What are the aims of this leaflet?

This leaflet has been written to help you understand more about a venous lake. It tells you what a venous lake is, what may have caused it, what can be done about it, and where you can find out further information.

What is a venous lake?

A venous lake is a small, enlarged vein in the skin. It does not cause serious harm. It is benign (not cancerous).

What does a venous lake look and feel like?

A venous lake often appears blue or purple, across different skin tones, and is often seen on the lower lip. It may be flat or dome-shaped, and can range from 2-10 millimetres wide. It usually affects sun-exposed areas of the skin, such as the lips, face, ears, and neck.

When compressed (pressure is applied to it) blood inside drains out of it, causing it to flatten and almost disappear. Once pressure is removed, it will refill from returning blood. Sometimes, if a blood clot develops with it, it may feel firm when pressed.

Most affected persons just have one venous lake; some people can have more than one. 

Apart from being visible, a venous lake does not cause any symptoms. If knocked or caught, it may become painful or bleed.

What causes venous lakes?

Although an exact reason is not known, factors that may lead to a venous lake forming include:

• long-term sun exposure
• cigarette smoking (particularly when a venous lake develops on the lips)

Venous lakes are usually seen in people older than 50. They are not contagious, nor ‘catching’, and are not inherited (passed on from one generation to another). 

How is a venous lake diagnosed? 

A venous lake is usually diagnosed by its characteristic visual appearance. Sometimes, a biopsy (whereby the lesion is removed surgically, under local anaesthetic) is performed, for investigation and confirmation of the diagnosis.

Can a venous lake be cured?

A venous lake will persist through life. Generally, no treatment is required, unless the venous lake causes recurring bleeding or soreness. Treatment may be desired for cosmetic reasons, such as being unsightly. Treatments usually leave permanent scar, so, in effect, one blemish is exchanged for another. Procedures for cosmetic purposes are not available on the NHS. 

How can a venous lake be treated?

Given that venous lakes are harmless and rarely cause symptoms, treatment is not needed. They can be made less noticeable with a camouflage cream (see below). Options for the treatment of venous lakes may include:

• Surgery: there are several methods to surgically treat venous lakes. Your healthcare professional will discuss this in more details and explain the benefits and risks. Simple pain relief may be required after the procedure for several days to a week.
• Cryotherapy: liquid nitrogen, applied to the skin, is used to treat venous lakes. The liquid nitrogen freezes the skin, causing shrinkage and destruction of the venous lake, and the area usually heals with a pale scar. This is usually performed in clinic. The treated site feels very cold and sore during the procedure. Simple pain relief may be required after the procedure for several days to a week. The venous lake may swell, blister, and crust, and this can last about 10-14 days.
• Laser treatment: lasers target the blood in the enlarged vein, heating it up, and causing the vessel to scar and shrink. There is mild discomfort during the procedure that may last for a few days. Colour change to the skin and scarring are risks, depending on the type of laser device used. Laser treatment may not be available on the NHS.

• Camouflage: Many people choose to manage a venous lake by using a cosmetic camouflage cream to conceal the discoloured area of skin. This is a special form of make-up, that is water-resistant and available in a range of shades to match different skin tones.

Where can I get more information about venous lakes?

Patient support groups providing information: 

Changing Faces

Tel: 0300 012 0276 (for the Skin Camouflage Service)

Email: skincam@changingfaces.org.uk
Web: www.changingfaces.org.uk

Website links to other relevant sources:

http://www.dermnetnz.org/vascular/venouslake-imgs.html

Jargon Buster: https://www.skinhealthinfo.org.uk/support-resources/jargon-buster/

Please note that the British Association of Dermatologists (BAD) provides web links to additional resources to help people access a range of information about their treatment or skin condition. The views expressed in these external resources may not be shared by the BAD or its members. The BAD has no control of and does not endorse the content of external links.

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor. 

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel. 

BRITISH ASSOCIATION OF DERMATOLOGISTS PATIENT INFORMATION LEAFLET

PRODUCED | OCTOBER 2014

UPDATED | MARCH 2018, NOVEMBER 2023

NEXT REVIEW DATE | NOVEMBER 2026