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
Fungal Nail Infection
A fungus that thickens and discolors toenails
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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Board-certified surgeons and podiatrists across eight Los Angeles area neighborhoods.
Book a visitOr call (323) 264-7600
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
- A fungal nail infection is one of many foot & ankle conditions our specialists evaluate every day.
- Mild nail infections may respond to topical antifungal medication; oral antifungals are more effective and are used for 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.
What is a fungal nail infection?
A fungal nail infection (onychomycosis) makes toenails thick, discolored, and brittle; treatment ranges from topical antifungals to oral medication. It usually develops slowly, is often painless at first, and rarely clears without treatment.
Mild fungal nail infections are usually treated first 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 usually need a course of oral antifungal medication, which is more effective than topical treatment and 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 a fungal nail infection, and the full range of treatment options, from the simplest to the most involved.
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.
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.
Symptoms and causes of a fungal nail infection
Common symptoms
- Thickened, discolored toenails
- Brittle or crumbling nail edges
- A foul smell from the affected nail
- Pain in tight shoes
Common causes
- Athlete's foot fungal organisms
- Exposure in communal wet areas (showers, gyms)
- Sweaty shoes and socks
- Nail injury or compromised circulation
How we diagnose a 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 a 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 at the LAOSS office nearest you.
How we treat a 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
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
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 a candidate if
These signs typically point toward an in-person evaluation with a foot & ankle specialist.
- Toenails that have become thick, discolored, or crumbly
- A nail that hurts in shoes or is hard to trim
- Diabetes or poor circulation, which make nail infections riskier
- Previous treatment that didn't fully resolve the problem
- Imaging or exam findings that suggest an underlying issue
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
- A nail clipping sent for lab testing when needed
- 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, or any sign of infection (fever, increasing redness or swelling).
Your foot & ankle recovery roadmap.
Recovery is rarely a straight line, but a clear plan with measurable milestones makes the path predictable.
- Days 0 to 14
Right after care
In the first two weeks we confirm the diagnosis, thin the thickened nail, and start antifungal treatment.
- Clear instructions for applying or taking your medication
- Trimming and thinning of the nail in the office
- Treatment of any athlete's foot at the same time
- Follow-up scheduled to track progress
- Weeks 2 to 8
Staying on treatment
Antifungal treatment continues while healthy nail slowly begins to grow in from the base.
- Topical medication applied on schedule, or the oral course continued
- Monitoring during oral medication as your doctor advises
- Repeat trimming and thinning of the nail as needed
- Shoe and sock hygiene to prevent reinfection
- Months 2+
Long-term care
A toenail grows slowly, so a clear nail takes many months. The focus shifts to finishing treatment and preventing reinfection.
- Checks as the new nail grows out
- Foot hygiene habits: dry feet, clean socks, and shoes that breathe
- Early retreatment if the fungus returns
- 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 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
Foot and ankle 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
Meet our foot & ankle doctors in the Greater Los Angeles area
At LAOSS, our foot & ankle specialists are board-certified and treat these problems every day. From minimally invasive arthroscopic techniques to joint replacement and arthritis management, our physicians bring decades of experience to every case. We have cared for Los Angeles patients since 2007, with one goal for each: less pain, better movement, and a return to the activities you love.
Fungal nail infection care starts here
Don't let a fungal nail infection be something you just power through. With same- or next-day appointments at multiple Los Angeles locations, you'll never wait weeks or months for answers. The same team handles your diagnosis, treatment, and recovery. Whether you need topical treatment, oral antifungal medication, or an in-office nail procedure, we plan it with you and coordinate each step.
Call or schedule online today to see a foot & ankle specialist in Los Angeles.
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.
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
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