Patient education: Superficial vein phlebitis and thrombosis (The Basics)

What is superficial vein phlebitis/thrombosis? — "Superficial vein phlebitis" and "superficial vein thrombosis" are medical terms for problems with the veins that are close to the surface of the skin (called the superficial veins):

●Superficial vein phlebitis is when the veins get inflamed.

●Superficial vein thrombosis is when blood clots form in the veins.

If both problems happen, it is called "superficial vein thrombophlebitis." Superficial vein phlebitis/thrombosis is related to another vein problem called "deep vein thrombosis" or "DVT."

DVT is when a vein located deep in the body gets inflamed or becomes clotted. DVT can be very dangerous because clots within a deep vein can break off and travel to the lungs, causing something called a "pulmonary embolism." But DVT is different from superficial vein phlebitis/thrombosis, which affects veins near the surface of the skin.

Is superficial vein phlebitis/thrombosis dangerous? — Superficial vein phlebitis is not usually dangerous. But with superficial vein thrombosis, clots in a superficial vein can extend into a deep vein causing DVT, or break off, causing pulmonary embolism. For these reasons, superficial vein thrombosis is taken very seriously, especially when it affects the places where superficial and deep veins meet, like in the thigh or upper arm.

How does superficial vein phlebitis/thrombosis relate to other vein problems? — People who get superficial vein phlebitis/thrombosis often also have a type of vein disease called "venous insufficiency."

Venous insufficiency can occur with or without varicose veins (twisted, swollen veins), and most often affects the legs. When the veins are healthy and working normally, they carry blood in only 1 direction, from the arms and legs back to the heart. Veins have valves inside them to keep blood moving toward the heart. The valves open to let blood flow to the heart, and close to keep blood from flowing backwards. When the valves are damaged or do not work well, blood flows backward and collects in the veins. This is called venous insufficiency.

People without venous insufficiency can also get superficial vein phlebitis/thrombosis. This usually happens after having an intravenous catheter, which is a tube that goes into a vein to give medicines. But even people who had nothing put into a vein can get superficial vein phlebitis/thrombosis. For instance, it can happen to people with blood clotting problems or cancer.

What are the symptoms of superficial vein phlebitis/thrombosis? — The symptoms include:

●Pain, tenderness, or redness along the length of a vein

●Hardening of the vein

●Fever

●Fluid draining from the area where a catheter was put in

●Swelling of the affected arm or leg

Should I see a doctor or nurse? — Yes, if you have symptoms of superficial vein phlebitis/thrombosis, see your doctor or nurse. See them right away if the affected arm or leg is swollen, or if the affected vein is in the thigh or upper arm or behind the knee.

Call for an ambulance (in the US and Canada, dial 9-1-1) if you get symptoms of a blood clot in the lungs, such as:

●Panting or trouble breathing

●Sharp, knife-like chest pain when you breathe in

●Coughing or coughing up blood

●A rapid heartbeat

Will I need tests? — Maybe. Your doctor or nurse might be able to tell what is happening by doing an exam and learning about your symptoms. They might also do a test called an ultrasound. An ultrasound will show if any of the veins are blocked, especially the deep veins. It can also check how well the valves in the veins work. In some cases, your doctor might order blood tests.

How is superficial vein phlebitis/thrombosis treated? — The treatment for superficial vein phlebitis/thrombosis focuses on easing the symptoms. To do this, doctors recommend that you:

●Use heating or cooling pads on the affected area

●Raise the arm or leg, propping it up on pillows or a chair when resting

●Take a medicine called an NSAID – Examples include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand names: Aleve, Naprosyn).

If your superficial vein phlebitis/thrombosis is near where you have (or had) an intravenous catheter, your doctor will check for infection. If you do have an infection, you might need antibiotics.

If superficial vein phlebitis/thrombosis is in your leg, your doctor or nurse might also suggest you wear compression stockings. These are special socks that fit tightly over the ankle and leg. If your doctor or nurse recommends them, they will tell you which type to wear and how to put them on.

Some people do not need treatment beyond what is described above. In some cases where superficial vein thrombosis is near the deep veins, doctors will prescribe an anti-clotting medicine (sometimes called a "blood thinner"). This helps prevent more clots from forming.

Can superficial vein phlebitis/thrombosis be prevented? — You can reduce your chances of getting superficial vein phlebitis/thrombosis in the leg veins by staying active and not sitting too long without moving.

If your doctor needs to use a catheter to give you medicine through a vein in your arm, this can sometimes lead to superficial vein phlebitis/thrombosis. Your doctor can lower this risk by removing the catheter as soon as it is no longer needed.

More on this topic

Patient education: Varicose veins and other vein disease in the legs (The Basics)
Patient education: Deep vein thrombosis (blood clot in the legs) (The Basics)
Patient education: Duplex ultrasound (The Basics)
Patient education: Swelling (The Basics)
Patient education: Choosing a medicine for blood clots (The Basics)
Patient education: Taking medicines for blood clots (The Basics)
Patient education: Lower extremity chronic venous disease (Beyond the Basics)
Patient education: Deep vein thrombosis (DVT) (Beyond the Basics)