Venous lake treatment

Venous Lakes; A Glance

  • Best Results1-2+ sessions
  • Treatment Recovery1+ days
  • Procedure Time3 seconds
  • Skin SpecialistDermatologist
  • Duration of ResultsLong term
  • AnaestheticCooling spray/gel
  • Back to WorkImmediately
  • Cost$ (Medicare rebate for some cases)

Venous Lake Treatment

Venous lakes are common spots. Most frequently they occur on the lower lip of middle aged to elderly people. They are commonly confused with skin cancers, including melanomas, however venous lakes are benign. The best way to treat these spots is with a vascular laser. This treatment is partially covered by Medicare.

FactsFacts On Venous Lakes

  • Venous lakes are a benign proliferation of harmless blood vessels
  • They are found in middle aged to elderly patients
  • The occur more frequently on the lower lip
  • Venous lakes are diagnosed clinically, without invasive testing
  • Vascular lasers can erase venous lakes within one simple painless treatment
  • Treatments take less than 3 seconds to perform

How do dermatologists diagnose venous lakes?

In 99% of cases a simple clinical examination with a hand held microscope can diagnose these lesions. Rarely, in equivocal cases, a simple skin biopsy can be useful. 

What is the best treatment for venous lakes?

A deep penetrating NdYag laser is the best way to treat these lesions. Lasers work by sealing off the blood vessels within the venous lake itself. Not all lasers can treat venous lakes; as this requires a longer wavelength for deeper penetration. 

We use the following lasers to treat vascular lesions; DermaV, VBeam Prima & Perfecta, Sciton Joule, 755 Alex as well as the Excel V in my Sydney office.

What is the venous lakes procedure like?

Laser light feels like a short snap on the lip.  In most cases we double pulse, meaning 2 short snaps delivered over 1-2 seconds. 

All procedures are done in our accredited laser suites in Brisbane & Sydney. During the procedure you will have eye protection glasses on. Pain? About 2 out of 10.

What is recovery like?

After the procedure you will have some swelling & color changes within the venous lake (gray to white). Swelling subsides within a day. Avoid hot food & drinks for 24 hours. 

Vaseline should be used for 7 nights, longer in the event of an ulcer (rarely). Your venous lake will fade after 1-5 days to reveal normal lip skin.

Will it recur?

Providing the initial venous lake is treated fully, recurrence is slim. Partially treated venous lakes may recur, the caveat is that if you have one venous lake, you may be prone to more venous lakes in the future. 

In most cases, small to medium size venous lakes (2 to 7 mm in diameter) require only one treatment. Larger venous lakes, up to & beyond 10 mm may require 2, rarely 3 sessions, spaced 4 weeks apart.

Davin’s viewpoint on treating venous lakes

Vascular lesions on the lower lip are often concerning as they may resemble pigmented lesions such as melanoma or melanoma in-situ (superficial melanomas). Fortunately, venous lakes can be easily diagnosed & treated by dermatologists. 

Dermatoscopy will reveal a featureless lesion with absent pigment network. The color is typically blue to purple. Pressure will cause blanching of the venous lake. In the absence of a dermatoscope, a simple glass slide can be used (glass slides are useful to compress the lesion prior to laser if one has a superficial wavelength such as 595 to 755 as these wavelengths do not penetrate deeply. Compression reduces the depth of venous lesions). 

I prefer lasers with cryo cooling, the best is probably DermaV; it is more reliable than the Candela Prima laser. Cooling gives that extra level of protection to the epidermis, allowing for higher energy levels & greater patient comfort. In Sydney I use the ExcelV laser by Cutera. Most cases require one session, for venous lakes that are large (>8 mm), 2 to 3 treatments may be required for optimal outcomes. 

Another treatment option that works very well is that of cryotherapy with liquid nitrogen. For venous lakes, the on-card cryo time ranges between 10 to 15 seconds, short bursts of nitrogen until the lesion is solid white. Wait for the lesion to completely thaw (about 20 to 40 seconds, depending on the size), then repeat. This constitutes a double freeze thaw cycle. It works; exceptionally well. Most cases resolve without scarring (less than 1 percent chance if done correctly). Cryotherapy is underutilized as it does not have a Medicare rebate. 

Join the conversation

Join Dr Davin Lim on Instagram to stay up to date


Enquire now!

Get In Touch

Quick Contact

Dr Lim has unparalleled experience in dermatology. Fill in the form below and he will get back to you with your query
This field is for validation purposes and should be left unchanged.