Venous Lakes

Venous lakes are very common in middle-aged and older adults, particularly those with fair or sun-exposed skin.

A venous lake is a small, dark blue or purple bump caused by a dilated vein just beneath the surface of the skin. These lesions are benign (non-cancerous) but can be cosmetically concerning, especially when they occur on visible areas such as the lip, ear, or face.

At Derma Reading, we can treat venous lakes safely and effectively using the advanced Excel V+ vascular laser. This state-of-the-art laser targets and seals the small dilated veins responsible for the lesion, restoring a clearer, natural skin tone with minimal discomfort or downtime.

Venous lakes are very common in middle-aged and older adults, particularly those with fair or sun-exposed skin. Though completely harmless, they can be mistaken for more serious conditions such as melanoma or pigmented moles, so accurate dermatological assessment is essential before treatment.

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Venous Lakes

These lesions are benign (non-cancerous) but can be cosmetically concerning, especially when they occur on visible areas such as the lip, ear, or face.

Symptoms of Venous Lakes

Venous lakes can cause concern for patients who fear they might be skin cancer.

Venous lakes are easy to recognise by their distinctive colour and texture. Typical features include:

Colour: dark blue, purplish, or occasionally black.
Shape: round or oval, smooth surface, and slightly raised.
Size: usually between 2 mm and 1 cm in diameter.
Compressibility: they flatten when gently pressed (the blood drains), then refill when pressure is released.
Location: most often on sun-exposed areas such as the lower lip, ear rim, face, or neck.
Sensation: generally painless, though they may bleed if traumatised.

Because of their colour and occasional growth, venous lakes can cause concern for patients who fear they might be skin cancer. Fortunately, dermatologists can distinguish them easily with examination or dermoscopy.

Causes of Venous Lakes

Venous lakes are not linked to systemic disease or blood disorders.

Venous lakes develop when small veins in the superficial dermis become dilated (enlarged) due to weakening of the vessel walls. Several factors contribute:

Sun exposure: ultraviolet (UV) damage weakens elastic fibres in the skin and vessel walls.
Ageing: as skin and connective tissue lose elasticity, superficial veins become more prone to dilation.
Genetic tendency: some people are naturally predisposed to develop superficial vascular lesions.
Chronic minor trauma: repeated biting, friction, or sunburn to the lips or ears may encourage their formation.

Venous lakes are not linked to systemic disease or blood disorders. They are simply a local vascular change within the skin.

Diagnosis

Diagnosis is clinical and straightforward for an experienced dermatologist. A venous lake is identified by its colour, compressibility, and typical location. To confirm, the dermatologist may use a dermatoscope — a magnifying light that shows the characteristic dark blue hue and vascular structure.

In uncertain cases, or when a pigmented skin cancer needs to be ruled out, a skin biopsy may be performed. This small sample confirms the diagnosis and ensures safe treatment planning.

Treatment of Venous Lakes at Derma

Your appointment will begin with the dermatologist’s thorough assessment of your skin, and inspection of the actinic keratoses lesions.

While venous lakes are harmless, many patients choose treatment for cosmetic reasons or because the lesion may occasionally bleed. At Derma Reading, our dermatologists offer the safest and most effective modern treatments, tailored to the lesion’s size, depth, and position.

Excel V+ Laser

Our preferred and most effective option is the Excel V+ vascular laser — a dual-wavelength laser (532 nm KTP and 1064 nm Nd:YAG) specifically designed to treat vascular lesions.

The laser delivers controlled pulses of energy that are absorbed by the blood within the dilated vein. The heat causes the vessel walls to collapse and seal shut. Over the following weeks, the treated vein is naturally reabsorbed by the body, and the overlying skin returns to its normal colour.

Advantages of Excel V+ treatment:

Precise targeting with minimal damage to surrounding tissue.
Safe for delicate areas such as the lips and ears.
Quick treatment — usually 10–15 minutes.
Minimal discomfort (often described as a brief warm snap).
No injections or sutures required.
Low risk of scarring or pigment change.

Most venous lakes resolve completely after one or two sessions, though larger or deeper lesions may require additional treatments spaced 4–6 weeks apart.

Electrocautery / Thermocoagulation

For smaller or raised venous lakes, a fine electrical current can be used to coagulate the vessels. The area forms a small crust that heals over a few days. While effective, this method has a slightly higher risk of pigment alteration, especially on darker skin.

Cryotherapy

Freezing with liquid nitrogen can destroy small vascular lesions but carries a risk of blistering, pigment change, or scarring on delicate facial skin. For this reason, it is less commonly used for venous lakes at Derma Reading.

Surgical Excision

In rare cases — particularly for large, firm, or atypical lesions — a minor surgical removal under local anaesthetic may be recommended. This ensures complete clearance and allows histological confirmation. Healing typically takes one to two weeks.

Our dermatologists will always discuss the pros and cons of each method and recommend the safest and most effective approach for you.

Recovery

Recovery from Excel V+ laser treatment is simple and requires little to no downtime. Immediately after the procedure, the treated area may look slightly darker or purplish as the vessel coagulates. Mild swelling or redness may occur for a few hours.

Over the following days, the lesion typically darkens further, then lightens and flattens as the vein is reabsorbed. The area heals completely within one to three weeks.

Aftercare Advice

Keep the area clean and dry for 24 hours.
Avoid picking, rubbing, or scratching the site.
Use a soothing ointment if any crust forms.
Protect the area from sun exposure using SPF 30+.
Avoid hot drinks, spicy foods, or excessive heat for a few days if the lesion is on the lip.

Make-up can usually be applied the next day. Most patients notice immediate colour reduction, with further improvement over subsequent weeks.

Results

Results from Excel V+ treatment are typically excellent. The dark blue or purple lesion fades, and the treated area blends smoothly with surrounding skin. Because the affected vein is destroyed, the result is permanent — the same lesion does not return.

Occasionally, patients may develop new venous lakes elsewhere over time, especially with continued sun exposure or ageing. Consistent sun protection helps minimise recurrence.

Further reading: Patient leaflet from the British Association of Dermatologists

Venous lake

Frequently Asked Questions

Are venous lakes dangerous?

No. Venous lakes are benign vascular lesions with no malignant potential. However, it’s important to confirm the diagnosis with a dermatologist, as some pigmented or vascular tumours can look similar.

Is treatment painful?

Most patients find laser treatment very tolerable. The Excel V+ laser’s cooling technology helps keep discomfort minimal — usually described as a brief warm snap or tingling sensation.

How many treatments will I need?

In many cases, one session is enough. Larger or deeper venous lakes may need a follow-up session to achieve full clearance.

Is there downtime?

Downtime is minimal. You may experience mild redness or darkening for a few days, but most patients return to normal activities immediately.

Can venous lakes come back?

The treated lesion will not recur, though new ones may form over time due to sun exposure or ageing.

Can Excel V+ be used on the lips safely?

Yes. The Excel V+ laser is safe for delicate areas, including the lips, provided it is used by an experienced dermatologist. Protective measures are taken to ensure comfort and precision.

Is scarring possible?

Scarring is rare with laser treatment, especially compared with older surgical methods. Following aftercare instructions helps minimise risk further.

Why choose Derma Reading?

At Derma Reading, all treatments are carried out or supervised by consultant dermatologists with extensive expertise in vascular and aesthetic laser medicine. Our clinic is CQC-registered, using the latest Cutera Excel V+ laser — a hospital-grade dual-wavelength device designed for maximum precision and safety.

We pride ourselves on combining medical accuracy with cosmetic excellence. Each treatment plan is personalised to your skin tone, lesion type, and preferences. Whether you’re seeking to remove a venous lake on your lip, ear, or face, our dermatologists will ensure your treatment is safe, comfortable, and achieves natural-looking results.