What is phlebitis and why does it occur?

Phlebitis is the name for the inflammation of a vein. A vein can inflame if a blood clot is inside it or if something damages the vein’s walls. Symptoms of phlebitis can include painful lumps beneath the skin and flushing or darkening of the skin.

Phlebitis most commonly occurs in the lower leg. But it may also affect surface veins in the arms, penis, or breasts.

If a blood clot is causing the inflammation, then the condition is called thrombophlebitis.

Thrombophlebitis primarily affects people between 25–50 years old, with the average age being around 40 years old. Males are three times more likely than females to experience thrombophlebitis.

In this article, we examine the types and causes of phlebitis. We also look at the potential treatments and possible complications.

There are two main types of phlebitis, known as superficial phlebitis and deep vein thrombosis (DVT).

Superficial phlebitis

If a person has superficial phlebitis, the inflamed veins are near to the skin’s surface. Healthcare professionals may treat this condition, but they do not consider it to be serious. This condition often goes away once the inflammation goes down.

If a blood clot is present, doctors will refer to this as superficial vein thrombosis (SVT).

Deep vein thrombosis

If a person has DVT, they tend to have inflammation in the larger veins located deeper in the body, usually in the legs.

Blood clots can often cause DVT, which can be severe. These blood clots can break away and travel through the vein into the lungs, which may cause a pulmonary embolism (PE).

A person should contact a doctor if they think they have DVT.

The following are symptoms of superficial phlebitis and deep vein phlebitis.

Superficial phlebitis

Symptoms of superficial phlebitis include:

• flushing or darkening of the skin
• swelling
• warmth in the area where the vein is
• visible streaking on the skin
• tenderness
• a rope-like structure people can feel through the skin

Deep vein phlebitis

Deep vein phlebitis may occur without the presence of any symptoms. But sometimes, the following symptoms do occur:

• pain in the affected limb
• swelling in the affected limb
• warmth in the affected limb
• discoloration of the skin

The leading two causes of phlebitis are a blood clot inside the vein or damage to the vein’s walls.

A person’s veins may receive damage in several ways. These include:

There is a wide range of factors that can cause a person to develop blood clots. These include:

• having obesity
• long periods of immobility
• pregnancy
• smoking
• some cancers

Some people can treat phlebitis at home with advice from their doctor, but others will need medical treatment.

Managing phlebitis at home

A person may wish to treat their inflammation with anti-inflammatory drugs such as aspirin or ibuprofen (Advil). But if a doctor prescribes an anticoagulant blood-thinning medicine, a person should avoid taking anti-inflammatory medications unless a doctor advises them to do so.

If phlebitis is present in a person’s leg, raising the leg may help reduce swelling. A person could also speak with their doctor about using a compression stocking, which may help reduce swelling.

Medical treatments

A doctor may treat deep vein phlebitis with an anticoagulant. These are blood-thinning medications that help prevent blood from clotting.

If a blood clot is present, a doctor may decide that the person should undergo a thrombectomy. A thrombectomy is a surgical procedure that aims to remove a blood clot from a blood vessel.

A surgeon inserts a wire and a catheter into a blood vessel during this procedure, commonly in the groin. They then advance the wire through the blood vessel until they reach the blood clot.

Once they reach the blood clot, a surgeon will use one of several methods to remove it. They may use:

• a vacuum to suck the clot out
• mechanical equipment to break the clot up
• medications to break the clot down

A doctor may also use an inferior vena cava filter. This small device sits in the vena cava, which is a large vein in the body.

This device does not stop blood clots from forming, but allows blood to flow while stopping the clots from moving into the lungs. This device can help prevent a PE from taking place.

A doctor may diagnose phlebitis using a basic examination and knowledge of a person’s symptoms. Often, they will not perform any specific tests.

But they may use an ultrasound, a CT scan, or an MRI scan to see if a blood clot is present.

If a person does have a blood clot, a doctor may carry out a blood test to look for certain blood clotting disorders, such as thrombophilia.

DVT is a significant complication of phlebitis. DVT is the presence of a blood clot in the veins, typically in the leg.

Blood clots in the vein can cause phlebitis. The blood clot may move from the vein and travel through the bloodstream to the lungs. Here, it can block the pulmonary artery, resulting in a PE.

Blood clots are a common cause of phlebitis. Many factors can increase a person’s chances of developing blood clots, such as:

• having obesity
• immobility
• sitting for long periods, such as during long journeys
• being inactive for long periods after surgery, during an illness, or when recovering from injury
• pregnancy
• older age
• surgery
• some cancers
• smoking

A person can help prevent blood clots in several ways. These include:

• getting up and moving around as soon as possible after spending long periods in bed, such as after surgery, illness, or injury
• using compression stockings
• taking anticoagulants
• reaching or maintaining a moderate weight
• avoiding a sedentary lifestyle

If a person has to sit for long periods, such as when traveling for longer than 4 hours, they could try getting up and walking around every 2–3 hours and wearing loose-fitting clothing.

They may also wish to exercise their legs while sitting down by:

• raising and lowering their heels, keeping their toes on the floor
• raising and lowering their toes, keeping their heels on the floor
• tightening and releasing their calves, hamstrings, and quadriceps

Learn about Medicare and compression stockings here.

Superficial phlebitis often goes away without treatment or any lasting effects.

Deep vein phlebitis can be more severe and requires treatment by a doctor. If a blood clot is causing deep vein phlebitis and the person has DVT, this can be life threatening.

According to the Centers for Disease Control and Prevention (CDC), one-third to one-half of people with DVT will develop long-term complications in the affected limb, such as:

• swelling
• pain
• skin discoloration
• scaling

The CDC also states that around one-third of people with DVT will have a reoccurrence within 10 years.

If a person experiences any symptoms of phlebitis, they should contact a doctor. A doctor can determine whether a person has superficial phlebitis or more severe deep vein phlebitis.

If the person has deep vein phlebitis, healthcare professionals will provide treatment immediately.

Phlebitis sometimes displays similar symptoms to another condition called cellulitis.

Phlebitis results from blood clots or damaged veins, and cellulitis is due to a bacterial infection.

Cellulitis affects the deeper layers of the skin and the fat and soft tissue that lies underneath.

Symptoms of cellulitis can resemble phlebitis, such as:

• flushing or darkening of the skin
• swelling
• painful skin that is warm and tender to touch

A person with cellulitis may also have skin that looks pitted, similar to orange peel, and may develop blisters on the skin. Some people also develop a fever and chills.

A person can develop cellulitis in various parts of the body. But it is most common on the legs and feet.

As cellulitis is a bacterial infection, doctors treat it with antibiotics.

Phlebitis is the name for the inflammation of a vein. Two causes of phlebitis are blood clots and damage to the vein’s wall.

Superficial phlebitis and deep vein phlebitis are the two main types of phlebitis. Superficial phlebitis affects veins that are near to the skin’s surface. Deep vein phlebitis affects veins located deeper in the body.

Symptoms of phlebitis include painful lumps beneath the skin and redness of the skin.

Healthcare professionals do not consider superficial phlebitis to be serious. But deep vein phlebitis can be severe if a blood clot is present, because the blood clot may travel through the bloodstream and cause a PE.

Doctors can treat phlebitis with anticoagulants. They may also wish to carry out a thrombectomy, which is a surgical procedure to remove a blood clot from a vein.