Phlebitis following Ultrasound-Guided Sclerotherapy (UGS)


Information for medical practitioners:

Phlebitis presents as tender, red, swollen, lumpy areas after treatment with UGS and is often confused with infection.  Infection is a very minimal risk from sclerotherapy and the red, swollen lumps are usually due to the presence of phlebitis.  Antibiotic therapy is unhelpful in managing the condition.

This condition is best prevented by adequate compression with appropriately fitted compression stockings after treatment.

If phlebitis does present, it should be managed with compression stockings and anti-inflammatory medication.

Risk factors for phlebitis are lack of compression after treatment, loose fitting stockings, and hormonal medications such at HRT or the OCP.


Information for patients:

What is phlebitis?

It is quite normal for your treated veins to become tender and lumpy after Ultrasound-Guided Sclerotherapy (UGS) treatment. It is a sign that the treatment has worked how we intended it to – causing an inflammatory reaction in the lining of the vein, prompting your body to shut the vein down.

However, some people find that their veins over-react to the treatment and become more inflamed than we need, and more than is comfortable. This post-treatment inflammation is called phlebitis.

This condition will cause red, hard areas over the treated veins that are painful to touch. Phlebitis can make it difficult to meet the daily walking targets.


How is it diagnosed?

If you are concerned that your treated veins are more sore or swollen than you expect, and causing difficulty in walking for 30 mins a day, please contact the clinic.

Phlebitis can be diagnosed by clinical examination as well as confirmed on ultrasound.


How is phlebitis treated?

If you suspect phlebitis, you can restart your aspirin (if you have stopped taking it after your 2-week review) and also reapply your compression stocking.  These measures may provide some immediate relief.

The doctor may also recommend additional anti-inflammatory medications, as well as possibly perform some local treatment to the area to relieve your symptoms.

Importantly, try to maintain your walking and hydration.