What are the other Names for this Condition? (Also known as/Synonyms)

• Phlebectases

What is Venous Lake? (Definition/Background Information)

• A Venous Lake is a benign, pigmented skin condition that is caused by a dilated small vein. It is present in the form of a papule
• A papule is an area of abnormal skin tissue that is less than 1 cm around. Usually a papule has distinct borders, and it can appear in a variety of shapes
• Venous Lakes usually occur in the head and neck region of older adults. They are particularly common on lips and ears. The cause of development of the condition is unknown
• These papules are generally asymptomatic. But, since they may resemble a melanoma (a malignant skin tumor), Venous Lakes may be biopsied to ensure a definitive diagnosis. With slow gentle pressure, the blood will slowly drain from the papule; on release, it will slowly refill in a distinctive fashion. If observed, this can render a biopsy unnecessary
• A treatment of Venous Lake may be undertaken, if they are of cosmetic concern to the individual. In such cases, a simple surgical excision is sufficient treatment. An Nd/YAG laser with a slow pulse duration and an appropriate spot size can quickly ablate Venous Lakes
• The prognosis is excellent with treatment (when the lesions are removed entirely) or without treatment, as Venous Lakes are benign

Who gets Venous Lake? (Age and Sex Distribution)

• Venous Lake are benign papules, usually found in individuals over 50 years (after the 5th decade)
• Both males and females are affected
• There is no ethnic or racial predisposition and this condition is observed worldwide

What are the Risk Factors for Venous Lake? (Predisposing Factors)

• Chronic sun exposure is the only identified risk factor for Venous Lake

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Venous Lake? (Etiology)

• The exact cause and mechanism of formation of Venous Lake is unknown
• However, Venous Lake papules form when very small blood vessels (called ‘venules’) enlarge 

What are the Signs and Symptoms of Venous Lake?

In most cases, there are no signs and symptoms of Venous Lake. However, the following may be noted:

• The skin lesions occur as single or multiple papules
• The pigmented papules are often bluish-red to bluish-black in color
• The most common locations are the head and neck region, especially on the lips and ears. But, they may occur anywhere, particularly on body areas that are prone to sun exposure
• Sometimes, the Venous Lake papule may resemble a melanoma because of the pigmentation, which can be a cause of concern. The mixed oxygenated (red) and deoxygenated (blue) blood gives a deep purple hue, close enough to black to be confounding

How is Venous Lake Diagnosed?

A diagnosis of Venous Lake may involve:

• Complete physical examination with evaluation of medical history
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: In majority of cases, the diagnosis of Venous Lake may not necessarily involve a biopsy. However, if there is a suspicion of melanoma (a malignant skin tumor), then the healthcare provider may recommend a biopsy.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Venous Lake?

No significant complications of Venous Lake are generally observed.

• However, some individuals may have cosmetic concerns due to the appearance of the papules, in which case a surgery may be recommended
• An incomplete removal of the papule may result in its recurrence

How is Venous Lake Treated?

Venous Lakes may be treated in case they present cosmetic concerns in the individual. In such cases, the treatment may involve the following steps:

• Embolization is used to provide temporary relief from the symptoms and reduce blood loss during a surgical procedure. This is undertaken for large internal lesions, not for small cutaneous ones
• Sclerotherapy can be considered, which is a lot less invasive technique than surgery and may benefit a majority of the patients
• Radiofrequency ablation: In this technique, which generally has very low complications, radio frequency waves are used to destroy the blood vessels. This technique is used in internal vascular tumors, which show low blood flow, as determined by vascular radiological studies, such as angiography and Doppler studies
• Wide surgical excision of Venous Lake and removal of the entire lesion is the treatment of choice. If the tumor is not fully removed, then it may recur
• Laser surgery can be used for small cutaneous lesions
• Post-operative care is important: A minimum activity level is to be ensured, until the surgical wound heals
• Follow-up care with regular screening and check-ups are important

If the tumor mass is small and causes no symptoms, then the healthcare provider may chose to maintain a periodic observation of the tumor.

How can Venous Lake be Prevented?

Current medical research has not established a way of preventing Venous Lake.

What is the Prognosis of Venous Lake? (Outcomes/Resolutions)

• The prognosis of Venous Lake is excellent on its complete excision and removal
• Since these are benign tumors, the prognosis is excellent, even if no treatment is provided and only periodic observation is maintained

Additional and Relevant Useful Information for Venous Lake:

• Venous Lakes are not infectious and they do not spread from one individual to another
• There is no definitive proof that certain types of diet may influence its development