Socks leave marks on legs: Causes and treatment

Socks can leave marks on a person’s legs when the elastic bands that hold the socks in place put pressure on the skin. Pressure marks are generally more noticeable when a person has peripheral edema, or swelling, in the lower legs.

The swelling may be mild and go away on its own, or it may be due to an underlying medical condition and be more persistent.

In this article, we discuss what can cause socks to leave marks on the legs and explain when a person should contact a doctor.

Socks leaving marks on the legs is common, and most of the time, it is not a sign of an underlying health condition.

Socks marks can occur as a result of peripheral edema. Edema is swelling that occurs in the body. Peripheral refers to swelling that happens in the outer extremities, such as the legs and arms.

According to a 2016 article, benign factors — such as pregnancy, standing for long periods, or flying on an airplane — may cause temporary peripheral edema. However, it can sometimes be a sign of a medical condition, such as heart failure, trauma, renal failure, or liver failure.

Sock marks can appear on the legs due to a variety of causes, which range in severity.

Water retention

Water retention can cause a person’s socks to leave marks on their legs.

Swelling that is the result of water retention is generally benign. It can cause general puffiness or swelling in the hands, feet, or face.

This symptom can occur when a person has been standing or sitting for too long. It can also happen during menstruation.

A person does not typically need to seek treatment for water retention because it will go away on its own.

Learn more about water retention here.

During pregnancy

The Office on Women’s Health note that while some swelling is common in pregnancy, it can sometimes be a sign of preeclampsia. Preeclampsia is a condition that causes high blood pressure during pregnancy and after a person has given birth.

A person who is pregnant and experiencing swelling should talk with their doctor.

Learn more about preeclampsia here.

Venous insufficiency

This condition can cause swelling in the feet and ankles.

Venous insufficiency means that the veins have difficulty transporting the blood to the feet and back to the heart. As a result, the blood collects in the legs, forcing fluid out of the blood vessels and into the surrounding tissues.

Venous insufficiency is the most common cause of peripheral edema in those over the age of 50 years.

Learn more about venous insufficiency here.

Varicose veins

Varicose veins are veins that are swollen and enlarged. They typically occur on the feet and legs.

According to the United Kingdom’s National Health Service (NHS), other symptoms include:

• swollen ankles and feet
• burning and throbbing in the legs
• legs that ache or feel heavy
• muscle cramps in the legs, especially during sleep
• dry and itchy skin over the vein

Learn more about varicose veins here.

Congestive heart failure

Congestive heart failure is a condition in which the heart is unable to pump blood around the body properly.

As a result, the blood flow out of the heart slows down, and blood accumulates in the veins. This buildup causes fluid to seep into the surrounding tissue, which causes swelling.

The swelling can affect the legs and abdomen.

Other symptoms include:

• shortness of breath
• fatigue
• swollen legs and ankles

Learn more about congestive heart failure here.

Kidney disease

The National Kidney Foundation note that more than 37 million people in the United States have kidney disease, with many of them being unaware.

Kidney disease can cause a person to experience swelling in the legs and around the eyes.

This swelling occurs because the kidneys are unable to remove sodium and water from the body effectively.

Learn more about chronic kidney disease here.

Liver disease

Cirrhosis is the term for scarring of the liver. It can occur as a result of various liver conditions.

The National Institute of Diabetes and Digestive and Kidney Diseases note that many people may not be aware that they have cirrhosis. The reason for this is that they may not experience symptoms until the liver is badly damaged.

Those who do have early symptoms may experience:

• fatigue
• weakness
• low appetite
• unexplained weight loss
• nausea
• vomiting
• mild discomfort or pain in the upper right side of the abdomen

As liver function worsens, a person can experience swelling in the lower legs, ankles, and feet.

Learn more about cirrhosis here.

Lung conditions

Lung conditions, such as chronic obstructive pulmonary disease (COPD), can cause a person to experience swelling in the legs and feet. This symptom can occur when the pressure in the lungs and heart becomes very high.

However, the NHS note that this is a less common symptom and that it can be a sign that COPD has reached an advanced stage.

Learn more about COPD here.

Lymphedema

Lymphedema is a chronic condition that occurs when the lymphatic system becomes damaged. Healthcare professionals can recognize the condition due to the collection of lymphatic fluid in the body.

Swelling can occur anywhere, but it mostly affects the:

• legs
• arms
• genitals
• face
• neck
• oral cavity
• chest wall

Learn more about lymphedema here.

If a person has developed sock marks on the legs due to water retention, they can try the following:

• lying down or sleeping with the feet raised on a pillow
• massaging the feet, ankles, or legs
• engaging in gentle exercise
• avoiding wearing tight socks, shoes, or clothes
• wearing compression stockings

When peripheral edema is the result of an underlying medical condition, a person will need to work with a doctor to treat the condition.

Diuretics can treat some of the conditions responsible for edema, such as congestive heart failure, kidney disease, and liver disease.

Specific therapies will vary depending on the condition affecting a person and their age and overall health.

When socks leave a mark on the legs, this may not be a sign of any major medical condition. It can sometimes occur due to standing for long periods, pregnancy, or flying in an airplane.

However, persistent or frequent swelling may be a sign of an underlying condition.

A person should speak with a doctor if swelling in the feet, hands, or other areas of the body occurs regularly.

They should also seek medical advice if other symptoms accompany the swelling, such as high blood pressure or blurry vision.

A doctor can determine the cause of the swelling and recommend a suitable treatment plan.

A person can take steps to help prevent or lessen the effects of edema in the legs and ankles.

These steps include:

• limiting sodium in the diet
• raising the feet on a stool
• avoiding tight-fitting clothing
• exercising regularly, if a doctor advises this
• taking medications according to the label or prescription

When socks leave an indentation, it is typically the result of peripheral edema. Several benign causes are possible, such as standing for long periods.

However, edema can sometimes result from an underlying health condition, such as renal or heart failure.

Anyone who experiences frequent or persistent swelling in their legs, hands, or face should speak with a doctor.

The treatment options will depend on the cause, but they may include diuretics and compression therapies. A person can take steps to reduce the risk of swelling, such as reducing sodium in their diet, keeping their feet up, and adhering to treatments for other conditions.

Causes, Diagnosis & Treatment for Sock Marks on Legs

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Sock marks on your legs are very common. Most socks contain elastic to keep them from slipping down. Pressure from the elastic leaves a mark.

The marks may be more noticeable if the soft tissue in your legs is swollen with fluid. This is called peripheral edema.

Most of the time, peripheral edema develops because you’re retaining fluid. Often the swelling is mild, goes away on its own, and isn’t associated with other symptoms.

Sometimes peripheral edema is more severe, however. This may indicate it’s caused by an underlying medical condition. When it is, there are usually other symptoms, and the edema doesn’t improve without treatment.

When peripheral edema is more serious

When other symptoms occur with peripheral edema, you might have a serious medical condition that requires urgent medical attention. Worrisome symptoms and their possible causes include:

• chest pain: heart failure
• dizziness or fainting: heart failure
• shortness of breath, especially when lying flat: heart failure
• swelling in only one leg: deep venous thrombosis (DVT), caused by a blood clot in a vein, or cellulitis
• sudden onset of painful swelling in your calf: DVT
• little urine production: kidney disease
• abdominal swelling: liver disease
• abdominal pain: tumor
• sudden high blood pressure during pregnancy: preeclampsia

Peripheral edema that’s moderate to severe, getting worse, or doesn’t improve with rest is more serious. It should be evaluated by your doctor, especially if you have other symptoms or a history of heart, liver, or kidney disease.

Peripheral edema is divided into two types based on what happens when you press on the swollen area:

• pitting edema, in which a dimple or “pit” persists when you stop pressing
• nonpitting edema, in which the dimple immediately disappears when you stop pressing

Sock marks are more likely if you have pitting edema.

Other symptoms of peripheral edema include:

• tight, shiny skin
• redness
• fluid oozing from the skin (if severe)

Most often, peripheral edema is the result of fluid retention rather than an underlying condition. The swelling is usually mild and temporary.

Dependent edema

When you stand or sit for long periods throughout the day, gravity pulls blood into your legs. The increased pressure pushes fluid from the blood vessel into the soft tissue, causing mild swelling.

Swelling related to gravity is called dependent edema. It’s more pronounced at the end of the day, which is why sock marks are typically worse in the evening. They are usually gone by morning.

Salt

Eating lots of salt makes your body retain water. This leads to peripheral edema, which may cause more noticeable sock marks the next evening.

Hormonal changes

Hormone levels change throughout a woman’s menstrual cycle. This can cause water retention and leg swelling the week before menstruation.

Pregnancy

As it enlarges, a pregnant woman’s uterus can push on the blood vessels leading to her legs. This slows the movement of blood from her legs up to her heart, which can lead to peripheral edema.

Most pregnant women get peripheral edema, but it can also be a sign of a serious condition called preeclampsia. Other symptoms are the sudden onset of high blood pressure and protein in your urine (proteinuria). It requires urgent medical attention.

Heat edema

Peripheral edema often occurs in hot weather. Heat causes your blood vessels to open wider, so more blood pools in your legs. If fluid leaks into the tissue, edema develops.

Obesity

Being obese can cause excess fat in your abdomen and pelvis to push on blood vessels, slowing blood flow out of your legs. It accumulates in your leg veins, and the increased pressure pushes fluid into the soft tissue.

Peripheral edema caused by an underlying medical condition is generally more severe and doesn’t go away without treatment.

Venous insufficiency

One-way valves in your veins keep blood from backing up into your legs instead of moving toward your heart.

These valves can get weak and start to fail with age. Blood then backs up in your leg veins and leads to peripheral edema. This condition is called venous insufficiency. It can make your legs cramp or ache.

Congestive heart failure

Congestive heart failure develops because your heart is weak or damaged and can’t pump blood efficiently. Blood and fluid back up into your legs and sometimes your lungs (pulmonary edema).

Other symptoms include rapid weight gain and shortness of breath.

Kidney disease

With kidney failure, your body can’t remove enough fluid, so it builds up in your tissues — especially your legs. Swelling around your eyes (periorbital edema) is also common.

Liver disease

Diseases like hepatitis and alcoholism can scar your liver (cirrhosis), making it harder for blood to pass through this organ.

As a result, blood backs up into your lower body, and fluid accumulates in your abdomen (ascites) and legs. You may also develop yellow eyes and skin (jaundice).

Malnutrition

The blood level of a protein called albumin is low when you’re malnourished. Albumin helps keep fluid in your blood vessels. Without it, fluid leaks into the soft tissue.

Certain medications

Some medications can cause peripheral edema, including drugs for:

• contraception: estrogen-containing birth control pills
• diabetes: rosiglitazone (Avandia), pioglitazone (Actos)
• high blood pressure: calcium channel blockers, such as amlodipine (Norvasc) and nifedipine (Adalat CC, Afeditab CR, and Procardia XL)
• inflammation: nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil)
• Parkinson’s disease: pramipexole (Mirapex)
• seizures: gabapentin (Neurontin)

Peripheral edema in only one leg is never normal and requires urgent medical attention. Causes include:

DVT

A blood clot in your leg vein is called a deep vein thrombosis, or DVT. It causes sudden pain and swelling, usually in your calf.

Without prompt treatment, the clot can break off and travel to your lungs. This is called a pulmonary embolism and can be life-threatening.

Cellulitis

Infected skin or soft tissue (cellulitis) is usually swollen. It may also be red, warm, and tender. Prompt treatment is necessary to prevent the infection from spreading to your bloodstream or bone.

Lymphedema

Lymph, fluid containing white blood cells, flows through your lymph nodes and special channels throughout your body.

Lymphedema develops when a tumor or other mass pushes on and blocks lymph channels, or when lymph nodes are surgically removed or damaged by radiation therapy. Your leg swells when the nodes or channels in your pelvis are involved.

Your health history and a physical exam will give your doctor clues about the cause of your leg swelling, but tests are often needed for the diagnosis.

The test is chosen based on the organ being evaluated.

• blood tests, which evaluate the function of most organs, including your heart, liver and kidneys, and albumin level
• urinalysis, which assesses kidney function
• chest X-ray, an imaging test that assesses your lungs and heart
• electrocardiogram, another test to evaluate your heart’s function
• echocardiogram, an imaging test that helps your doctor assess your heart
• ultrasound, an imaging test to help diagnose DVT and abdominal mass (ascites)
• abdominal CT, an imaging test that helps your doctor check for an abdominal mass

There are general things you can do to help reduce mild peripheral edema. You can also try these alongside specific treatment for the medical condition causing your edema.

Ways to reduce the swelling

• Reduce your salt intake.
• Lose weight.
• Elevate your feet above the level of your heart while sitting or lying down so that gravity pushes the fluid out of your legs instead of into them.
• Take frequent breaks and elevate your legs whenever possible if you’re standing or sitting for a long time.
• Wear compression stockings to apply pressure that keeps fluid out of your legs. Shop for nonprescription compression stockings online.
• Exercise your calf muscles. Contractions help push blood through your veins so it can’t pool in your leg and move into the soft tissue.

Diuretics

Diuretics (water pills) remove excess fluid from your body. They’re only used when peripheral edema is caused by an underlying condition.

Treatments for specific underlying causes

Treatments may depend on what’s causing peripheral edema. Here are some of the possible treatment options for specific causes of peripheral edema:

• venous insufficiency: compression stockings, removing the vein (vein stripping), or surgical repair
• congestive heart failure: diuretics or medications that help your heart work more efficiently
• kidney disease: medications that increase urine production, dialysis, or a kidney transplant
• liver disease: antiviral medication for hepatitis, limiting alcohol, or a liver transplant
• malnutrition: a nutritious diet that contains an adequate amount of protein
• lymphedema: compression stockings or lymphatic drainage massage
• DVT: blood-thinning medication
• cellulitis: antibiotics

Sock marks themselves aren’t harmful, but very noticeable ones could mean you have peripheral edema.

The outlook of peripheral edema depends on the cause. Temporary edema that’s mild and doesn’t occur with other symptoms shouldn’t be worrisome.

Peripheral edema that’s more severe and persistent may be due to a serious medical condition. The outlook depends on the cause, but it improves with prompt diagnosis and treatment.

Sock marks are caused by pressure from the elastic in them. Peripheral edema can make sock marks more noticeable.

Most often, peripheral edema develops when excess fluid in your body is pulled into your legs by gravity. The edema is usually mild, temporary, and harmless.

However, peripheral edema can be a symptom of an underlying medical condition. If so, the edema is more severe and persistent, and there are usually other symptoms.

If your sock marks are more noticeable, look at your legs. If there’s new or increased swelling or pitting edema, see your doctor right away. You may have a medical condition that requires prompt treatment.

Swollen feet: the doctor explained how to distinguish harmless edema from dangerous

• Health

If it is difficult to get into your favorite shoes in the morning or there are marks from socks on your feet in the evening, this indicates swelling of the legs. In most cases, this is not dangerous, but swelling of the legs can be a sign of illness.

August 8, 2022

Source:

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Edema is the exit of part of the fluid from the vessels with its accumulation in the intercellular space. Most often, this problem occurs in hot weather or against the background of poor nutrition, excessive consumption of salt or water, inactivity, prolonged sitting or standing. In women, due to hormonal influences, swelling in the legs occurs more often. Often, swelling occurs before menstruation, during menopause or in the presence of varicose veins.

Often, apart from external manifestations, there are no special complaints. But if the swelling is severe enough, the legs literally swell, there may be aches and pains, discomfort when wearing shoes, fatigue and other serious symptoms. “Doctor Peter” asked Olga Poltoratskaya, a therapist at the CMD Center for Molecular Diagnostics of the Central Research Institute of Epidemiology of Rospotrebnadzor, how to remove swelling in the legs.

What types of edema can be removed on your own?

You can independently remove physiological edema that appeared as a result of exposure to adverse factors:

• Hot weather.

• Excessive consumption of salty foods, especially at night.

• Drinking alcohol.

• Prolonged sitting (especially with crossed legs) or standing, blood stagnation occurs in the veins, this leads to edema.

• Uncomfortable shoes, there is a violation of blood circulation in the foot.

• Premenstrual syndrome in women due to hormonal imbalance, an increase in estrogen – hormones that retain fluid in the body.

When these factors are eliminated, the blood flow will be restored and the swelling will go away on its own.

And if you sit for a long time?

Yes, as a result of sedentary work, stagnation of blood in the veins occurs, circulation is disturbed, as a result of which edema may appear. For prevention, you need to do gymnastics for the legs during the day, for example, rise on the toes 50 times twice a day, if possible, give the limb an elevated position for 5-10 minutes.

Read also

If the legs are swollen and do not fit into shoes

If the legs are swollen so that they do not fit into shoes, is this a reason to worry and take serious measures? The expert believes that this is certainly a reason to go to the doctor to find out the cause of edema. If this is a physiological edema, it is not very pronounced and does not disturb the usual life. If the legs swell very much, it is worth discussing the problem with a doctor.

When do you need to urgently go to the doctor?

If there is severe pain in the leg, it is swollen, has acquired a purple-bluish tint, there is a clear asymmetry compared to a healthy limb, this is a signal for urgent medical attention, since all this may be a manifestation of acute thrombosis.

Read also

Why legs swell – the most common causes

The most common cause of swelling of the lower extremities is chronic venous insufficiency. Legs can also swell in chronic heart failure, which is a consequence of any heart disease, for example, coronary heart disease with a previous myocardial infarction, heart defects; cardiomyopathy.

One of the mechanisms of pathogenesis (development of the disease) in heart failure is considered to be the activation of the mineralocorticoid hormone aldosterone, which increases the ability of body tissues to retain water, and it enters the tissues from the vascular bed. The appearance of edema of the lower extremities indicates a serious violation of cardiac activity. In this case, treatment and examination by a cardiologist is required. In more severe cases, in the later stages, hospitalization is necessary.

Read also

How to understand that edema is due to diseased kidneys

The appearance of edema is possible in the presence of chronic kidney disease, nephrotic syndrome. Nephrotic (renal) edema is loose, easily moved and leaves a hole when pressed with a finger. Most often localized on the face, less often on the arms, legs, torso. There may be moderate to severe anasarcas with dropsy cavities: ascites – fluid in the abdominal cavity, hydrothorax – fluid in the pleural cavity.

The cause of such edema is proteinuria – protein loss as a result of impaired filtration and reabsorption processes, a decrease in oncotic (intracellular) pressure, an increase in aldosterone secretion, an increase in sodium reabsorption, fluid retention and the appearance of edema.

See also

Maybe it’s varicose veins?

It depends on a person’s attitude to their health, compliance – the degree of implementation of medical recommendations. In case of varicose veins of the lower extremities diagnosed by a phlebologist or a vascular surgeon, observation by a specialist and the implementation of his recommendations are required – wearing compression underwear, course taking angioprotectors; blood coagulation study. If you follow the doctor’s recommendations, you can significantly reduce the risk of developing thrombosis.

Which doctor to go to with edema

If edema occurs, you should contact a general practitioner. The doctor will determine the exact cause of their occurrence and prescribe the necessary examination, refer to a narrow specialist – a phlebologist, cardiologist or nephrologist. Phlebological Center “Antireflux” However, some people calm themselves for a long time with the so-called physiological factors that supposedly affect swelling – and postpone the visit to the doctor until the last. Among the most popular excuses are the following:

“I just spent a lot of time on my feet” ,

“These shoes are too tight for me” ,

“It’s crazy hot outside”,

“The day before I drank too much liquid and in addition, I ate salted bream” …

In fairness, we note that sometimes edema is really caused by prolonged static load, which provokes venous congestion – and it, in turn, causes fluid retention in the tissues. However, if edema recurs regularly, then it is in your interest to find out their real origin as soon as possible.

In this case, the prerequisite for the development of edema, most likely, is quite serious pathologies of the body , both local and systemic.

Please note that even if the puffiness subsides in the morning, this is not a reason to relax and postpone a visit to the doctor. With varicose disease swelling of the ankles and legs is more pronounced in the evening – and by morning it usually does not happen.

Also swelling of the legs, which increases in the evening, characteristic of acute or chronic thrombosis, or thrombophlebitis – and these dangerous conditions already require emergency medical assistance.

• About the pathologies of the cardiovascular system
• About diseases of the genitourinary system
• About diseases of the thyroid gland and some other endocrine disorders (in particular, about diabetes)
• About liver cirrhosis
• About disorders of the functions of the lymphatic system (lymphedema)

Lymphedema is the second most common vascular cause of leg swelling after varicose veins. Below we will tell you how to distinguish swelling caused by lymphedema from varicose edema.

• Features of edema in varicose veins
• Edema develops gradually. The development of sudden pronounced swelling is rare
• Even a not too tight sock band leaves a deep mark on the leg
• Edema is evenly distributed over the lower leg and foot of one leg, but at the same time, it appears asymmetrically on both legs (swelling on one leg is usually more pronounced)
• Edema may be accompanied by pigmentation of the skin of the affected limbs
• The more the varicose veins progress, the more the leg swells: often with “neglected” varicose veins, edema is accompanied by visible varicose veins and pulling pain in the calf muscle
• Edema subsides after the person assumes a horizontal position. A temporary improvement in a person’s condition creates an illusion in a person that the whole situation is not serious – and he postpones a visit to the doctor until the last minute

• Features of edema in lymphedema
• The first phalanges of the toes swell quite pronouncedly
• Swelling evenly distributed over the top of the foot and ankle
• The foot noticeably swells: visually and tactilely, it resembles a pillow
• At the initial stage of the disease, the edema subsides overnight – and by morning the person practically does not feel discomfort. However, in the evening, he again hardly takes off his shoes after returning from work. If during this period the puffiness is attributed to the heat on the street, uncomfortable shoes and other physiological factors, then lymphostasis will progress – and soon it will become difficult for a person to move in any shoes
• On palpation of the edematous area, a person feels pain
• In the case of progression of edema and the development of lymphostasis, the skin of the affected limb becomes thinner and changes color. There is a risk of developing trophic ulcers – long-term non-healing purulent-necrotic processes

Edema with varicose veins

Edema with lymphedema

Next, we briefly list the characteristic features of edema in other diseases:

But, since the most common cause of edema is varicose veins, it is advisable to start the examination of with a phlebologist. The phlebologist will take an anamnesis, perform an ultrasound angioscanning of the vessels of the lower extremities and prescribe the optimal treatment regimen.

If necessary, the phlebologist will refer you to other doctors. In particular, you may need to consult a lymphologist.

The convenience of the ANTIREFLUX Phlebological Center lies in the fact that both phlebologists and lymphologists are received within its walls – that is, the patient literally in one day undergoes a comprehensive examination of the vessels of the lower extremities and finds out the true cause of his condition.

To do this, he does not have to run to different clinics and offices, take “numbers” according to the old Soviet system, stand in long queues, aggravating the condition of his already sore legs … In a word, waste his time and nerves.

Leading specialists of the specialized clinic ANTIREFLUX previously formed the “backbone” of the Phlebological Center of the NMHC named after.