There’s a long-held association of “support hose” with grandmothers, but in reality, these snug-fitting garments can help you manage skin concerns and take a proactive step towards overall leg health, from preventing tired legs if you’re on your feet all day to keeping varicose veins under control. 

Today, we’re covering the basics of compression hosiery, including how they work, what conditions they can help treat, and how to choose the perfect pair. 

How Does Compression Hosiery Work?

Compression hosiery is precisely what it sounds like– socks, stockings, and pantyhose designed to give your legs a gentle but targeted squeeze to promote better blood flow and reduce swelling.

It can be difficult for our veins to pump oxygen-depleted blood all the way back up our legs and to our heart, resulting in backups that result in painful, swollen limbs. Because compression hosiery consists of a particular ratio of elastic and fabric, they have a pressure gradient that’s tightest at the ankles and gradually decreases up the leg, which supports the natural upward flow of blood back to your heart. 

They’re the ideal non-invasive solution for anyone looking for help easing achy legs, including frequent flyers, athletes, people with jobs requiring being on your feet all day, or anyone with circulation issues. 

The Dermatological Benefits of Compression Hosiery

While most people think of compression hosiery as a circulation treatment, it can also prevent skin issues that might arise from poor blood flow. Good circulation contributes to healthy, glowing skin by delivering oxygen- and nutrient-rich blood to your cells and removing waste materials. 

General Swelling

Many different conditions can cause edema (swelling) in the legs– pregnancy, being overweight, sitting too much, staying on your feet too long, diabetes, and even eating too much sodium! Mild to moderate compression socks are ideal for daily use, keeping edema at bay and reducing chronic strain on overstretched skin. 

Varicose Veins

Varicose veins are swollen, damaged blood vessels in the legs and feet. With increasing age, the efficiency of the vein valves, which are responsible for maintaining unidirectional blood flow, decreases, leading to poor circulation and blood accumulation in the veins, resulting in their dilation and varicosity.

Age, genetics, occupation, and lifestyle all contribute to the formation of varicose veins. Pregnancy increases blood volume but decreases blood flow from the legs to the pelvis, which can form spider veins. Obesity puts additional pressure on the veins, and occupations requiring extended periods of standing or sitting can exacerbate vein pressure, all of which can contribute to the development of spider veins.

Chronic Insufficiency

One of the most common uses of compression hosiery is managing stasisdermatis, a common side effect of chronic insufficiency, in which blood doesn’t flow back up to the heart as efficiently as it should. One symptom is itchy, flaky skin, which can lead to skin thickening and discoloring. Left untreated, it can escalate into slow-healing ulcers, particularly around the ankles. 

Lymphedema

Compression hosiery can help with lymphedema or swelling that occurs due to a blockage in the lymphatic system. They apply pressure to the affected area and encourage the lymphatic fluid to drain properly, reducing the swelling. 

Deep Vein Thrombosis

Frequent travelers and surgical patients can be at particular risk for deep vein thrombosis (DVT), a blood clot that forms in one of the leg’s deep veins. It can cause pain, swelling, and, if the clot travels to the lungs, potentially life-threatening complications. If you’re at risk of DVT, compression hosiery encourages blood flow and reduces the likelihood of clot formation. 

Complications of DVT can also manifest on your skin as inflammation and, if left untreated, can lead to post-thrombotic syndrome, leading to chronic swelling, hyperpigmentation, eczema, and ulcers due to damaged valves in the veins. 

Choosing the Right Compression Hosiery

If you want to reap the maximum benefits from your compression hosiery, it has to fit well and apply the proper pressure. Hosiery that is too large won’t squeeze tightly enough to address the issues, while hosiery that is too small will be incredibly uncomfortable and, in some cases, further prevent efficient circulation. 

Compression Levels

Compression hosiery is categorized by the pressure it exerts, measured in millimeters of mercury (mmHg). The levels range from mild (8-15 mmHg) to extra firm (30-40 mmHg or higher), with each level serving different needs:

  • Mild compression (8-15 mmHg): Daily wear for mild achiness and comfort during extended periods spent sitting or standing.
  • Medium compression (15-20 mmHg): Moderate daily pain and swelling, during travel, more efficient circulations, and pregnancy to prevent varicose veins.
  • Firm compression (20-30 mmHg): The compression level to treat varicose veins, chronic pain and fatigue, and medical conditions that affect circulation. They’re also used in combination with sclerotherapy. 
  • Extra firm compression (30-40 mmHg and above): Lymphedema, severe varicose veins, DVT, venous stasis ulcers, healing following bone fractures and surgeries. 

Material

When choosing your compression hosiery, pay close attention to the fabric to prevent discomfort. Look for breathable and moisture-wicking materials to keep your skin dry and prevent painful chafing. You can often find hosiery made with antibacterial properties to prevent odors and infections or hypoallergenic options for sensitive skin.  

Length and Size

You can purchase various lengths of compression hosiery– knee-high socks, thigh-high socks, and pantyhose. The correct length will depend on the area of your leg that needs compression. 

You’ll also want to carefully measure your legs first thing in the morning (when swelling is at its lowest) with a soft tape measure. You’ll take four measurements total– the narrowest part of the ankle, the widest part of the calf, the widest part of your thigh, and the distance from the floor to the point where your buttocks meet your leg. 

Tips for Using Compression Hosiery

Once you invest in a high-quality pair of compression hosiery, you’ll want to take extra care to ensure they’re used and maintained properly. 

  • To put on compression hosiery, gather the hosiery up to the heel, insert your foot, and gradually unroll them up your leg. Check that there are no twists or wrinkles. 
  • When it’s time to take them off, never pull your hosiery down from the top. Instead, roll it carefully down your leg to prevent overstretching and snags. 
  • Take the time to hand-wash and dry your compression hosiery according to the manufacturing instructions. It’s worth spending a few extra minutes treating them delicately in lukewarm water with a mild detergent, then air drying to preserve the integrity of the elastic. 
  • If you notice signs of wear and tear, like thinning fabric and holes, it’s time to replace your hosiery, as any damage can compromise how effectively it provides compression. 
  • Regardless of wear and tear, you should still replace your compression hosiery every 3-6 months, depending on how often you wear them. Elastic breaks down over time, which means less compression ability. 
  • Always follow medical professionals instructions on length of time to wear compression hosiery.

Final Thoughts

If you’re concerned about leg swelling and varicose veins, the first step is scheduling an appointment with Dr. Elizabeth Briden or one of the Physician Assistants at Advanced Dermatology & Cosmetic Institute. She’ll work with you to uncover the possible causes and evaluate your needs to help you find the right compression level to give your legs much-needed relief. You can also shop our selection of Health Support hosiery products made with advanced yarn techniques, a floating reinforced heel, and balloon toe for maximum comfort.