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A reference on parapharmacy in Europe

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Compression stockings

Medical compression stockings apply graduated pressure to the lower limb, intended to support venous return. They are medical devices in the EU, classified by compression class under European standards, and differ from ordinary "support hosiery".

Medical compression vs. support hosiery

Two product groups are sold under similar appearance but with different regulatory and performance characteristics:

The decisive distinction is the manufacturer's declared intended purpose and the conformity-assessment route under the MDR. Anything claiming a medical purpose (prevention or alleviation of venous-related complaints) is a medical device. A pair of "shaping" tights without medical claims is a textile, not a device.

European compression classes

European medical compression is conventionally graded into four classes, defined by the ankle pressure in mmHg as measured under the relevant standard. The thresholds vary slightly between national standards; the table below summarises the German RAL classification, which is the most widely cited reference in cross-border literature.

ClassAnkle pressure (mmHg, RAL)Indicative use category
I — light18–21Sensation of heaviness in the legs, mild venous symptoms
II — medium23–32Manifest varicose veins, post-thrombotic syndrome (under medical supervision)
III — strong34–46Marked chronic venous insufficiency (under medical supervision)
IV — very strong≥49Severe lymphoedema; specialist setting

This site does not give clinical guidance. The selection of a compression class for a specific individual and indication is a clinical decision and requires the advice of a physician or a trained pharmacist. The table above is provided as a reference to the regulatory and standards-based classification, not as a recommendation.

CE marking under the MDR

Medical compression stockings are medical devices under Regulation (EU) 2017/745. Their classification under Annex VIII rules typically places them in Class I, although specific products may be in higher classes depending on their intended purpose. They bear the CE mark and must come with instructions for use in the appropriate languages of the Member State of placing on the market.

Measurement

Effective medical compression depends on the stocking being the correct size for the wearer's leg. National practice typically requires measurement of the ankle and calf circumferences, the leg length, and (for thigh-length and tights) the thigh circumference. Measurement is normally done by a trained fitter — often a pharmacist or orthopaedic technician — particularly for Class II and above. In countries where compression stockings are reimbursed under national health insurance schemes (France, Germany and others), the measurement and dispensing process is part of the reimbursed service and requires a prescription.

What labels do and do not tell you

A medical compression stocking package will indicate the compression class, the size code, the manufacturer, the CE mark and reference to the manufacturing standard. It will not, by itself, indicate whether the stocking is suitable for a given clinical situation — that is a clinical decision. For interpretation in any specific situation, the appropriate advice is from a pharmacist or a physician.

References & further reading

  1. Regulation (EU) 2017/745 (MDR), consolidated text: eur-lex.europa.eu.
  2. RAL-GZ 387/1, Medical compression hosiery — quality assurance: ral-guetezeichen.de.
  3. NF G30-102B (France) — medical compression stockings standard, available via AFNOR: afnor.org.

Last reviewed: May 2026.