5/10/2019 Superficial thrombophlebitis | DermNet NZ

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10th May 2019

Super cial thrombophlebitis

Author: Vanessa Ngan, Sta Writer, 2013. Minor revision, 22 February 2014.

What is super cial thrombophlebitis?

Super cial thrombophlebitis is an in ammation of a super cial vein due to a blood clot and is found just under the skin. It most
commonly a ects the veins in the leg but can occur in other veins around the body, for example, on the arms, penis and breasts.

What causes super cial thrombophlebitis?

The cause of super cial thrombophlebitis is not completely clear but it is believed to be associated with a change in the dynamic balance
of haemostasis. In 1846, the German pathologist Virchow showed that damage to a blood vessel wall, abnormal blood ow, or a change
in blood constituents causing abnormal blood clotting, could lead to in ammation or formation of blood clots in the veins.

Who gets super cial thrombophlebitis?

Super cial thrombophlebitis can occur spontaneously and without apparent reason.

Risk factors for super cial thrombophlebitis

History of super cial phlebitis, deep vein thrombosis, and pulmonary embolism
Varicose veins — people with varicose veins are prone to minor injuries of the blood vessels, which can lead to in ammation.
Intravenous injection or infusion sites — super cial thrombophlebitis in the arm or neck region may occur at infusion sites or sites of
trauma.
Blood clotting abnormalities — there are various conditions or drugs that can make blood clot more easily and cause super cial
thrombophlebitis:
Pregnancy — through most of the pregnancy and for about 6 weeks after delivery. Thrombophlebitis is especially of concern in
pregnant women who carry prothrombin 20210 gene mutation, as they have a predisposition to clotting.
Oral contraceptive pill and hormone replacement therapy — high dose oestrogen treatments may increase the risk of
thrombosis by 3–12 times.
Diseases associated with vasculitis, such as Buerger disease and polyarteritis nodosa
Smoking
Underlying cancer
Reduced blood ow (stasis) — this may occur in veins in people during long air ights, those that are immobile, or had recent major
surgery.

What are the signs and symptoms of super cial

thrombophlebitis?
Characteristic signs and symptoms of super cial thrombophlebitis include:

Slight swelling, redness and tenderness along a part of the a ected vein
Veins on the foot, ankle and area just behind the knee are swollen and pop-out
Other veins in the a ected area may appear blue colour
If a blood clot develops the vein may feel hard or knobbly
If the condition has been present for a while and the swelling has resolved, the skin may appear stained or darkened.

Super cial thrombophlebitis

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How is super cial thrombophlebitis diagnosed?

The visual characteristics of super cial thrombophlebitis are not enough to con rm the diagnosis as several other conditions have
similar symptoms. A thorough history and complete physical examination are essential.

If the condition is often recurring or there is the possibility of complications, your doctor may perform other tests, such as blood tests,
ultrasound scan and radiographic imaging.

What is the treatment for super cial thrombophlebitis?

Mild cases of super cial thrombophlebitis may not need any treatment. Usually, symptoms will resolve within 3–4 weeks. You should try
to keep up with normal routines and remain active.

In more severe cases the following treatments may be used.

Raise the leg and apply warm compresses. This can be done with a hot annel placed over the vein or using a blanket and hot water
bottles. Take care not to burn.
Elastic supports or compression stockings can help to reduce swelling whilst the in ammation settles.
Painkilling medication — paracetamol, aspirin or non-steroidal anti-in ammatories such as ibuprofen. Always check with your doctor
or pharmacist before taking any medication.
Anti-in ammatory gels or creams such as ibuprofen gel may be useful in mild cases.
Low molecular weight heparin (LMWH) medications, for example, enoxaparin, may help to reduce swelling and pain and also
decrease the chances of blood clots moving further up the vein and causing a DVT.
Antibiotics should be taken if an infection is present.
Puncture and evacuation — this procedure gives rapid relief and resolution of a palpable clot that causes extreme pain. It involves
puncture incision with a needle and evacuation of the clot after local anaesthesia.
Surgical excision and ligation — patients with septic thrombophlebitis require urgent venous excision to stop the spread of bacterial
infection. This is done with a direct cut over the vein and removal of the infected segment and any surrounding infected or necrotic
tissue. This procedure may also bene t patients with recurrent super cial thrombophlebitis that do not respond to any other
treatments.

What is the outcome after super cial thrombophlebitis?

Super cial thrombophlebitis is not usually a serious condition and often settles down and goes away on its own within 2–6 weeks.
However, it can be recurrent and persistent and cause signi cant pain and immobility. In addition, complications may occur if the
a ected veins become infected or the blood clot moves further up the vein to where the super cial and deep veins join; leading to a
more serious condition called deep vein thrombosis (DVT).

 
Related information

References

Super cial Thrombophlebitis – Medscape Reference.

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On DermNet NZ

Varicose veins
Trousseau syndrome
Nodular vasculitis
Rashes a ecting the lower legs
Cutaneous polyarteritis nodosa

Other websites

Super cial thrombophlebitis – MedlinePlus

Thrombophlebitis – MedlinePlus
Super cial thrombophlebitis – The Merck Manual Home Health Handbook

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