Treatment of venous lakes

Venous lakes are dark blue to violet compressible small swelling caused by dilatation of venules. These are common on sun-exposed skin. They also commonly occur on lips and are uncommon before 50 years of age.

The diagnosis is clinical and not difficult for the trained eye. Differential diagnosis includes melanoma and pigmented basal cell carcinoma. Venous lakes are soft, compressible, well defined and usually a few mm in size. Direct pressure created by a glass slide causes a vascular lesion such as a venous lake to blanch or fade as the blood is forced out.

Various treatments are available but the best treatment is with long pulsed Nd-Yag laser. There is lack of awareness of this even amongst the medical professionals. I believe that with recent advances in laser technology and wide availability of these, there is no role for any destructive modality in most cases. A variety of treatment modalities have been described. These include cryo therapy, diathermy, surgery and sclerotherapy. These can cause scarring and textural changes. A variety of lasers have been described but most success has been achieved with the long pulsed Nd-Yag laser.

Usually only one treatment session is required and patients are delighted with the outcome.  The results shown here are typical in our clinic. So this is one more instance where a particular laser is the obvious choice. It is non-invasive, quick and no anaesthesia or operation is required. There is no scarring and excellent results are achieved at a very reasonable cost.