Compression stockings are among the most widely used treatments for vein problems, and for most people they are safe. Still, they are not risk-free. Knowing the possible side effects of wearing compression stockings, and the situations in which they are not suitable, helps you use them confidently and spot problems early.
This guide covers the common and rare problems, who should be cautious, and how to reduce the chance of trouble. For what stockings are and how they work, see our compression stockings guide.
Are compression stockings safe?
Medical compression has been used for decades for varicose veins, leg swelling, venous ulcers and after vein procedures. Guidelines such as NICE CG168 and the ESVS 2022 chronic venous disease guideline discuss it as a standard option for symptom relief. Safety depends mainly on three things: the right size, the right strength and a suitable reason to wear them.
Common side effects
Skin dryness, itching and irritation
Elastic fabric can dry the skin, and sweat trapped under tight material can cause itching or a heat rash. This is the most frequent complaint, particularly in warm and humid climates like Singapore and the surrounding region. Moisturising at night, wearing a thin liner or changing to a different fabric may help.
Allergic or contact reactions
Some people react to latex, dyes, adhesives on silicone bands or detergent residue. This can cause redness, blisters or a rash where the fabric touches the skin. The NHS describes the signs of contact dermatitis. If you develop a rash, stop wearing the stockings and ask a pharmacist or doctor about alternative materials.
Discomfort, tightness and heat
Compression feels firm by design, and it can take a few days to get used to it. Mild tightness is expected. Pain, throbbing or numbness is not. Warm weather can make stockings feel hot. Lighter fabrics and breathable knits may help.
Difficulty putting them on and taking them off
Firm stockings are hard to put on, especially for people with arthritis, limited strength or limited mobility. Struggling with them can lead to skin tears from nails or rings, or to stockings being worn badly. Donning aids, gloves or help from a family member can solve this. If it is not manageable, tell your clinician, since other options exist.
Problems caused by poor fit or incorrect use
Rolling or bunching at the top band
If a stocking is too long, too loose or folded over, the top band can roll into a thick ring that acts like a tight band around the leg. This can restrict flow and leave deep grooves. Smooth the stocking up, never fold it over, and replace it if it keeps rolling.
Pressure marks and skin damage
Stockings that are too small or have wrinkles can leave red or dented lines. Prolonged pressure on thin or fragile skin can lead to blisters, sores or skin breakdown, especially over the heel, ankle bones and shin. Check your skin daily.
Nerve compression
Rarely, very tight stockings or a band that cuts in behind the knee or at the top of the calf may press on a nerve. Warning signs are tingling, pins and needles or numbness in the foot or leg.
Swelling at the foot or top of the leg
A stocking that is correct at the ankle but wrong higher up, or a sock that does not cover the foot, may leave swelling in the uncovered area. A better-fitting product or a different length may be needed.
Worn-out stockings
Elastic loses its strength over time. Old stockings may feel looser and give less support, so symptoms creep back. Replace them according to the manufacturer’s guidance.
Who should not wear compression stockings?
Some people should get medical advice before using compression, and a few should avoid it. If you fall into one of these groups, check with a doctor first rather than buying stockings over the counter.
- Peripheral arterial disease (PAD). If blood supply to the legs is reduced, compression can reduce flow further and cause damage. Signs of PAD include leg pain on walking that eases with rest, cold or pale feet, hair loss on the legs and slow-healing sores. The NHS has more on peripheral arterial disease. A doctor may check pulses or measure blood pressure in the ankles before recommending compression.
- Severe heart failure. Squeezing fluid back into the circulation may overload a weak heart in some people.
- Fragile skin, infection or open wounds without clinical guidance. Ulcers are sometimes treated with specialist compression, which should be applied by trained staff.
- Diabetes with nerve damage and reduced feeling in the feet. You may not notice pressure damage.
- Known allergy to latex, rubber or fabric components.
- Severe leg deformity or very large leg sizes that make standard sizes unsuitable.
- Recent or suspected blood clot in the leg. This needs urgent assessment first, and any decision about compression is made by your doctor. See deep vein thrombosis from the NHS for symptoms.
If you are pregnant, stockings are often used to ease swelling and heaviness, but ask your midwife or doctor about the right type.
How to reduce your risk of side effects
- Get measured properly. Do not guess sizes. Measure in the morning when swelling is least.
- Match strength to the reason. Lighter levels suit tired legs and travel. Firmer levels should be recommended by a clinician.
- Put them on correctly. Smooth out wrinkles, keep the band flat and avoid folding down.
- Check your skin every day. Look at the heels, ankle bones, toes and the area behind the knee.
- Moisturise at night, not just before wearing.
- Wash and replace as directed.
- Start gradually if you are new to compression, perhaps wearing them for a few hours at first.
- Take them off at bedtime unless advised otherwise.
For choosing stockings for a particular problem, see compression stockings for leg swelling and compression socks for varicose veins.
Do the benefits outweigh the risks?
For most people with symptomatic varicose veins or venous swelling, the benefit is relief of aching and swelling, and the risk of serious problems is low when stockings fit well. Compression does not fix faulty valves, though. If symptoms continue or you want a longer-term solution, other options exist, compared in varicose vein treatments compared. And if you cannot tolerate stockings, you have other ways to ease symptoms, such as walking, leg elevation and treatment of the veins themselves.
When to see a doctor
Take the stockings off and seek medical advice if you notice:
- numbness, tingling or pins and needles in the foot or leg
- skin turning pale, blue, dusky or very cold
- severe or increasing pain while wearing them
- blisters, sores, skin breaks or signs of infection such as spreading redness, warmth or discharge
- a rash that does not settle
- swelling that gets worse rather than better
- pain, swelling and warmth in one leg that comes on suddenly
Call 995 immediately if you have sudden chest pain, sudden breathlessness or you cough up blood, particularly if one leg is swollen and painful, as these can signal a blood clot that has travelled to the lungs. For help sorting out your symptoms, try our vein symptom check or learn how to find a vein specialist.
Frequently asked questions
Are compression stockings safe to wear every day?
For most people, yes, when they fit well and suit the condition being treated. Check your skin daily, replace worn stockings and ask your doctor or pharmacist if you are unsure.
Can compression stockings make swelling worse?
They can if they are the wrong size, or if a band rolls down and acts like a tight tourniquet. Swelling that worsens may also mean the cause is something other than veins. Stop and get advice.
Can compression stockings cause blood clots?
Properly fitted stockings are not known to cause clots, and are used to help reduce symptoms in venous disease. Incorrectly worn stockings that bunch up may restrict flow, so fit and care matter. A new swollen, painful leg needs urgent assessment whether or not you wear stockings.
Can I sleep in compression stockings?
Usually not, unless your doctor has told you to. Most daytime stockings are designed to be worn while upright.
Who should not wear compression stockings?
People with significant peripheral arterial disease, some with severe heart failure, fragile or infected leg skin, or an allergy to the material should get medical advice first. See the full list below.
Sources and further reading
This article is general information, not personal medical advice. Please speak to a doctor about your own symptoms. How we create our content.
