ask: Venous lake on my lip

I googeled it & here's what I foung

Background
Venous lakes manifest as dark blue-to-violaceous compressible papules caused by dilation of venules. They were first described in 1956 by Bean and Walsh, who noted how they can be easily compressed and their tendency to occur on sun-exposed skin, especially the ears of elderly patients. Although venous lakes may be considered clinically insignificant from a biological standpoint, they are important because of their mimicry of more ominous lesions, such as melanoma and pigmented basal cell carcinoma.

Pathophysiology
Vascular anomalies are classified into various groups, including malformations, hamartomas, vascular ectasias, vascular hyperplasias, and benign and malignant neoplasms. Venous lakes represent a form of vascular ectasia (vascular dilatation). This group of diseases also includes spider angiomas and telangiectases. A capillary aneurysm is considered a precursor or variant of a venous lake.

The development of venous lakes is believed to be exacerbated by solar exposure and damage. One theory is that chronic solar damage injures the vascular adventitia and the dermal elastic tissue, permitting dilatation of superficial venous structures.

Vascular thrombosis also may play a role in the development of these lesions because thrombosis is commonly present in lesions of this type. Whether thrombosis is a primary or a secondary event in the development of these lesions is unclear.

Frequency
United States
The incidence of disease in the United States is not believed to differ from the incidence worldwide.

International
Although the exact incidence is unknown, venous lakes are common.

Mortality/Morbidity
Mortality from venous lakes has not been reported. There is very little associated morbidity, and lesions typically are considered biologically harmless. Venous lakes are usually asymptomatic, although pain, tenderness, and excessive bleeding can occur once a lesion has been traumatized.

Race
No racial predilection has been documented.

Sex
Bean and Walsh reported that 95% of venous lakes were observed in males. Another review of venous lakes confirmed the same gender distribution. It has been suggested that the disproportionately male distribution may be related to occupational sun exposure, hair length, and hairstyles. Women comprised the majority of treated patients in a large study of laser therapy for venous lakes; however, this may be related to increased concern among women regarding cosmetic appearance rather than with true incidence (a selection bias).

Age
Venous lakes have been reported only in adults and usually occur in patients older than 50 years. The average age of presentation has been reported to be 65 years.

Clinical
History
Venous lakes occur most commonly in adults older than 50 years with a history of chronic sun exposure. The typical presentation is as an asymptomatic lesion.

Physical
Physical examination usually reveals a soft, compressible, violaceous papule, up to 1 cm in greatest diameter. The lesions usually are well demarcated with a smooth surface, and compression often causes a transient depression. Lesions typically are distributed on the sun-exposed surfaces of the face and neck, especially on the helix and antihelix of the ear and the posterior aspect of the pinna (see Image 2). Another common site of involvement is the vermilion border of the lower lip (see Image 3). Sometimes, several lesions are found on the same person, and the surrounding skin reveals actinic damage (see Image 1).

Causes
Solar elastosis is believed to contribute to the development of venous lakes via alteration of vascular and dermal elastic fibers.

Island Girl, can you tell us a little more? Did your dermatologist recommend treatment or surgery (perhaps laser surgery)?

A venous lake is just that -- a small "lake" filled with blood from your veins that has developed, sometimes on the ears and as with you, on the lip. (They are actually similar to varicose veins, which occur most often on the legs).

Arteries take oxygen-rich blood from your heart to your organs and extremities; veins are the blood vessels that carry that blood back to the heart to pick up more oxygen. Veins have one-way valves that help to keep the blood flowing toward the heart. When the valves don’t work well, blood backs up and pools, creating the blue area that you see.

You might appreciate reading a little more about varicose veins from the Mayo Clinic site:

http://www.mayoclinic.com/health/varicose-veins/DS00256

From what I could research on the web (in addition to Anon, above), it appears that there is not medicine available to treat a venous lake, and that it won't go away by itself. Diet doesn't have anything to do with it -- it isn't something you can make worse or better by what you take in. And they aren't contagious, nor should they proliferate. And they do not evolve into anything more serious, like a skin cancer.

Dermatologists Jining Wang (Dean Health System) and Kim Wang (Department of Pathology, Northwestern University Medical School) wrote an article discussion venous lakes and their treatments, which can include laser or photo therapy:

http://emedicine.medscape.com/article/1085199-treatment

If you'll write back and let us know what your dermatologist is suggesting as treatment, we'd be glad to research more for you.

My dermatologist didn't recommend any type of treatment, she said I just needed to keep an eye on it and if it got bigger to go back and see her. I did ask about treatment and she said that any type of surgery would make it look bad and surgery wasn't necessary.

gilless10 - thanks for the information!

Thanks for your help ladies!!

I am a male who had one and I think u need to go see a platic surgeon and get a 2nd opinion about getting it removed,....It may be best to get it removed before it does get bigger..you should not wait

Some doctors are afarid to remove them since they are afraid of the bleeding and the fear of it coming back if they do not remove the whole thing.

There are reasons to remove it but if u are comfortable with it on your lip then fine but don't wait for it to grow.

HI! i have a venous lake on my lip- i'm female, and it came when i was in adolescence. i had it removed three times when i was 10,11,12 years old. once surgically (a mess of stitches, swelling...very painful) and twice with laser. this was 20 years ago. it came back each time. i've left it alone for 20 years (now i'm 31) and i have an appointment tomorrow with a vascular surgeon who specializes in laser treatment for vascular abnormalities. the catch is he doesn't take insurance so i will have to wait to see how much it costs. other plastic surgeons were willing to remove it, covered by insurance, but they did not have much experience in the venous lake removal.
try to get several opinions from reputable plastic surgeons that are affiliated with large hospitals. try plastic surgeons as well as vascular...
good luck!

Make sure u can go to a surgeon that has a good reputation...There are a few of them that know what they are doing and will do it right. Some doctors do not care how long it takes to remove it nor do they are how u suffer. Best thing to do is find someone for sure that can remove it all....I hope your laser surgery goes well..If he does not take your insurance still send the paper work to your insurance and see if u can get some money back

all The best

One appeared on my upper lip in my junior year of college '93. I finally saw a dermatologist that recommended a plastic surgeon. I had the surgery about 5 years ago and it went well. I was stitched up for a while...but it healed nicely.... There is a small scar, but with lip liner and gloss is goes unseen. I can still feel the imperfection and pray that it doesn't re-occur.. Of course I was told that it could re-appear.....anywhere.

Hope this helps you..... Oh yeah and insurance paid for it.....

I have one on my upper lip and I'm a professional flutist. I am self conscious,and would like to have it removed w/out it affecting my playing. I am near NYC any suggestions?

Fluteon