Most thrombosis in the ankle is a superficial venous thrombosis, also called thrombotic superficial phlebitis, which occurs in addition to the varicose veins already present. When thrombosis occurs, the local blood vessels become painful, stiff, cord-like and surrounded by significant redness and swelling, which may lead to further spread of the thrombosis. Therefore, if varicose veins are also present, surgery for varicose veins should be performed as soon as possible. If the patient is not physically able to undergo surgery, topical medications, including Xylitol or sodium heparin ointment, can be applied topically. If symptoms are severe, oral NSAIDs such as ibuprofen or diclofenac sodium may also be used. If the clot continues to spread upward, anticoagulants are needed to inhibit this tendency.