Medicines for Superficial thrombophlebitis

What it is

Superficial thrombophlebitis is inflammation of a vein just under the surface of the skin (a superficial vein), together with a small blood clot (thrombus) within it. It causes a tender, firm, cord-like area along the line of the affected vein, with redness or discolouration, warmth, and pain or tenderness of the overlying skin; it most commonly affects the legs (often in association with varicose veins), but can occur elsewhere, including the arms (for example after a drip). Unlike a deep vein thrombosis (DVT), which is a clot in a deep vein and carries a risk of the clot travelling to the lungs, superficial thrombophlebitis involves a surface vein and is usually not dangerous, tending to settle over a couple of weeks. However, it is important to be aware that superficial thrombophlebitis can occasionally be associated with, or extend into, a deep vein thrombosis, particularly when it affects the longer veins near the groin or is extensive — so it sometimes needs assessment (including a scan) to check the deep veins, and the two can be confused. It can be triggered by varicose veins, injury or irritation of a vein (such as from a drip), immobility, or, occasionally, an underlying tendency to clot. It is usually a self-limiting, treatable condition, but warrants a check to ensure it is not a DVT and to identify any that needs more active treatment.

How it is treated

Management depends on the location and extent of the affected vein, and on excluding or identifying any deep vein involvement. Assessment by a doctor confirms the diagnosis and, where the thrombophlebitis is extensive, near the groin, or the diagnosis is uncertain, an ultrasound scan is used to check the deep veins (since it can be associated with, or extend into, a DVT). For typical, limited superficial thrombophlebitis, treatment is usually supportive and symptoms settle over a couple of weeks: this includes anti-inflammatory measures (such as anti-inflammatory painkillers, where suitable), and simple measures like keeping the limb moving, elevating a leg when resting, warm or cool compresses for comfort, and compression stockings for leg involvement. Where the clot is more extensive or close to the deep veins (raising the risk of extending into a DVT), a course of blood-thinning (anticoagulant) medicine may be recommended to reduce this risk, guided by the assessment. Treating any underlying cause (such as managing varicose veins, or removing a drip that has caused it) helps. Recurrent or unusual superficial thrombophlebitis may occasionally prompt looking for an underlying clotting tendency. The reassuring message is that superficial thrombophlebitis is usually not dangerous and settles with supportive treatment, but it warrants assessment to exclude or identify any deep vein clot and to treat extensive cases appropriately.