Varicose veins occur when blood collects behind the small valves in a person's veins instead of flowing smoothly back to the heart. They are more common in the legs and feet, because blood returning to the heart has farther to travel.
Doctors often recommend compression stockings to improve circulation, stop varicose veins from getting worse, and reduce pain or discomfort.
Here, we look at evidence that supports the use of these stockings, as well as associated risks. We also discuss how to choose the right size and shape.
How do compression stockings work?
Compression stockings may help to improve circulation and treat the symptoms of varicose veins.
Compression stockings are traditionally used to improve circulation. According to the authors of Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins, Roman soldiers often wrapped their legs in leather straps to improve circulation during long marches.
Modern compression stockings are more sophisticated and designed to provide consistent pressure in the legs, helping blood to flow back toward the heart. Stockings usually exert more pressure near the ankles and feet, providing an extra squeeze that promotes blood flow.
Studies suggest that compression stockings can improve some symptoms of varicose veins, but little evidence supports the idea that stockings alone will eliminate them. Different types of stockings exert different amounts of pressure.
Some recent research into varicose veins includes:
- A 2018 study, which found that wearing compression stockings with pressures of 18 to 21 millimeters of mercury (mm Hg) for 1 week helped to reduce aches and pain associated with varicose veins, compared to normal stockings.
- A 2017 study, which determined that wearing stockings of 22 mm Hg for 6 months helped to control leg swelling during pregnancy in people with varicose veins. However, the authors noted that an oral medication called pycnogenol was more effective than using stockings.
- A 2014 study, which concluded that surgery to remove varicose veins was a more effective treatment than compression stockings.
Overall, results are mixed. A review from 2015 found that little reliable evidence supports compression stockings as a treatment for varicose veins.
Which type of compression stocking should I use?
The right amount of pressure and the right kind of stocking depends on the number, type, and underlying cause of a person's varicose veins.
The three main kinds are:
- Support pantyhose. These exert some pressure, but are the least tight option.
- Compression socks and stockings. A range of pressures are available for purchase at many drugstores, pharmacies, and online stores. These provide more support than pantyhose.
- Prescription compression stockings. These exert the greatest amount of pressure, and are fitted by a specialist to ensure that they are effective but not so tight that they affect a person's circulation.
Stockings are typically knee- or thigh-high. Knee-high stockings promote circulation in the lower leg and when exercising.
A doctor may recommend thigh-high compression stockings for varicose veins, though these are more often used to prevent blood clots after surgery, particularly after knee replacement surgery.
When should I wear compression stockings?
People tend to wear compression stockings during the day, because sitting upright and standing are more likely to cause circulation problems.
A person with varicose veins might try putting their feet up at night, to improve circulation. However, a doctor may recommend wearing stockings at night as well.
Risks of compression stockings
Compression stockings may cause skin irritation if worn incorrectly or for too long.
Because compression stockings are intentionally tight, they can be difficult to put on. The legs should be clean and dry. Wait for any lotion to be absorbed before putting on stockings.
Using compression stockings can have side effects, including:
- broken skin
- skin irritation
- temporary dents in the skin
Stockings that are wrinkled, worn incorrectly, or the wrong size are more likely to cause problems.
When circulation is inhibited by a condition such as peripheral neuropathy, which can damage the nerves in the legs, a person may not be able to tell whether stockings are too tight or falling down.
A person is more likely to experience negative effects if they wear stockings for too long. Remove stockings every day and check the legs and feet for signs of damage or irritation, using a mirror if necessary. It may help to use a long-handled mirror or a mirror placed on the ground.
If new areas of irritation occur, contact a doctor.
Compression stockings may not eliminate varicose veins, but they may reduce associated pain and swelling.
Examine their legs daily for signs of irritation and damage, and replace compression stockings every 3 to 6 months. Keep the legs and stockings clean and dry to achieve the best results.