What Are the Different Venous Lake Treatments?

A. Pasbjerg

While treatment of the benign lesions known as venous lakes is not typically medically necessary, people who develop them may wish to have them removed for cosmetic reasons, as they are usually found on the lips or ears and are dark blue or purple in color. There are a number of different types of venous lake treatments available, though many doctors prefer laser treatments which are safe, effective, and normally do not cause any scars. Surgical excision is also possible, using a scalpel or electrosurgery, but may be more likely to cause scarring. Other options include sclerotherapy, where a solution is injected into the lesion, and cryotherapy, which freezes it.

Scalpels are among a surgeon's essential tools.
Scalpels are among a surgeon's essential tools.

One of the most common venous lake treatments is laser therapy. This form of treatment has been found in many cases to be the safest, most effective way to get rid of the lesions and is unlikely to leave scarring. Typically, a type of laser called a pulsed dye laser, or PDL, is used to target the small vessels where the blood is pooling and causing the venous lake.

Venous lakes may be removed using a scalpel.
Venous lakes may be removed using a scalpel.

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The doctor may need to use different settings on the laser depending on the depth of the lesion. An anesthetic gel may be used on the skin first to numb it before the procedure. While a venous lake may be cleared with a single laser treatment, it is not uncommon to need additional sessions to remove it completely.

Another of the types of venous lake treatments available is excision, where the lesion is surgically cut out. This can be done with actual cuts made from a scalpel, or it may be accomplished with electrosurgery. In that procedure, an electrical current is used to precisely target and cut out the lesion. These procedures may not be the most preferred, however, because while some patients see very good results, others may find that they have discoloration or scarring afterward.

There are other types of venous lake treatments that use alternate methods to seal off the problematic blood vessels. One of these is sclerotherapy, a procedure in which the vein is injected with a solution that causes it to collapse. Over time, the closed off vessel will absorb back into the body, causing the venous lake to fade away. Another form of treatment is cryotherapy, where liquid nitrogen or other agents are applied to lesions to freeze them. This type of treatment can usually be done quickly, painlessly, and normally only requires one or two sessions to be effective.

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