A blue or purple spot on the lip can be concerning, especially if it appears suddenly or changes over time. According to Dr. Jaqueline Watchmaker of U.S. Dermatology Partners Scottsdale, “Venous lakes are benign, but they may cause a patient to worry, especially because they often develop on the lips and other very visible parts of the face. Even the smallest change in appearance on the face can draw a lot of attention and cause concern. The good news is that it can be easily treated with a simple, in-office laser procedure.” In this blog, Dr. Watchmaker answers frequently asked questions like what are venous lakes, how is this condition treated, and who would benefit from visiting a dermatologist to address vascular dilation?
What Are Venous Lakes?
The simplest definition of venous lakes is that they are blue, purple, or violet spots on your lip and other parts of the face. They develop when a small pool of blood forms within a vein that’s close to the skin’s surface. These benign vascular lesions are non-cancerous, they don’t spread, and they are not infectious. Venous lakes are slow to develop, and they typically remain unchanged for years. The cause of venous lake formation is the widening of small veins that lose their structural support. This can occur for a variety of reasons, including:
- Aging – as we age, skin becomes thinner, loses elasticity, and supportive structures weaken, allowing veins to enlarge.
- Sun exposure – damage from ultraviolet (UV) radiation damages skin, especially with persistent or frequent exposure. Collagen and elastin fibers that strengthen and support skin and provide structure for veins are broken down by chronic sun exposure.
- Loss of vascular strength – small blood vessels may naturally weaken over time, increasing risk for vascular dilation.
Where Do Venous Lakes Commonly Appear?
A blue spot on the lip or other areas frequently exposed to sunlight may be a venous lake. Sun exposure plays a big role in the formation of venous lakes as UV radiation damages and weakens collagen and elastin proteins. These benign skin lesions are most common in individuals with significant lifetime sun exposure. It’s essential to protect skin from UV damage by applying sunscreen daily (including lip protection) and reducing exposure to sunlight as often as possible. The most common locations where venous lakes develop include:
- Lips, especially lower lip.
- Ears, especially the tops of ears.
- Face
- Other sun-exposed areas
How Venous Lakes Differ from Moles or Skin Cancer
Venous lakes may create a blue, violent, or purple spot on lips, ears, and other sun exposed areas that resembles moles or even melanoma and other types of skin cancer. Knowing the differences can alleviate stress. According to Dr. Watchmaker, “Professional evaluation of new or changing spots on skin is essential. It ensures you don’t leave something serious untreated, and your dermatologist can provide education to help you better understand side effects and skin health concerns. Self-diagnosis is discouraged because venous lakes can look very similar to melanoma, pigmented basal cell carcinoma, or hemangiomas to the untrained eye.” Venous lakes are often mistaken for moles or melanoma. The key differences between the three are outlined below:
| Feature | Venous Lake | Benign Mole (Nevus) | Melanoma |
| Color | Blue, purple, or dark violet | Uniform tan, brown, or flesh-colored | Brown, black, or unevenly pigmented |
| Texture | Soft and compressible; may lighten with pressure | Smooth surface; doesn’t change color with pressure | Raised or flat; doesn’t change color with pressure |
| Shape & Borders | Usually round or oval with smooth, regular borders | Symmetrical shape with smooth, even borders | Irregular shape with uneven, poorly defined borders |
| Growth Pattern | Slow-growing and stable | Stable over time or very slow change | Rapid change in size, color, or shape warrants evaluation |
Symptoms and What Patients May Notice
If you have a vascular lesion on your lip, you may notice:
- A discolored spot that’s blue, purple, or dark violet colored.
- Flat to skin or slightly raised lesion.
- Soft, compressible growth.
- Darker coloring that fades with gentle pressure.
- Very slow growth or stable lesion size.
- Bleeding when bumped or irritated.
When Is Treatment Recommended?
When it comes to treatment, Dr. Watchmaker says, “Venous lakes don’t have to be treated. They won’t cause harm or spread to other areas. That doesn’t mean patients can’t elect to receive treatment for venous lakes. If a patient wants to improve the appearance of venous lakes for cosmetic reasons, a dermatologist can remove the lesion with simple, minimally invasive treatments. I may recommend treatment if lesions are bleeding or are very irritated to reduce discomfort and minimize risk for infection.”
In-Office Treatment Options for Venous Lakes
For those who choose to move forward with in-office venous lake treatment, there are several minimally invasive treatment options. Dr. Watchmaker says, “The long pulsed 1064nm laser (also called the Nd:Yag laser) is the best option. Typically, anywhere from 1-3 treatments is needed (depending on the size of the venous lake) and there is little to no downtime. Sometimes electrosurgery can be performed, especially if laser therapy is not available.”
Nd:Yag 1064nm laser
The Nd:YAG laser is a safe and effective way to treat venous lakes. This laser works by delivering a specific wavelength of light (1064nm) that targets blue vessels beneath the skin, gently heating and collapsing them without damaging the surrounding tissue. Over time, the treated vessel is naturally reabsorbed by the body, leading to a clearer, more even appearance.
Treatments are quick, typically require little to no downtime, and most patients notice improvement after just one session.
Electrosurgery
When laser is not available, electrosurgery may be recommended. This treatment uses a controlled electrical current to cauterize the dilated vessel. This leads to shrinking blood vessels and resolves lesions. This procedure is chosen when the size and location of the lesion allow for safe use of electrosurgery techniques.
What to Expect After Treatment
Following treatment, there may be some mild swelling or darkening of the spot, which resolves as the area heals. Full results are typically seen after 3-4 weeks.
When to See a Dermatologist
A dermatologist lip lesion evaluation ensures patients receive accurate diagnosis and treatment plans. A professional consultation reassures patients that they are doing their best to keep skin healthy. Any changes in skin’s color, texture, new or growing lesions, and other concerns should always be reviewed by a dermatologist to rule out serious health conditions.
Address this Common, Benign Condition
In conclusion, Dr. Watchmaker says, “Venous lakes are common, especially for those who spend large amounts of time in the sun. I always recommend patients have new spots examined by a dermatologist. Even if it’s a benign lesion that you choose not to treat, knowing for sure means greater peace of mind.”
Schedule a Dermatology Consultation
Whether you’re interested in treatment options for venous lakes, you’re concerned about a new lesion, or you just have questions about skin health, the trusted professionals at U.S. Dermatology Partners have you covered. We make requesting an appointment quick and easy for our patients. Simply fill out our scheduling request online. It takes less than a minute, and one of our local team members will reach out to finalize the details of your visit.
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