Superficial thrombophlebitis is an inflammatory condition of the veins due to a blood clot just below the surface of the skin. It usually occurs in the legs, but it can occasionally occur in the arms and neck. Anyone can develop superficial thrombophlebitis, but females are affected more than males.
Several factors contribute to and increase the risk of developing superficial thrombophlebitis. The more common risk factors include:
- recent IV, catheter, or injection into a vein
- sitting or lying down for too long, such as on a long flight
- varicose veins
- disorders that increase blood clotting
- oral contraceptives and hormone replacement medications
- being over 60
- chemical irritation, such as from cancer treatments
Superficial thrombophlebitis is also associated with more serious medical conditions, including:
- deep vein thrombosis (blood clot in a deep vein)
- cancers of the abdomen, such as pancreatic cancer
- Factor V Leiden (a genetic blood clotting disorder)
- prothrombin gene mutation (a gene mutation that causes a blood clotting disorder)
- thromboangiitis obliterans (blockage of the blood vessels in the hands and feet)
Two very rare conditions, antithrombin III (AT-III) and protein C and protein S deficiencies, can also lead to the development of superficial thrombophlebitis.
Symptoms of superficial thrombophlebitis include:
- redness and inflammation of the skin along a vein
- warmth of the skin and tissue around the vein
- tenderness and pain that worsens with added pressure
- pain in the limb
- darkening of the skin over the vein
- hardening of the vein
Call your doctor if the above symptoms appear, worsen, or you develop new symptoms such as fever and chills. They could be a sign of a more serious illness or condition.
Your doctor will examine the area and skin. He or she will check your pulse, blood pressure, blood flow, and temperature. Your doctor may also perform the following tests:
- Doppler ultrasound: a noninvasive test that uses sound waves to measure blood flow and blood pressure
- duplex ultrasound: a combination of Doppler ultrasound and traditional ultrasound to capture pictures of your blood flow
- venography: a rarely used type of X-ray that captures images of your blood flow by injecting a special dye into your veins
- skin and/or blood culture if an infection is also suspected: a cotton swab will be used to take a sample of the surface of the skin, or blood will be drawn from a vein for laboratory tests
- magnetic resonance imaging (MRI) or computed tomography (CT): scans the affected area to check your veins for clots
Superficial thrombophlebitis is treated at home in most cases. Your doctor might recommend applying a warm compress to the affected area and elevating it to relieve swelling. Wearing support stockings can also help reduce swelling.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin can help reduce the redness and irritation caused by inflammation. This condition usually goes away within two weeks. It can take longer for the hardness in your vein to subside.
In a rare, serious instance, removal or stripping of the vein is necessary. This is more common if you have varicose veins.
Superficial thrombophlebitis is a short-term condition. Generally, there are no complications. However, they are possible in rare cases. One possible complication is a skin infection called cellulitis. Cellulitis is caused by bacteria and treated with antibiotics in most cases. Another possible complication is deep vein thrombosis. It occurs when a blood clot forms in a vein deeper inside your body. This condition can be life-threatening if the clot breaks apart and travels to your lungs.
Barring these rare complications, a full recovery is expected in one to two weeks. However, hardening of the vein may take a little longer to heal. Recovery may also take longer if an infection is involved, or if you also have deep vein thrombosis.
Superficial thrombophlebitis may recur if you have varicose veins. Further testing and treatment may be necessary if you have recurrent superficial thrombophlebitis but do not have varicose veins.
Prevention of superficial thrombophlebitis is limited, but you can take some steps. For example, if an IV is causing it, remove or change the location of the IV. The IV should be taken out at the first sign of inflammation.
Stand up and move around every couple of hours when traveling. Move your arms and legs around and stretch if you must sit or lie down for long periods.