Significant hemorrhage or bleeding from a ruptured small varicose or spider vein in the lower leg in not uncommon. This usually occurs in longer standing venous insufficiency disorders when the blood pressure in the small veins in the lower leg increases significantly due to refluxing blood over a long period of time. It can also occur in older individuals as the skin becomes thinner and the subcutaneous tissue under the skin thins exposing the small veins to injury or dry skin conditions. Typically, these veins are dark, almost black and bulge a bit above the skin surface. These are usually located in the lower leg around the ankle surrounded by numerous other similar looking spider veins.

Bleeding can be profuse at times and is best managed emergently by putting your foot and leg as high as possible above one’s head(up against a wall or over the back of a couch), putting the tip of one’s finger on the bleeding site and applying pressure for about 15-20 minutes without peeking to see if bleeding has stopped. Once controlled, applying a small dime or nickel sized rolled up gauze/cotton ball plus a snug ACE bandage should control this situation until you can see your doctor or vein specialist. Such bleeding rarely happens in those wearing their medical grade compression stockings or after definitive treatment which may include injection sclerotherapy. Do not remain standing or in sitting position and try to control this bleeding. It will not work.

If you cannot control the bleeding with elevation and pinpoint pressure, you may need to summon help through your local hospital emergency room or by calling 911.