Written and medically reviewed by Mohamed T. Hassan, MD, DABVLM, RPVI, on November 8 2025
Imagine waking up in the middle of the night to find your bedsheets soaked in blood with no apparent reason why. That is precisely what happened to one of my patients, whom I’ll call Mrs. L. What caused this profuse bleeding? She accidentally opened a bulging varicose vein simply by stirring in her sleep. Despite wrapping towels around her leg, the bleeding wouldn’t stop, prompting her husband to call 911. Not wanting to “wait and see,” they raced to the emergency room while the blood continued to ooze through the makeshift dressing.
While this true story may sound dramatic (and it is), bleeding varicose veins are more common than many people realize. I want to use what happened in Mrs. L’s case to review which everyday activities can trigger vein bleeding and why tending to a bleeding varicose vein is urgent. I’ll also share five practical ways to care for a bleeding vein at home and advise you on when to seek medical help.
I’ll also discuss why seeing a vein specialist matters: because controlling the bleed is secondary to treating varicose veins and vein disease.
Spontaneous bleeding can be triggered by simple, everyday actions that increase pressure in weakened veins or injure fragile skin. Here are some of the most common situations that can cause a varicose vein to rupture or bleed unexpectedly.
🛑 Don’t wait for a bleeding episode to happen! Schedule an evaluation with a board-certified vein specialist at Center for Vein Restoration (CVR) to identify diseased veins early and prevent bleeding before it starts.
Leg swelling, heaviness, achiness, or visible varicose veins could put you at risk for a bleeding episode. Early care by a board-certified vein specialist is the best prevention.
Center for Vein Restoration (CVR) is the nation’s leader in vein care and largest physician-led vein center, with more than 120 locations and 80+ board-certified physicians who specialize in treating vein disease safely, effectively, and compassionately.
Call 240-249-8250 to speak with a Patient Services Representative or schedule your consultation online at a CVR near you today.
Varicose veins form when the small valves inside leg veins stop working properly. Instead of blood being pumped upward toward the heart, it pools in the legs. The veins enlarge and bulge under the skin.
Bleeding from varicose veins can occur after something as minor as shaving, bumping the leg, or even pressure during sleep. For older adults with fragile skin or those taking aspirin or anticoagulants, even a minor injury can lead to heavy bleeding. In Ms. L’s case, the bleeding incident was triggered by a minor scratch overnight on the skin covering a bulging vein.
In the 2022 British Journal of General Practice article Bleeding from Varicose Veins: Advice in Primary Care and Referral, the authors highlight the often-overlooked danger of bleeding varicose veins, especially among frail or isolated individuals. The authors emphasize that while most varicose veins covered by healthy skin pose little risk, veins beneath fragile skin, thin-walled “blebs,” or ulcers can rupture and bleed profusely, sometimes fatally, if not managed properly.
A study published in the National Library of Medicine (NIH) titled Management of bleeding varicose veins emphasizes two levels of response: immediate first aid (leg elevation, direct pressure, and firm compression without removing the dressing) and urgent medical management, including resuscitation if needed and rapid referral for duplex ultrasound and minimally invasive outpatient vein treatment options such as endovenous ablation or sclerotherapy.
The authors stress that both patients and non-vascular clinicians must recognize these bleeds as medical emergencies requiring prompt, specialized care to prevent recurrence or fatal outcomes, including:
1. Elevate the leg above heart level.
As soon as you notice the bleeding, raise the leg. Elevating the limb above the level of the heart reduces venous pressure and slows bleeding.
2. Apply firm, direct pressure over the bleeding site using a clean cloth or bandage.
Use a clean cloth or sterile gauze and press firmly over the site. Apply firm and continuous pressure! Do not repeatedly lift and check the dressing, as doing so may disrupt clot formation and worsen bleeding.
3. Avoid tempting to change the dressing repeatedly, even if it’s soaked.
While it is alarming to see blood soaking through towels or sheets (as happened with Mrs. L), removing or rewinding the dressing too often can break down early clot formation. Instead, maintain pressure and go to the next step.
4. Call emergency services or go to the ER promptly, even if the bleeding seems to stop.
Bleeding from a varicose vein may seem to stop, but beware: it can restart. Especially for patients who are on blood thinners, have fragile skin, or live far from an emergency department, the risk of re-bleeding or developing shock (lightheadedness, dizziness, paleness) is real. In Ms. L’s case, the sheets were soaked, and she needed urgent care.
In the emergency room, the care typically includes:
While these are lifesaving and critical steps, they do not fix the underlying venous valve failure or reflux that led to the bleed in the first place. That’s why, after ER care, patients remain at risk for another episode.
5. Schedule a follow-up with a vein specialist for definitive treatment.
Treating the immediate bleed is necessary—but doesn’t end when the bleeding stops. The underlying venous disease remains. As noted in peer-reviewed guidance per the NIH, once the bleeding has stopped, addressing the root cause is necessary to prevent recurrence.
Living with varicose veins means being proactive about your leg health, especially after a bleeding episode. These practical tips can help you stay safe, prevent complications, and know when it’s time to call for expert care.
You don’t have to accept aching, swollen, or bleeding veins as “just part of getting older.” Modern vein treatment is quick, comfortable, and life-changing. Whether you’ve experienced a bleeding incident or want to prevent one, our team can help you regain confidence and peace of mind.
Request your consultation today and take the first step toward healthier circulation and a healthier you.
📞 Call Center for Vein Restoration at 240-249-8250
📅 Or book online HERE
Bleeding varicose veins are more than just a surprise or a “one-time oops.” They signal a failure in the venous valve system and demand both immediate action and long-term correction. Early intervention can prevent repeated episodes, avoid complications, and help restore both leg comfort and mobility.
If you stop at treating only the bleed, you remain at risk for:
In short, the bleed is an urgent alarm. But the bigger issue is the diseased venous system. As I always tell my patients: stabilize the emergency, then fix the plumbing!
You don’t have to live in constant worry of what your sheets might reveal overnight when vein treatment is minimally invasive, effective, performed as an outpatient, and covered by insurance.
1. What should I do first if a varicose vein starts bleeding?
The first and most crucial step is to elevate your leg above your heart to reduce venous pressure, then apply firm, direct pressure over the bleeding site with a clean cloth or bandage. Maintain that pressure continuously—do not lift the dressing to check underneath—and call emergency services right away.
2. Why do varicose veins bleed so heavily?
When the small valves in the veins fail, pressure builds inside the leg veins, causing them to bulge and stretch beneath the skin. If that thin, weakened skin tears or is scratched, blood can spurt or flow rapidly because of the high venous pressure, especially if the leg remains below heart level.
3. Can I treat a bleeding varicose vein at home without going to the ER?
You can perform immediate first aid, including elevating the leg, applying pressure, and keeping the bandage in place, but these are temporary measures. Even if the bleeding stops, you must still seek medical evaluation, as untreated vein disease can lead to repeat episodes or serious complications like ulcers and infection.
4. How can I prevent varicose veins from bleeding again?
Preventing another episode means addressing the underlying venous disease, not just the surface wound. Modern, outpatient minimally invasive vein treatments performed by board-certified vein specialists at Center for Vein Restoration can permanently close faulty veins, improve circulation, and stop vein bleeding from recurring.
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