Do you ever take off your socks and notice deep indentations on your legs? Although you might not be surprised to see these marks after a long day on your feet, you may sometimes wonder if they indicate something more serious, like high blood pressure or a heart condition.

In this article, we’ll discuss what causes sock marks, when they might signal a health concern, and when to seek medical advice.

What Are Sock Marks?

Sock marks are indentations on your skin caused by socks, especially pairs that are tight or have elastic bands. They result from pressure on the skin for long periods, leading to temporary creases. Most of the time, sock marks that disappear quickly are harmless.

Minor sock marks tend to be normal if they occur because of:

• Tight socks — Elastic bands or tight-fitting fabric can compress the skin and displace the fluid underneath, leaving temporary indentations.
• Prolonged sitting or standing — Staying in one position for a long time leads fluid to pool in your legs, making you more prone to edema (swelling) and sock marks.
• Heat and humidity — Hot weather causes your blood vessels to dilate and fluid to leak out of your veins, leading to slight swelling in the legs.

Mild, occasional sock marks usually aren’t a concern. Sometimes, however, severe sock marks that last a while can indicate an underlying health issue.

When Can Sock Marks Be a Sign of a Health Concern?

Persistent sock marks can be caused by peripheral edema, which is swelling caused by fluid retention in the lower legs. Edema can result from a variety of health conditions, some of which can be a long-term consequence of hypertension (high blood pressure).

Causes of Peripheral Edema

Leg swelling can result from various conditions, ranging from mild and common to serious and rare. Treating these conditions reduces blood pressure in veins. Examples of those diseases include:

• Heart failure — When the heart can’t pump blood efficiently, fluid backs up in the veins and leaks into surrounding tissues, resulting in swelling and marks from tight clothing.
• Kidney problems — The kidneys play an important role in removing extra body fluid by producing urine. When the organs are damaged, fluid can’t leave the body as effectively and may build up in the legs.
• Liver disease — The liver produces important proteins that keep fluid inside blood vessels. An impaired liver may produce fewer proteins that help keep fluid in the blood vessels, causing leakage into tissues.
• Chronic venous insufficiency — In this condition, damaged veins cause poor blood flow, leading to fluid buildup in the legs, swelling, and sock marks.

Many members of MyHeartDiseaseTeam experience a combination of these conditions, resulting in extreme leg swelling and sock marks. “I have excessive edema in my feet and legs even after taking diuretics,” one member said. Another shared, “Compression socks help to reduce my swelling, but they feel so bloody tight! Definitely gonna have to get used to this.”

Sock Marks That May Indicate a Serious Condition

Sock marks that are severe, frequent, or long-lasting may indicate a more serious issue. Speak with your doctor to find out if you should be evaluated for heart, lung, or kidney problems.

Additionally, always look out for signs of deep vein thrombosis (DVT), a blood clot that forms in a large vein, such as the leg. A DVT, which is different from peripheral edema, can cause swelling, pain, and redness in just one limb. This is an emergency that requires immediate medical attention.

Sock Marks and High Blood Pressure

Sock marks alone aren’t directly related to high blood pressure. However, hypertension can lead to complications that may cause peripheral edema, such as damage to the blood vessels, heart, or kidneys. Not everyone with high blood pressure will develop sock marks or leg swelling, however.

The most effective way to monitor your blood pressure is with an automatic home blood pressure cuff. The American Heart Association recommends that all people with hypertension regularly track their blood pressure.

Blood Pressure Medications

If you’re diagnosed with arterial hypertension, your doctor may prescribe antihypertensive medications. Many drugs can work to lower your blood pressure, but some MyHeartDiseaseTeam members have shared how diuretics (water pills) specifically helped reduce their swelling. “Since I started furosemide, my painful ankle swelling is almost gone,” one member said.

It’s important to note that a particular type of blood pressure medication can cause leg swelling. This class of drugs is called calcium channel blockers. If you have hypertension and are being treated by drugs such as amlodipine (Norvasc) and notice worsening edema, let your health care provider know.

Lifestyle Changes To Manage Leg Swelling

You can try some at-home strategies to treat and manage leg swelling and the conditions that cause it. Talk to your health care provider for a more specific plan that best meets your health needs.

If you notice sock marks at the end of a long day, especially if you’ve been on your feet or in hot weather, first try elevating your legs. When your legs are raised above the level of your heart, fluid can more easily return to your bloodstream instead of pooling in your feet. This should temporarily reduce sock marks and overall swelling. Many MyHeartDiseaseTeam members also use compression stockings to help improve blood flow from the feet back to the rest of the body.

In addition, following a diet low in sodium (salt) can help reduce swelling that tends to occur daily.

When To Get Help

If you notice sock marks along with symptoms such as shortness of breath, chest pain, or dizziness, it could indicate that your blood pressure is affecting your heart’s ability to function well. Go to an emergency room right away, as you may be experiencing a heart attack and need immediate care.

Also, seek medical advice if you notice sock marks in addition to any of these symptoms:

• Unexplained weight gain — Sudden weight gain can be due to an increased amount of fluid in your body, which can be caused by heart or kidney problems.
• Breathlessness — Difficulty breathing when lying down could indicate that fluid is building up in your lungs.
• One-sided pain or discolored skin — Swelling in just one leg that’s also painful or feels hot could be due to a blood clot that should be treated right away.

Speak With Your Health Care Provider

In most cases, sock marks aren’t a cause for concern and are simply the result of wearing tight socks or sitting or standing for a long stretch. However, if you notice persistent or severe sock marks along with swelling or other concerning symptoms, be sure to consult your health care provider. Arterial hypertension doesn’t directly cause leg swelling, but some of its consequences do. Your doctor can help determine if your symptoms are related to high blood pressure medications, heart disease, or another underlying condition.

Remember, it’s always better to err on the side of caution when it comes to your heart health.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 61,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Do you ever have sock marks that take a while to go away? Have you made heart-healthy lifestyle changes? Share your experience in the comments below, or start a conversation by posting on your Activities page.