Superficial Thrombophlebitis

What is thrombophlebitis?

  • Phlebitis means inflammation of a vein.
  • Thrombo(sis) means a blood clot in a vein.


What is superficial thrombophlebitis?



See separate leaflet called Deep Vein Thrombosis for more detail.

What causes superficial thrombophlebitis?


Risk factors

There are a number of risk factors that make it more likely for inflammation to develop in a vein:

  • Varicose veins – many cases occur in people who have varicose veins of the legs. Varicose veins are prone to minor injuries which can lead to inflammation.
  • Intravenous injection or cannulation – sometimes it occurs after having intravenous injections (injections into the veins) or intravenous infusions (‘drips’) in hospital. These are commonly given in hand or arm veins. Such procedures can injure the vein and may trigger inflammation. Damage to the veins in this way is also common in people who inject ‘street drugs’.
  • Previous problems with veins – if someone has had previous superficial thrombophlebitis or a previous DVT, they are more likely to get superficial thrombophlebitis.
  • Abnormalities of blood clotting factors – various conditions can alter certain chemicals (‘clotting factors’) in the bloodstream, which make the blood clot more easily. These include: using the oral contraceptive pill, using hormone replacement therapy, cancer, smoking, and pregnancy. There are also some less common hereditary blood disorders where blood clots develop more readily than usual.
  • Blood flowing more slowly than normal (stasis) – this might occur in veins that are varicose, during long flights, or in people who are immobile, and also following major surgery.

What are the symptoms of superficial thrombophlebitis?

Swelling, redness, and tenderness along a part of the vein are the usual symptoms. You may develop a fever (high temperature). If a blood clot develops inside the inflamed part of the vein, the vein may then feel hard or knobbly. The blood clot is usually of little concern, as it is small. There are other veins which carry the blood, and bypass the blocked vein.

When the inflammation settles, a persistent darker area of skin (hyperpigmentation) may remain over the affected vein. A small firm lump may also persist below the skin. This may be tender to the touch for some time.

Do I need any investigations?



What is the treatment for superficial thrombophlebitis?

Most bouts of superficial thrombophlebitis last for 3-4 weeks. If they are associated with varicose veins, they are likely to recur. No treatment may be needed if the symptoms are mild. Treatment aims to ease symptoms. The following treatments may be helpful:

  • Keep active. Try to keep up your normal activities. This should be possible unless the pain is severe.
  • Painkilling tablets. Anti-inflammatory painkillers such as ibuprofen may ease the pain (but are not advised if you are pregnant). Paracetamol is an alternative. Some people may not be able to take anti-inflammatory painkillers. Check with your doctor or pharmacist. Always read the packet leaflet that explains possible side-effects. See separate leaflet called Anti-inflammatory Painkillers for more detail. There is also some evidence that anti-inflammatory tablets may reduce the risk of superficial thrombophlebitis enlarging or extending within a vein and/or it coming back. However, more studies are needed to confirm this.
  • Anti-inflammatory creams or gels. An example is ibuprofen gel. These are an alternative if superficial thrombophlebitis is mild and only affects a small area of vein. They tend to produce fewer side-effects than those taken by mouth.
  • Hirudoid® cream (heparinoid) improves your symptoms, although there is some evidence that heparin gel may be more effective.
  • Fondaparinux (also called Arixtra®) is an injected medicine which inhibits one of the body’s clotting factors. When given for six weeks it reduces the risk of DVT, extension and recurrence of thrombophlebitis.
  • Compression (support) stockings. These may be advised by your doctor if a vein in your leg is affected. They may ease discomfort and reduce swelling whilst the inflammation settles.


If your doctor feels that you may have a DVT or be at high risk of developing one, they may suggest that you are referred either to the hospital or to a special DVT clinic so that you can have any investigations or treatment necessary (see above). Sometimes, prophylactic (just in case) treatment may be given to people who have superficial thrombophlebitis and may be at high risk of developing a DVT. This involves injection of a drug to thin the blood.

Are there any complications from superficial thrombophlebitis?

The inflammation and pain usually settle within a few weeks. Most people make a full recovery. The possible complications listed below are uncommon, but are listed to give guidance on what to look out for. See a doctor as soon as possible if you suspect that a complication is developing.


Sometimes the affected vein becomes infected. The pain may then become worse, and the redness spreads. You are likely to feel generally unwell. Infection is more common in someone who has had a drip inserted for a long period, in people who abuse ‘street drugs’ or in people with a weakened immune system. Antibiotics are needed to treat the infection. If the infection is severe, you may need to be admitted to hospital for antibiotics (given directly into a vein). Rarely, infection in a vein becomes severe and may spread to other areas of the body.

Blood clot extension



  • Your whole leg swells.
  • Pain becomes suddenly worse.
  • You develop any new breathing problems, or get chest pains. Sometimes a clot from a DVT breaks off and travels to the lung.

When a DVT leads to thrombophlebitis, there is an increased risk of developing further deep vein thromboses and possibly clots on the lung – pulmonary embolism (PE).

Recurrent superficial thrombophlebitis

It is common for people with varicose veins to get recurrent bouts of superficial thrombophlebitis. However, for a small number of people this may be the first sign of a more serious condition such as cancer or polyarteritis nodosa (a rare condition where there is patchy inflammation of the walls of the arteries). This is more likely if the bouts occur at different sites, or in different veins in someone without varicose veins.

Tests may be advised if there is no obvious explanation for recurring bouts of superficial thrombophlebitis.

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