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Phlebitis: causes, symptoms and treatments

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 5 minutes read

Phlebitis (also known as superficial thrombophlebitis) occurs when the superficial veins in your skin become inflamed, with the potential of having a small blood clot inside of it. It typically occurs in the veins in your leg but it can occur in any vein in your body.

Different things can trigger the inflammation. Trauma or injury to the vein (for example from a blood test), people with problems with their veins already (for example varicose veins or a previous blood clot), or people who have conditions that make their blood clot more easily. People who smoke, or are immobile, or have had major surgery are also more at risk.

What are the symptoms?

The symptoms of phlebitis are usually mild. They can cause pain, swelling, and redness along the course of the vein. In some cases, you may also feel unwell with a fever.

If a clot develops inside the vein, it will usually feel hard and thickened. Only small areas are usually affected, and they are nothing to worry about as the blood can be carried via other superficial veins. When the swelling settles, your veins may be slightly discolored, appearing bruised or darkened.

When should I see my doctor

If you are concerned you have phlebitis, book a routine appointment with your doctor. Your doctor will examine the area of concern and let you know if this is phlebitis. No further investigations are needed to diagnose this but if there is any concern that this may be a deep vein thrombosis then you will likely have further tests arranged.

How can I manage the symptoms?

Mild symptoms will likely go away on their own and this can take a few weeks.

You can do simple things at home that can help. Staying fit and active is always advised to ensure that there is good circulation around your body. Keeping your leg elevated when you are sitting down to help encourage the return of blood to the heart. Your doctor may advise you to use compression stockings to help with this process and reduce swelling.

If there is evidence of inflammation a cool flannel over the vein can help ease the symptoms.  Ibuprofen (tablet or gel form) or paracetamol can be used to reduce pain and inflammation.

Treatments for phlebitis

#1 Conservative

Initial treatment often involves conservative measures to alleviate symptoms. This includes the application of warm compresses to the affected area to reduce pain and inflammation. Elevation of the affected limb helps minimise swelling, and over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be recommended to manage pain.

#2 Compression therapy

Compression therapy, involving the use of compression stockings or bandages, is commonly employed to reduce swelling and improve blood flow. The application of compression helps prevent the pooling of blood and minimisees the risk of clot formation. Healthcare providers may recommend specific compression levels based on the severity and location of the phlebitis.

#3 Medications

In some cases, medications may be prescribed to address inflammation and prevent the progression of blood clots. Nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics can help manage pain and inflammation. Anticoagulants, or blood thinners, may be considered if there is a significant risk of clot extension or if the inflammation involves deeper veins.

If phlebitis is associated with an infection, antibiotics may be prescribed to target the underlying bacterial or microbial cause. Infections can exacerbate inflammation and increase the risk of complications, making prompt treatment essential.

#4 Surgical intervention

While most cases of phlebitis can be managed conservatively, surgical intervention may be considered in rare instances. This might involve removing the affected vein or addressing complications such as the presence of a large clot.

Top 10 Causes of phlebitis

Understanding the causes is crucial for effective management and prevention of this condition.

1. Blood Clot Formation

A primary cause of phlebitis is the formation of blood clots within veins. These clots can obstruct blood flow, leading to inflammation. Conditions such as venous stasis, where blood pools in the veins, and hypercoagulability, an increased tendency for blood clotting, can contribute to clot formation.

2. Trauma or Injury

Physical trauma or injury to a vein can trigger inflammation and the development of phlebitis. This may occur due to accidents, surgical procedures, or medical interventions involving the insertion of catheters or intravenous lines.

3. Infection

Infections can lead to phlebitis when bacteria or other pathogens enter the bloodstream and cause inflammation within the veins. Catheter-related infections or infections spreading from nearby tissues can be associated with phlebitis.

4. Medical Procedures

Certain medical procedures that involve veins, such as intravenous drug use or the administration of medications through veins, can increase the risk of phlebitis. Improper technique or inadequate hygiene during these procedures may contribute to inflammation.

5. Varicose Veins

Varicose veins, which are enlarged and twisted veins, pose a risk for developing phlebitis. The irregular blood flow in varicose veins can contribute to the formation of clots and inflammation.

6. Autoimmune Disorders

Autoimmune disorders, where the immune system mistakenly attacks the body's own tissues, can result in inflammation of the veins. Conditions such as vasculitis may contribute to the development of phlebitis.

7. Hormonal Factors

Hormonal changes, particularly in women, can influence the development of phlebitis. Pregnancy, hormonal contraceptives, and hormone replacement therapy may contribute to changes in blood clotting factors, increasing the risk of inflammation.

8. Genetic Predisposition

Genetic factors can play a role in an individual's susceptibility to phlebitis. A family history of clotting disorders or venous insufficiency may increase the likelihood of developing this condition.

9. Obesity and Sedentary Lifestyle

Obesity and a sedentary lifestyle can contribute to venous stasis, where blood pools in the veins due to reduced circulation. This stagnant blood can promote clot formation and inflammation.

10. Smoking

Smoking is a known risk factor for vascular issues. It can compromise blood vessel health and contribute to inflammation, potentially increasing the risk of phlebitis.

In conclusion, phlebitis can arise from a combination of factors, including clot formation, trauma, infections, medical procedures, and underlying health conditions. Identifying and addressing these contributing factors is essential for effective treatment and prevention strategies.

Are there any complications?

It is important to watch out for signs of infection, which can cause worsening pain, redness, warmth and swelling in the area. You may also feel generally unwell. In this event, you will need antibiotics and it is advised to speak to your doctor straight away. 

In some cases, a deep vein thrombosis can form from an extension of phlebitis. If you experience worsening pain, whole leg swelling, hardness or inflammation extending up the leg or you feel unwell in yourself with difficulty breathing or chest pain then it is important to seek urgent medical attention.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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