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.
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 or get worse, or you develop new symptoms such as fever and chills. This could be a sign of a more serious illness or condition.
Several factors 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 the age of 60
- chemical irritation, such as from cancer treatments
- a stroke or injury that caused paralysis of the arms or legs
Superficial thrombophlebitis is also associated with more serious medical conditions, including:
- deep vein thrombosis, which is a 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, a blockage of the blood vessels in the hands and feet
Several very rare conditions can also lead to the development of superficial thrombophlebitis:
- antithrombin III (AT-III) deficiency
- protein C deficiency
- protein S deficiency
Your doctor will examine the affected area and the skin. They will also check your:
- blood pressure
- blood flow
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
- MRI or CT scan: a scan that provides images of the affected area so your doctor can check your veins for clots
- Skin or blood culture, if an infection is also suspected: Your doctor will use a cotton swab to take a sample of the surface of the skin, or draw blood from a vein for laboratory tests.
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 or 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 rare, serious cases, removal or stripping of the vein is necessary. This is more common if you have varicose veins.
Superficial thrombophlebitis is generally a short-term condition without complications. Complications that may arise in rare cases include:
- Cellulitis: a skin infection caused by bacteria and treated in most cases with antibiotics
- Deep vein thrombosis: a condition in which 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.
Except for these rare complications, you can expect a full recovery in one to two weeks. 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 there are some steps you can take.
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.
When traveling, make sure to stand up and move around every couple of hours. Move your arms and legs around and stretch if you must sit or lie down for long periods. Also, stay hydrated by drinking plenty of water. If you’re planning a long trip or you have risk factors for superficial thrombophlebitis, talk to your doctor about taking a low dose of aspirin daily.