What are the aims of this leaflet?

This leaflet has been written to help you understand more about a venous lake (which can also be referred to as phlebectasis or phlebectasia). 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 blood vessel (vein) in the skin, which over time has become enlarged and wider (or dilated).

What causes venous lakes?

It is thought that long-term sun exposure can cause venous lakes and possibly smoking, although the cause is unknown. They are usually seen in people older than 50 and are more common in men than in women.

Are venous lakes hereditary?

Venous lakes are common and may affect more than one member of a family, but they are not inherited (passed on from one generation to another).

They are not contagious or ‘catching’. They are benign (harmless) and are not cancerous.

What are the symptoms of a venous lake?

Usually, venous lakes despite being visible do not cause any other symptoms. However, if they have been knocked or caught, they may become painful or bleed.

What does a venous lake look like?

A venous lake is a usually a small soft blue lump, up to 1cm wide, which may be flat or slightly dome-shaped. It usually affects sun-exposed areas of skin, most commonly on the lower lip or the rim of the ear. When compressed (pressure is applied to it), the blood may drain out of it causing it to flatten and almost disappear, the blood then returns once the pressure is removed.

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

How is a venous lake diagnosed?

A venous lake is usually diagnosed by its characteristic appearance. If there is any doubt, surgical removal (excision) may be advised to examine the affected skin under the microscope. This requires an injection of a local anaesthetic to numb the area, cutting out the affected area and then closing the skin wound with stitches that may be dissolving or need removing after a week or so. A small but permanent scar will usually be left behind once the area has healed. If surgical removal is needed the person seeing you in clinic will discuss this in more detail prior to the procedure.

Can a venous lake be cured?

No treatment is required, unless the venous lake causes bleeding or soreness. Treatment may be desired for cosmetic reasons, but often leaves a permanent scar so one blemish is exchanged for another. Treatment for cosmetic purposes is not available on the NHS.

How can a venous lake be treated?

Treatment is not usually needed as they are harmless and rarely cause any symptoms. They can be made less noticeable with a camouflage cream (see below). Treatment options include:

• Surgery: excision under a local anaesthetic (described above);
• Cryotherapy:(the application of a freezing agent such as liquid nitrogen to skin cells with the aim of removing them) this means freezing the venous lake with liquid nitrogen (a procedure performed in clinic); the treated site feels very cold and sore during the procedure. This is usually followed by swelling, blistering and crusting that can last about 10-14 days). It usually leaves a pale scar.
• Laser treatment: the pulsed dye laser or other ‘vascular lasers’ are commonly used. These target the blood in the enlarged vein, heating it up and causing the vessel to shrink. Laser treatment may not be available on the NHS.

Other Treatment

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, used for medical purposes, 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?

Web links to detailed leaflets:

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

Skin camouflage organisations:

British Association of Skin Camouflage (NHS and private practice)
Tel: 01254 703 107
Email: info@skin-camouflage.net
Web: www.skin-camouflage.net

Changing Faces
Tel: 0300 012 0276 (for the Skin Camouflage Service)
Email: skincam@changingfaces.org.uk
Web: www.changingfaces.org.uk

Please note that the 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
NEXT REVIEW DATE MARCH 2021