Why swollen legs weep
Weeping legs and swelling skin care has two parts: protecting the skin, and finding out why the legs are swollen.
Swelling, also called edema, is extra fluid held in the tissue under the skin. As it builds, the skin stretches, thins and turns shiny or tight. When it can stretch no further, clear or pale yellow fluid seeps out through tiny breaks, or collects under the top layer of skin as blisters.
If you are looking for help with this wound close to home, start with our overview of wound care in St. Louis.
The medical cause comes first
Leg swelling is a sign, not a diagnosis. Dressings can manage the leaking, but the skin is unlikely to settle until the reason for the swelling is addressed. A clinician may consider:
- Leg veins that no longer move blood back up well
- Heart failure, in which fluid backs up in the body
- Kidney or liver disease
- Lymphedema, a problem with the body’s lymph drainage system
- Side effects of certain medicines
- Long hours sitting with the legs down and little walking
- A blood clot, especially when one leg swells suddenly
- Skin infection
Often more than one applies. The treating clinician may review your history and medication list, examine your heart, lungs and legs, and order blood work or other tests. Gateway’s guide on heart failure, swelling and skin explains one common connection.
What the skin needs while the legs are leaking
While the cause is being sorted out, the treating clinician chooses a skin care approach that usually aims to:
- Absorb fluid so the skin is not sitting in moisture
- Shield intact skin around blisters and open areas
- Cover open areas with dressings that do not stick to or tear fragile skin
- Keep skin folds and the spaces between toes clean and dry
Leave blisters alone unless the clinician decides otherwise. An intact blister protects the skin beneath it. If open sores are already present, see our pages on venous leg ulcers and lymphedema wounds.
Compression is a clinician’s decision
Compression means wraps, stockings or other garments that apply steady pressure to move fluid out of the leg. For many people with vein-related swelling it is a central part of care. It is not right for everyone, and the wrong pressure can cause harm.
Before ordering compression, a clinician usually checks blood flow into the legs, since squeezing a leg with poor arterial circulation can damage it. The guide on circulation tests before compression explains what that involves. The clinician also weighs heart function, infection, pain and whether the person can manage the garment.
Do not start, tighten or stop compression on your own. If a wrap feels wrong, call. Ask in advance when to take one off. Our compression therapy in St. Louis page describes how orders are coordinated.
Questions to ask about daily care
Advice differs with the cause, so ask the treating clinician:
- How and how often to raise your legs, and whether that is safe with your heart or breathing
- How much walking or ankle movement to aim for
- Whether to weigh yourself daily and which changes to report
- Which cleansers and moisturizers suit your skin
Look at both legs every day, including the backs of the calves and between the toes. Bring a current list of your medicines to every visit.
Changes to report and when to call 911
Call the treating clinician about:
- Swelling that is rising higher up the leg or getting worse quickly
- New blisters, open areas or much more leaking
- Redness, warmth or tenderness that spreads, or a fever
- Fluid that turns cloudy, thick or foul-smelling
- Rapid weight gain over a few days
- Toes that turn pale, blue, cold or numb under a wrap
Sudden swelling, pain and warmth in one leg can signal a blood clot and needs medical attention right away. Call 911 for chest pain, trouble breathing, coughing up blood, fainting or new confusion.
How Gateway helps with swollen, weeping legs
Gateway arranges wound care and primary care with partner clinicians in homes, assisted living, skilled nursing and other settings across Greater St. Louis and the Metro East. For swollen, leaking legs, our work often involves linking the wound care clinician with the prescriber who manages the heart, kidneys or medicines, arranging testing, and tracking orders for dressings and compression supplies. Clinical decisions stay with the treating clinician.
Our page on lymphedema and edema management explains more. To get started, call 314-325-0126 or request care online. No referral is needed to ask, and we confirm visit availability by location and care setting.
Common questions
Is the fluid leaking from my legs dangerous?
The fluid is mostly water, salts and protein from your own tissue. The concern is your skin: constant moisture breaks it down and raises the chance of infection. Swelling severe enough to leak also suggests the underlying cause needs attention. Have a clinician look at it soon, even if it does not hurt.
Should I wrap my legs myself to stop the weeping?
Not with compression, unless a clinician has ordered it and shown you how. Pressure that is too tight, uneven or applied to a leg with poor circulation can injure skin and tissue. A clinician can tell you what is safe to use for absorbing fluid until you are seen.
Will a water pill stop my legs from leaking?
It depends on why the legs are swollen. Water pills help with some causes, such as fluid buildup from heart failure, and do little for others. They also affect the kidneys, blood pressure and body salts, so the prescriber may order lab tests. Do not change a dose yourself. Ask whether a medication review would help.
Who should I call first, primary care or wound care?
Either is a reasonable start, because you are likely to need both. Primary care looks for the cause of the swelling and manages the conditions and medicines behind it. Wound care protects the skin and treats open areas. Gateway arranges both with partner clinicians, and our page on primary care and wound care together explains how the two are coordinated.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.