Varicose veins are enlarged, twisted blood vessels, often appearing blue or purple, most commonly developing in the legs and feet. This occurs because weakened one-way valves allow blood to pool instead of efficiently returning to the heart. The resulting increased pressure causes the vein walls to stretch and bulge beneath the skin surface. A rupture of a varicose vein is a serious event that can lead to rapid and significant blood loss. Understanding the appearance of a burst vein and knowing how to respond is important.
What a Ruptured Varicose Vein Looks Like
A ruptured varicose vein typically presents in one of two ways: externally through the skin or internally beneath it. An external rupture is the most dramatic presentation, characterized by a sudden and profuse flow of blood from a small opening in the skin. The blood is typically dark red, consistent with venous blood, and is often described as gushing rather than slowly oozing. This rapid flow is driven by the high pressure built up within the vein.
The rupture site may appear as a small tear, a minor cut, or an ulceration where the skin over the bulging vein has become fragile and thin. Sudden, sharp pain or a burning sensation may precede the bleed. In some cases, the overlying skin may have looked discolored, dark, or bruised due to advanced venous disease before the rupture.
An internal rupture is less visually alarming but still requires medical attention, presenting like a large, rapidly expanding bruise. This occurs when the vein wall breaks but the overlying skin remains intact, causing blood to leak into surrounding tissues. The affected area will show sudden, dark discoloration and may become noticeably swollen. Tenderness, throbbing, or a firm, warm lump under the skin may also be present.
Immediate Steps for Managing Acute Bleeding
Managing an external rupture requires immediate action to control the blood flow and reduce pressure within the vein. The first step is to lie down and immediately elevate the affected leg above the level of the heart. This simple maneuver uses gravity to rapidly decrease the venous pressure, often slowing the bleeding almost instantly.
Next, apply firm, direct pressure onto the bleeding site using a clean cloth, sterile gauze, or a medical bandage. Maintain continuous pressure for at least 10 to 15 minutes without checking the wound to allow a clot to form. If the cloth becomes saturated, layer a fresh cloth on top and continue pressing firmly.
If bleeding does not slow or stop after 15 minutes of continuous pressure and elevation, or if you feel dizzy, seek emergency medical care immediately. Once controlled, gently clean the wound with soap and warm water, avoiding harsh scrubbing, and apply a sterile dressing to prevent infection. Contact a vein specialist promptly for a follow-up appointment to treat the damaged vein and prevent recurrence.
Why Varicose Veins Rupture
The primary reason a varicose vein ruptures is the chronic high pressure within the vessel walls caused by venous insufficiency. When the valves fail, blood pools, and the resulting pressure continually stretches and weakens the vein structure. This internal strain makes the vein susceptible to bursting.
As the venous disease progresses, the skin directly over the prominent vein thins and becomes fragile. This skin deterioration, sometimes accompanied by inflammation or ulceration, provides less protective barrier over the pressurized vein. The combination of high internal pressure and fragile overlying skin sets the stage for a rupture.
The actual break is often triggered by minor external trauma, such as a slight bump against furniture or a shaving nick. Ruptures can also occur spontaneously when the maximum pressure capacity of the stretched vein wall is exceeded. Individuals taking blood-thinning medications face a higher risk of severe, prolonged bleeding if a rupture occurs.