective option as it is only suitable for much smaller and superficial venous lakes. The laser treatment with Nd:YAG laser is very quick and straightforward. There is no need for topical application of local anaesthetic cream. The skin is pre-cooled with an ice cube for 5 seconds to relieve any discomfort from the laser pulse and also to prevent excessive thermal damage. Skin cooling with cold air is applied and the first laser pulse applied leads to moderate shrinkage and greyish discolouration of the venous lake. This appearance is due to coagulation and swelling of the blood vessels caused by the deep penetration of the Nd:YAG laser. For most lesions, one treatment is all that is required. For larger lesions, occasionally more than one treatment is required. After the procedure, a suitable protective ointment is applied several times per day to facilitate healing.

Potential complications of venous lake treatment

With larger lesions, it may very occasionally have a residual flat and lighter coloured mark where the venous lake originally was. This appearance is much less prominent compared with the original lesion and therefore more cosmetically acceptable. Rare complications include the risk of skin necrosis, scarring or ulceration. This usually occurs from inadequate cooling prior to laser treatment or the use of inappropriately high laser settings. These risks are reduced even further when venous lake treatment is undertaken by a dermatologist skilled in the laser treatment of facial vascular lesions.

All our doctors are on the GMC specialist register. Our London dermatology clinic at 106 Crawford Street was recently inspected and rated as good across all 5 domains.

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Case 3:

This is a 65 year old male with a venous lake located on the upper lip. No skin preparation was required. The procedure is performed under topical anaesthesia which is applied 30 minutes beforehand. Ten minutes before starting the procedure, ice is placed over the lesion to minimise bleeding. Just one pass of the laser is enough to eliminate the venous lake. Cold air cooling is used during treatment.

Centre for Surgery is located at 106 Crawford Street in Marylebone. Crawford Street is just off Baker Street. We are easily accessible by all major bus routes that pass through Baker Street as well as Baker Street underground station.

From the tube station, we are just a 5 minute walk southwards down Baker Street followed by a right turn onto Crawford Street. The clinic is about 200 yards on the left.

There is ample local pay & display parking in the surrounding area and an NCP car park is located further west along Crawford Street. Our local residential parking zone is the City of Westminster.

Address: 106 Crawford Street, Marylebone, London, W1H 2HY

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