How to Control Bleeding Varicose and Spider Veins

How to Control Bleeding Varicose and Spider Veins

What Causes Veins to Bleed?

Contrary to popular belief, all spider and surface veins are not just cosmetic.

It’s a common misconception that if a vein doesn’t hurt, ache, or cause heaviness that it must be cosmetic and is not a medical problem.

Most people don’t know that varicose and spider veins can bleed. Some people have learned that if they scratch or bump a very superficial vein, massive external bleeding can result.

If you don’t understand the difference between a varicose and a spider vein, that’s OK.

Here is the link to understand the difference between varicose and spider veins. 

As the pressure builds up in abnormal veins, they are more liable to burst. This is especially true if the vein wall and the overlying skin is thin. These susceptible veins to bleeding often look like a “blue bleb”. They are often dark purple in color.

Only these dark blue or purple veins that are covered by a very thin layer of skin bleed spontaneously.

The most common scenario for this massive bleeding occurs in the shower.

Because the water is running, you cannot feel the blood dripping down the leg. The heat of the shower dilates the vein. That heat also increases the pressure inside the vein.

The shower water tends to soften the skin providing less of a barrier. The skin becomes softer or “pruny”- sort of like when tissue paper becomes less strong when it becomes wet.

Gravity increases the pressure in your leg veins. When you stand, the pressure increases in your varicose and spider veins.

How Does Increased Pressure Increase the Chance of Bleeding?

The venous pressure becomes higher near the ankle than above the knee. That is why most bleeding from veins occurs closer to the foot rather than in the thigh.

Pressure in the veins at this level can approach 100 mm Hg. That is close to the blood pressure in your arteries.

Blood should flow in only one direction – toward your heart. There are one-way valves inside of your veins that prevent blood from backing up in the wrong direction – toward your feet.

The surprise occurs when you look down on the floor of the shower. It looks like a massacre has occurred.

This can be frightening. The blood that comes from these types of veins often squirts because of the high pressure inside of the vein. It doesn’t usually just drip like a bloody nose.

Here is a video taken of an actively bleeding leg vein as seen on the television show, The Doctors.

This video is not for the faint of heart and can be disturbing for some to watch.

If the bleeding from a broken vein occurs under the surface, a bruise or a hematoma is the result. A hematoma is just a larger collection of blood under the skin that will be lumpy and sore to the touch.

First Aid Treatment of Bleeding Veins

  1. First aid starts with point pressure with a finger applied directly on top of the site of the bleeding. Elevation at the same time is extremely important. Do not stand or sit while you are applying finger pressure.
  2. Do not apply a towel to the bleeding areas. That will just absorb the blood and result in a larger blood loss.
  3. Do not start walking until the bleeding stops.
  4. Do not apply a tourniquet. A tourniquet will make the bleeding from a vein worse. Tourniquets may be useful in some cases of arterial bleeding – not venous bleeding.
  5. Call 911 if the bleeding does not stop after applying finger pressure and elevation the leg for thirty minutes. Most of the time, the bleeding will stop with these tips sooner than this.
  6. Occasionally, if you need to go to an emergency room, a doctor will stitch or glue the area. This is rarely necessary.
  7. Apply a pressure bandage like an ace bandage after the bleeding stops.
  8. If you are on blood thinners, call your doctor.
  9. A scab usually occurs on the spot of bleeding. Do not disturb the scab.
  10. Avoid any friction on the scab by protecting it from rubbing on your clothing.
  11. Avoid standing or sitting for prolonged periods until you can see a vein specialist.
  12. Seek help from a qualified and experienced vein specialist.

Long Term Treatment of Bleeding Veins

A vein specialist will perform a Doppler ultrasound test to determine the source of the pressure in the underlying veins.

Determining the underlying cause of the vein that bled is the first step in designing a customized plan for treatment.

The pressure in other feeding veins may need to be treated in addition to the one vein that has bled.

The reason that the underlying veins may need attention is that other nearby dark surface veins may also bleed in the future. Options for treatment of these veins include:

  1. Endovenous laser or radiofrequency treatment of the saphenous vein
  2. Sclerotherapy
  3. Phlebectomy

Can You Die from a Bleeding Vein?

Yes. That’s scary, but ruthlessly honest.

However, fortunately this is rare. Even small veins only a few millimeters in size can bleed massively and can result in a mortality. Often death from varicose vein bleeding occurs when a person has an underlying medical condition or bleeding disorder. Death could be avoided by applying the first aid treatment described above.

In some of the cases where the person died from the bleeding, an underlying ulcer eroded into the vein causing it to bleed. At least sixty six in the United Kingdom have died from bleeding varicose veins. The youngest was twenty nine years old.

In some cases, the person had limited mobility and could not elevate the leg with the bleeding vein.


If a varicose or spider vein bleeds, elevate the leg, apply point pressure until it stops and apply a pressure dressing (like an ace bandage.)

Seek medical attention as soon as possible.

Seek out a vascular specialist.

A board certified vascular surgeon who specializes in the treatment of veins is your best bet.

The qualifications, training, experience and specialization of the treating physician is most important to help you prevent future episodes of bleeding form varicose and spider veins of the legs, ankles and feet.

A vascular surgeon can diagnose and treat the underlying cause to prevent bleeding in the future.

At Happel Laser & Vein Centre, we bring the innovative latest vein treatments to the people of our community.

Call us at 724-969-0600 or click here to learn more.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.