Superficial Thrombophlebitis

Superficial thrombophlebitis is pain and inflammation in a vein just under the skin (superficial vein).

Superficial thrombophlebitis is common. The cause is a blood clot (thrombus) in the vein. Veins in a leg are most often affected. Superficial thrombophlebitis usually develops in a varicose vein, but most varicose veins are not affected.

Superficial thrombophlebitis does not usually cause serious problems. Some people with superficial thrombophlebitis in the leg also have deep vein thrombosis, which is more serious.

Causes

Any condition that causes blood to pool and clot, such as varicose veins or a minor injury that causes swelling in a vein, can lead to superficial thrombophlebitis. Occasionally, superficial thrombophlebitis develops after a long, thin tube (catheter) is inserted into a vein as part of treatment, especially if the vein is irritated or an infection develops.

Rarely, thrombophlebitis occurs repeatedly in normal veins. This disorder is called migratory phlebitis or migratory thrombophlebitis. It may be a sign of a serious underlying disorder, such as cancer or excessive blood clotting.

Symptoms and Diagnosis

The skin over the affected vein becomes red, swollen, warm, and tender. This area is sometimes very painful. Because blood in the vein is clotted, the vein feels like a hard cord under the skin. The vein may feel hard along its entire length.

The diagnosis is based on symptoms and results of a physical examination. If superficial thrombophlebitis develops in a leg—particularly if the person is at risk of having deep vein thrombosis or if the leg is swollen—tests such as Doppler ultrasonography may be done to check for blood clots in deep leg veins.

Treatment and Outlook

Usually, superficial thrombophlebitis resolves within several days. Occasionally, swelling and hardness persist for weeks. If the cause is a serious disorder or if the person has deep vein thrombosis, superficial thrombophlebitis may last longer or may recur.

The goal of treatment is to relieve symptoms. Usually, a nonsteroidal anti-inflammatory drug (NSAID) is recommended. Soaking the leg in warm water or placing warm compresses on the affected area and elevating the leg may help.

Superficial thrombophlebitis rarely causes serious problems. In superficial thrombophlebitis, blood clots are unlikely to break off, travel through the bloodstream, and block an artery elsewhere in the body. The clots usually adhere to the vein. Drugs that make blood less likely to clot (anticoagulants) are not needed, unless the clot extends into the femoral vein, the largest vein in the leg.