Can You Soak or Warm Your Feet with Varicose Veins?

Soaking your feet in hot water or keeping your legs warm for long periods is best avoided if you have varicose veins: heat widens the veins, blood pools in them, and swelling and heaviness are usually worse by evening. A short soak in warm, not hot, water is generally fine, and cool showers, swimming pools and the sea are good for your legs. A vein that is painful, red and hard, however, should never be warmed at all: that is a reason to see a doctor.

It is a familiar routine: in the evening you put your feet in a basin of hot water, perhaps with salt or herbs, to ease the tiredness. While your feet are in the water, it feels better. An hour or two later your calves feel tight and the veins look fuller. Few people connect the two.

Steam rooms, hammams and saunas have their own article: Bathhouse and sauna with varicose veins. This one covers heat and water at home, in the pool, at the beach and at a spa resort.

Can you soak your feet in hot water with varicose veins?

Heat relaxes the muscle layer in the vein wall, so the vein stretches. With varicose veins the valves already work poorly, and a vein widened by heat holds even more stagnant blood. Some fluid leaks into the surrounding tissue, and that is what swelling is. On top of that, your legs hang down and stay still in the basin, so the calf muscles are not pumping blood back up.

There is no evidence that a hot foot soak causes varicose veins in a healthy person, and a single soak will not make a vein burst. But when the veins are already enlarged, regular hot soaking usually adds to the heaviness, the bursting feeling and the evening swelling.

If you do need a foot bath, for example to soften the skin on your feet, make it safer:

• use warm water, not hot: your skin should not turn red;
• keep it short, just until your feet are warm;
• put only your feet in the water, not the shins where the veins are;
• finish by rinsing your legs with cool water, moving from the feet up to the knees;
• afterwards, lie down for a while with a pillow under your legs;
• salt and herbs do not change how heat affects the veins, and mustard can irritate the skin.

If your feet are numb or you have diabetes

With diabetes, or any loss of sensation in the feet (numbness, tingling, a cotton-wool feeling), you may not notice that the water is too hot and can end up with a burn. On a diabetic foot even a small blister heals poorly and can turn into an ulcer. More on this in Varicose veins and diabetes.

• do not soak your feet in hot water or warm them with a heating pad, next to a heater or under a sandal (the traditional heated low table with a quilt over it);
• check the water for washing your feet with your elbow or a thermometer, not with your foot: it should be barely warm, below 37 °C;
• do not leave your feet in water for long: soaked skin is easier to injure;
• after washing, dry your feet thoroughly, especially between the toes, and check them for damage.

Can you warm your legs or take a hot bath with varicose veins?

Dry heat works the same way: a hot-water bottle, an electric blanket, a space heater. This matters especially in winter under a sandal, where people sit for hours with their legs down next to a heat source. If you sit under a sandal, get up and walk around regularly, do not keep your legs right against the heat, and before bed lie down with your legs raised.

If your feet are cold all the time, even in a warm room, varicose veins are usually not the cause. Cold, pale feet and calf pain when walking are a reason to have the arteries in your legs checked. With poor arterial circulation, heating pads and hot water are particularly risky because you can get a burn without noticing.

A hot bath is closer to a sauna: the whole body heats up, and veins widen everywhere, not only in the legs. A short warm bath is a different matter: if your legs are no more swollen than usual that evening, it suits you. The self-check below will help you find out.

After vein procedures (endovenous laser ablation, sclerotherapy, miniphlebectomy), warming the legs is put off for as long as your doctor advises.

Myth: a sore vein should be warmed up so it settles down

Sometimes a vein becomes hard, red, hot and painful. The first impulse is to put a heating pad on it, apply a warm compress or soak the leg. Do not do this. Most often this is thrombophlebitis, an inflamed vein with a blood clot inside, although other kinds of inflammation can look similar. Only an examination and an ultrasound can tell them apart.

Heat does not dissolve a clot or treat vein inflammation, and it costs you time: while the leg is being warmed at home for several days, the clot can quietly extend up the vein towards the deep veins. An ultrasound comes first, to see where the clot ends, and the doctor chooses topical products and treatment based on what it shows.

Contrast showers and cold-water rinses

Coolness has the opposite effect on veins: the wall narrows and the legs feel lighter. A cool or contrast shower on the legs in the evening reduces heaviness. In small studies, hydrotherapy with alternating temperatures eased symptoms. It does not repair the valves, though, and it does not make varicose veins disappear.

• avoid extremes: warm rather than scalding, cool rather than icy;
• finish with cool water;
• move the stream from the bottom up, from the feet towards the thighs;
• if you have heart disease, high blood pressure, poor circulation in the leg arteries or numb feet, discuss sudden ice-cold rinses with your doctor first.

Can you swim in a pool or the sea with varicose veins?

Yes, in most cases you can, and it is actually good for you. Swimming works the calf muscles, the muscle pump that pushes blood upwards. Your body is horizontal, and the water pressure gently compresses your legs. The water is also cooler than your body.

• choose an ordinary pool rather than a hot tub, thermal pool or hot spring: in hot water the benefit disappears;
• swim rather than just standing in the water; water aerobics and walking in water also work;
• after swimming, do not sit for long in the sauna at the pool;
• with acute thrombophlebitis or thrombosis, or with wounds or ulcers on the lower leg, the pool waits until a doctor has examined you and given the go-ahead;
• after vein procedures, you can return to the pool once the puncture sites have healed and your doctor agrees.

The sea, Lake Charvak or Issyk-Kul work the same way as a pool, with two downsides: sun and heat on the beach, and a long journey to get there. Do not lie for hours on hot sand. On the road, get up often and move your feet.

Are mud baths, radon baths and body wraps safe with varicose veins?

There is no one-size-fits-all answer. Hot mud packs on legs with varicose veins are essentially just another way of heating them, and I do not recommend them. The same goes for hot wraps at a salon, whether with mud, paraffin or a warming formula. Cold wraps are better tolerated but do not treat the veins. A strong Charcot jet shower should never be aimed at varicose veins or spider veins; a circular shower is gentler but should not be hot. Mineral and radon baths are prescribed by the spa doctor based on your health, so tell them about your varicose veins in advance.

According to research, spa hydrotherapy gives at best a modest improvement in how you feel. It does not restore the veins and is not a substitute for treatment.

Before a spa stay, have your veins checked: I look at them on ultrasound first and only then discuss which procedures are suitable. Heating procedures are ruled out after a recent thrombosis or thrombophlebitis, with ulcers on the lower leg, or with marked swelling of unclear cause.

Quick guide and self-check: is this procedure right for you?

A simple self-check will show whether a particular procedure suits you:

1. 1Take an ordinary day without the procedure and, in the evening, note how deep the sock elastic marks are and whether a dent stays after you press a finger into the front of your shin.
2. 2On a day with a similar level of activity, do the procedure: foot bath, bath or pool.
3. 3Check the same things that evening and the next morning.
4. 4If swelling and heaviness are worse than usual, the procedure does not suit you in this form: make the water cooler, the time shorter, or drop it. If your legs feel lighter, carry on.
5. 5If one leg has swollen or a painful vein has appeared, the water temperature is not the issue: see the urgent section below.

If swelling appears without any procedures at all, water is not the cause: possible reasons are covered in Leg swelling.

When to see a doctor urgently

See a doctor the same day, and call an ambulance (103 in Uzbekistan) if the signs are alarming, when:

• after heat, or for no obvious reason, a red, hot, painful, firm cord has appeared along a vein;
• one leg has suddenly swollen and the skin has become tight, bluish or purplish;
• you have a bursting pain in the calf, especially together with swelling of that leg; the absence of pain when moving the foot does not rule out thrombosis;
• there is a burn, blister or wound on the foot after hot water, especially if you have diabetes;
• a varicose vein has started bleeding after a bath or shower: lie down, raise the leg, press firmly on the bleeding spot and call an ambulance;
• you develop shortness of breath, chest pain, coughing up blood or sudden weakness: call an ambulance immediately.

While you wait to be seen, do not warm, massage or rub the suspicious vein, and do not apply warming ointments to it.

Bottom line: veins need coolness and movement

Swap the hot basin for a cool shower and a walk, and the heating pad for raised legs. If evening heaviness and swelling have become routine, start with a vein ultrasound: it shows which veins are not working properly and which procedures are right for you.

This article is for informational purposes only and does not replace a consultation with a qualified physician. If you are experiencing symptoms, please see a specialist.