Common foot & ankle concerns we treat
- Pain that limits walking, lifting, or sleep
- Stiffness, swelling, or reduced range of motion
- Sports injuries — acute or overuse
- Arthritis or post-traumatic joint changes
- Conditions other doctors couldn't resolve
Foot & Ankle · Conditions A–Z
Fungal Nail Infection thickened nails
A fungal nail infection (onychomycosis) makes toenails thick, discolored, and brittle; treatment ranges from topical antifungals to oral medication. Same-day or next-day evaluations across eight LA-area offices.
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Experts in foot & ankle care.
Surgical and non-surgical options at LAOSS.
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What sets LAOSS apart
- Same- or next-day appointments at eight Los Angeles–area offices
- On-site imaging; PT coordinated with your in-network provider
- Conservative-first care, surgery only when needed
- Board-certified specialists, not generalists
Key takeaways
- Fungal Nail Infection is one of many foot & ankle conditions our specialists evaluate every day.
- Most nail infections improve with topical antifungal medication; oral antifungals treat thicker or more extensive involvement.
- When a procedure is the right call, we explain every option, recovery timeline, and return-to-activity milestone.
- On-site imaging at most offices and same-day appointments across eight Los Angeles–area locations.
Overview
What is fungal nail infection?
A fungal nail infection (onychomycosis) makes toenails thick, discolored, and brittle; treatment ranges from topical antifungals to oral medication. Symptoms can develop gradually or after a specific injury, so early evaluation matters when function starts to decline.
Most patients with fungal nail infection improve with topical antifungal medication and regular nail care — trimming and thinning the thickened nail so medication can reach the fungus. Thicker or multi-nail infections often need a course of oral antifungal medication, which we prescribe and monitor. For a badly damaged, painful nail that doesn't respond, removing part or all of the nail in the office is a simple, well-tolerated option.
Below, we walk through the anatomy involved, the symptoms and causes we most often see, how we diagnose fungal nail infection, and the full range of treatment options — from the simplest to the most involved.
Patient education
Watch: Nail Infection (Paronychia)
This is an infection of the tissue around a fingernail or a toenail. Most often, it's not serious. But in some cases, it can be hard to treat. It can become a long-term problem. When this happens, we say you have a "chronic" infection.
Animations licensed from ViewMedica · Swarm Interactive
Anatomy of the foot & ankle — tibia, talus, calcaneus, metatarsals, and the plantar fascia.
Anatomy
Inside the foot & ankle.
The foot and ankle have 26 bones, more than 30 joints, and over 100 ligaments and tendons. The plantar fascia spans the bottom of the foot, the Achilles tendon anchors the calf to the heel, and the ankle is a hinge that handles every step you take. Most foot and ankle problems trace back to overload, alignment, or footwear that doesn't match the way your foot is built.
Self-orient
When fungal nail infection shows up.
Symptoms
Common symptoms
- Thickened, discolored toenails
- Brittle or crumbling nail edges
- A foul smell from the affected nail
- Pain in tight shoes
Causes
Common causes
- Athlete's foot fungal organisms
- Exposure in communal wet areas (showers, gyms)
- Sweaty shoes and socks
- Nail injury or compromised circulation
Diagnostics
How we diagnose fungal nail infection
You want answers, fast — and we're built to give them. Most patients leave their first LAOSS visit with a clear diagnosis and a written plan, not another referral chain.
Here's what your initial visit for fungal nail infection typically looks like:
- Detailed history — when it started, what makes it better or worse, what you've already tried
- Nail and skin exam — the pattern of nail involvement, plus any co-existing athlete's foot that could reseed the nail
- Confirmatory testing — a small nail clipping (KOH, PAS stain, or culture) before committing to months of medication
- A written plan with options from topical treatment to oral medication or in-office nail procedures, in plain English
Schedule your evaluation with a trusted Greater Los Angeles orthopedic expert today.
Treatment options
How we treat fungal nail infection at LAOSS
Once we've confirmed the diagnosis, the next step is matching the right treatment to your situation. We start with the least-invasive option that fits — and escalate only when it doesn't.
Conservative care
Step 1Medication & nail care first
Most fungal nails improve with antifungal treatment matched to how much of the nail is involved.
- Topical antifungal lacquers and solutions (efinaconazole, ciclopirox)
- Oral antifungal medication (terbinafine) for thicker or multi-nail infection
- Regular trimming and debridement of the thickened nail
- Treating co-existing athlete's foot so it doesn't reseed the nail
- Footwear and hygiene changes to prevent reinfection
Surgical care
When neededIn-office procedures for resistant nails
Reserved for painful, badly damaged nails that don't respond to medication — done under local anesthetic in the office.
- Partial or complete nail removal (avulsion)
- Permanent nail removal (matrixectomy) for repeatedly painful nails
- Debridement of severely thickened nails for comfort and shoe fit
Surgeon expertise
Why experience matters.
Why experience matters
Foot & ankle care is highly technique-dependent. Volume, training, and judgment together determine the outcome you actually feel six months later.
- Precise diagnosis from imaging and exam
- Conservative-first care that avoids unnecessary surgery
- Surgical technique refined over thousands of cases
- On-site imaging + coordinated PT through your in-network provider
The LAOSS approach
Our foot & ankle specialists move stepwise — start with the least-invasive option that fits your situation, escalate only when it doesn't.
- Same-day imaging at most offices
- PT coordinated in your insurance network
- Board-certified surgeons performing the procedures themselves
- Direct access to your specialist between visits
Candidacy
Am I a candidate?
If most of these match your situation, an evaluation with a foot & ankle specialist is the next step.
You may be
You may be a candidate if
These signs typically point toward an in-person evaluation with a foot & ankle specialist.
- Pain or stiffness in the foot & ankle that lasts more than a few days
- Swelling, instability, or noticeable change in function
- Symptoms that limit walking, lifting, sleep, or work
- Previous treatment that didn't fully resolve the problem
- Imaging or exam findings that suggest an underlying issue
Evaluation
What evaluation includes
Your first visit is built to give you an answer the same day, not just another referral.
- Detailed history — onset, mechanism, what makes it better or worse
- Hands-on exam focused on the affected joint or region
- On-site imaging at most offices (X-ray, ultrasound)
- Clear plan with options ranging from conservative to surgical
- Same-day or next-day scheduling for any follow-up tests
ImportantSeek urgent evaluation for sudden severe pain, numbness, progressive weakness, loss of bowel or bladder control, or any sign of infection (fever, increasing redness or swelling).
Recovery
Your foot & ankle recovery roadmap.
Recovery is rarely a straight line — but a clear plan with measurable milestones makes the path predictable.
01Days 0–14
Right after care
In the first two weeks we focus on protecting the foot & ankle, calming inflammation, and restoring basic motion.
- Activity modification with clear do/don't guidance
- Ice, elevation, and pain control as needed
- Gentle range-of-motion within safe limits
- Follow-up scheduled to track healing
02Weeks 2–8
Rehabilitation
Targeted physical therapy rebuilds strength, mobility, and confidence in the foot & ankle.
- Progressive strengthening and neuromuscular work
- Manual therapy and soft-tissue treatment
- Sport- or job-specific movement re-training
- Coordinated PT through your in-network provider
03Months 2+
Long-term care
Once function is restored, the focus shifts to keeping you there — and catching any recurrence early.
- Return-to-activity plan with measured benchmarks
- Home program tailored to your sport or job
- Maintenance visits or imaging if symptoms change
- Direct line back to your specialist if needed
Risks & considerations
What to weigh before you decide.
We talk through the risks and benefits with every patient — informed consent is a conversation, not a form.
General
General considerations
Every orthopedic intervention carries a small set of standard risks. We screen, prepare, and monitor for these on every patient.
- Infection (rare with modern technique and prophylaxis)
- Bleeding or bruising at the treatment site
- Reaction to anesthesia or medications
- Need for additional procedures in some cases
Specific
Foot & ankle-specific considerations
Some risks are tied to the structures we're treating in the foot & ankle. We discuss these in detail at your visit so you can weigh them against the benefits.
- Temporary stiffness or weakness during recovery
- Incomplete pain relief in a small percentage of cases
- Nerve or vessel irritation near the treatment area
- Need for follow-up therapy to fully restore function
Your care team
Meet our foot & ankle doctors in the Greater Los Angeles area
At LAOSS, our foot & ankle specialists combine advanced surgical expertise with a patient-first approach. From minimally invasive arthroscopic techniques to joint replacement and arthritis management, our physicians bring decades of experience to every case. Trusted across Los Angeles, our team is dedicated to restoring mobility, relieving pain, and helping you return to the activities you love.
Specialists
Meet your foot & ankle specialists.
4 providers
About this care
Reliable Fungal Nail Infection pain relief starts here
Don't let fungal nail infection be something you just power through. At LAOSS, expert care is close to home. With same- or next-day appointments at multiple Los Angeles locations, you'll never wait weeks or months for answers. Our team offers comprehensive treatment from diagnosis through recovery. Whether you need topical treatment, oral antifungal medication, or an in-office nail procedure, you'll receive coordinated, personalized care every step of the way.
Call or schedule online today to begin your recovery with a trusted foot & ankle specialist in Los Angeles. Relief, confidence, and renewed strength are within reach.
FAQ
Common fungal nail infection questions
- We examine the nail and usually send a small clipping for testing (KOH, PAS stain, or culture) to confirm fungus before starting months of medication — nail psoriasis and old trauma can look identical. Most patients leave the first visit with a clear diagnosis and a written plan.
- Oral antifungal medication — most often terbinafine — clears the majority of stubborn nail infections, and we monitor treatment and check for sources of reinfection like athlete's foot. For a painful, badly damaged nail that doesn't respond, removing part or all of the nail under local anesthetic in the office is a quick, well-tolerated option.
- If foot & ankle pain lasts more than a few days, limits movement, or interferes with daily activities, it's time to see a doctor. Sudden injuries, swelling, or weakness should be evaluated right away.
- If you have a PPO plan, no referral is needed — book directly with any of our specialists. HMO plans require a referral from your PCP. If you are unsure, call us at (323) 264-7600 and our team will walk you through it.
Ready when you are
Don't wait on pain.
Book a visit with a foot & ankle specialist at any of our eight Los Angeles–area offices.
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21 specialists · 8 offices
Greater Los Angeles
On-site X-raySame visit
Most insurers acceptedIn-network