What Is Superficial Thrombophlebitis?

Superficial thrombophlebitis is inflammation of a vein just below the skin. It is the result of a small clot in the vein. It typically affects the leg and is generally not serious. Superficial thrombophlebitis is sometimes called superficial venous thrombosis (SVT).

The condition will resolve within a few weeks, with or without treatment. Treatment aims to ease discomfort and bring down inflammation. 

In a few instances, complications can occur because the blood clot is deeper in the vein. Superficial thrombophlebitis can sometimes lead to a more serious condition called deep vein thrombosis (DVT) or a bacterial skin infection.

This article covers the symptoms of superficial thrombophlebitis, its causes, treatment, and more. 

Superficial Thrombophlebitis Symptoms

The superficial veins are the veins you can see and feel just below the skin. Most incidences of superficial thrombophlebitis occur in the leg. However, any superficial vein can be affected throughout the body. 

Superficial thrombophlebitis is a type of thrombophlebitis. It tends to be a benign, self-limiting condition. It sometimes does not cause symptoms and can be challenging to diagnose. However, if superficial thrombophlebitis causes symptoms, those occur because of severe inflammation in the vein walls and nearby tissues.

If you develop superficial thrombophlebitis, you might experience the following symptoms:

• Pain in the affected area

• Red or discolored skin in the affected area

• Swelling and tenderness of the affected area

• Warm or hot skin

• An enlarged or inflamed vein

• Darkening of the skin over the affected vein

• The vein feeling hard or like a cord or knot

You should call a healthcare provider if you experience any of the above symptoms or if symptoms worsen. 

While it is rare, it is possible to experience a complication from superficial thrombophlebitis. Complications include cellulitis and deep vein thrombosis.

Cellulitis is a bacterial skin infection that can become life-threatening if not treated. Symptoms of cellulitis include fever and chills, pain, tenderness, blisters, and skin dimpling in the affected area. You should seek medical attention right away because cellulitis can spread rapidly.

DVT occurs when a blood clot forms in the deeper vein. Symptoms of DVT include swelling of the affected leg area, severe leg pain and cramping, and warm and discolored skin.

DVT can be life-threatening if the clot breaks loose and travels to the lungs, causing a pulmonary embolism (PE). Symptoms of PE include shortness of breath, chest pain, and cough.

Causes

The incidence of superficial thrombophlebitis is unclear, but researchers believe the condition is more common than DVT, which affects 1 in 1,000 people. Superficial thrombophlebitis is also less well-studied than DVT. It frequently affects the legs and shares the same risk factors as DVT.

A blood clot leads to superficial thrombophlebitis. Blood clots have different causes, such as trauma or inactivity. Certain medical conditions, like high blood pressure, high levels of low-density lipoprotein (LDL) cholesterol (considered the "bad" cholesterol), diabetes, or atrial fibrillation (abnormal heart rhythm), can increase your risk for a blood clot.

Additional risk factors for blood clots and superficial thrombophlebitis include:

• Pregnancy

• Infection

• Oral contraceptive or hormone replacement therapy use

• Current smoking

• Obesity

• Being over age 65

• Being female

• Having a chronic inflammatory condition

• Varicose veins (twisted, enlarged veins, often affecting the legs)

• Sitting or lying down for long periods, such as while traveling

• Being immobile or bedridden

• Cancer

• A blood-clotting disorder like thrombophilia

• Chronic venous insufficiency

• Family history of superficial thrombophlebitis, DVT, or PE

• Prior medical history of superficial thrombophlebitis, DVT, or PE
  

Discuss all risk factors for superficial thrombophlebitis, DVT, or PE with a healthcare provider. They can advise you on managing risk factors and preventing blood clots. 

Diagnosis

Diagnosing superficial thrombophlebitis involves confirming the condition and ruling out DVT and PE. According to a 2019 Brazilian Vascular Journal report, superficial thrombophlebitis is associated with 6% to 40% of DVT cases, 20% to 33% of asymptomatic (no symptoms) PE cases, and 2% to 13% of symptomatic PE cases.

A diagnosis starts with your healthcare provider examining the affected vein and the skin around it. You will be asked about symptoms you have experienced and when they started. 

Your healthcare provider may request one or more of the following tests:

• Duplex ultrasound: This is the standard method for confirming superficial thrombophlebitis of the lower limbs. This test is low-cost, effective, and presents a low risk.

• Venography: This X-ray method is used to examine blood flow. It involves injecting a special dye into the veins to better view the veins.

• Magnetic resonance imaging (MRI) or computed tomography (CT): An MRI or CT scan can give your healthcare provider detailed images of your veins to look for blood clots.

• Skin or blood culture: A skin or blood culture might be done if the skin appears infected. A sample from near the affected vein might be taken, or blood could be drawn from the affected vein and sent to a lab for examination.
  

Treatment

Superficial thrombophlebitis is typically treated at home. Your healthcare provider might recommend applying warm compresses to the affected area to reduce swelling. Compression stockings are also helpful for reducing swelling.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen) and Aleve (naproxen), can manage pain and inflammation in the affected vein.

For some people, vein stripping might be necessary. This is typically done if there is ongoing pain or recurrent blood clots from varicose veins. Vein stripping is a minor surgical procedure in which a vein is pulled out from under the skin using minor cuts and stitches.

If superficial thrombophlebitis leads to DVT or you have recurrent episodes of superficial thrombophlebitis, your healthcare provider might recommend an anticoagulant medicine (a blood thinner).

Prognosis

Most people who experience superficial thrombophlebitis recover over a few weeks and experience no serious complications. People with varicose veins might have recurrent episodes. Discoloration and pain resolve over time. 

DVT and PE are rare but occur in people with risk factors. If you have risk factors or your healthcare provider suspects the blood clot is deeper into the vein, anticoagulant drugs can improve your prognosis.

Summary

Superficial thrombophlebitis is a blood clot in a superficial vein. Symptoms include pain, swelling, and redness in the affected area. The condition usually affects a vein in one of the legs. 

It is diagnosed with a physical examination, although ultrasound and other testing methods might be used to confirm the condition and rule out DVT and PE.

Treatment goals are to improve symptoms and include warm compresses, NSAIDs, and compression stockings to treat pain and swelling. Sometimes, anticoagulants are given if DVT is a concern or the blood clot is deeper in the vein. 

Most people who experience superficial thrombophlebitis fully recover in a few weeks. Long-term complications are rare, although some people may experience recurrent episodes, especially those with varicose veins.