Prehensile. I had to sneak away to the bathroom and look up the word on my phone’s Google app, suspecting that it wasn’t going to be altogether complimentary.
It was during a work trip to Croatia when a colleague pointed to my Birkenstock-clad feet and said, out lout, to the whole group – as if revealing an extra gruesome detail at a fairground freak show: ‘Look everyone! Simon’s big toenails are prehensile!’
All eyes were now on my feet, particularly my yellow-tipped halluxes.
‘Ew,’ was the collective response.
‘Disgusting,’ decided my colleague’s wife. ‘Why don’t you do something about them?’
Prehensile, by the way, means an animal’s appendage adapted for grasping or holding objects. My colleague was clearly suggesting my toenails looked less human than animal – as though they might latch on to the edge of a tree branch.
I was crushed. I went back to my room in shame, swapped my sandals for loafers and, for the remaining days never went bare-toed in public again.
Summer is a cruel time for middle-aged men. Their flabby dad-bods are unclothed, skin gets burned and blotchy. And, for some of us, via the merciless exposure of flip-flops, sliders and sandals, ugly feet with fungally infested toenails are on show for everyone at the easyJet check-in to look at and comment on.
In previous Augusts, I’ve been called ‘Shrek toes’ and ‘Homer Simpson feet’, my orangey-yellow nails likened to ‘crumbly cornflakes’. Mostly by my family.
When they were young, my daughters went to the beach with a father whose callused, Hobbit-ish hooves were tipped with something that resembled blackened, flaky slag.
It was during a work trip to Croatia when a colleague pointed to my Birkenstock-clad feet and said: ‘Look everyone! Simon’s big toenails are prehensile!’ writes Simon Mills
Sometimes, often on holidays – to their absolute squealing horror – a big toenail might decide to detach itself from its digital footing altogether, leaving a scary, slough of skin underneath that looked like discarded alien pupae.
This went on for years – 30 years at least.
I developed a fungal infection in my toes after they’d been repeatedly stamped on during weekly five-a-side football. A habit of going sockless, during the summer, in stinky leather shoes, didn’t help either.
After abuse in town and on the field, my toenails would first go black, then yellow, then eventually fall off. Usually in the bath. Ew, indeed.
Every time this happened I’d think: ‘Well at least they’ll grow back healthy and pink now.’ But they never did.
They just returned thicker, coarser, more crumbly and jaundiced than ever.
Cutting them was like trying to carve marble with kitchen scissors. Robust German-engineered nail clippers would literally fall apart in my hands.
Perhaps the lady in Croatia was right; after three decades of disgusting other people around the hotel swimming pool, after failing with expensive, wildly promising topical treatments and covering up my brackish shame with flesh-coloured nail varnish (Superdrug does a decent one for £1.99) maybe I should, finally, actually do something about my prehensile toenails.
But wouldn’t it hurt? I was, understandably, squeamish about the idea of anything invasively surgical. With my boy’s own memory banks embedded with grisly stories about WWII toenail extraction as the only cure, I’d been inspired by news of an exciting new and painless solution available at Marion Yau’s Harley Medical Foot and Laser Clinic. Or, as it says on the brass plate by the door ‘Miss Foot Fixer’.
Deploying the power of light radiation, Yau’s Lunula Laser machine both kills off fungus and accelerates sprouting of healthy nail tissue. No torturous, nail-pulling necessary. Clearer nails gradually emerge over the following months. So, I removed my socks and shoes, hopped up on to the examination bed and let Miss Yau take a good look.
How bad were they? On a scale of one to ten – ten being the grimmest – my hardened Cheerios were marked at a five. ‘I’ve seen a lot worse,’ she confirmed.
Yes, the big toenails had severe fungal infections. I also had trauma-induced discolouration and onycholysis – the separation of the nail plate from the underlying nail bed. Laser treatments alone weren’t going to fix this.
Simon’s big toenails had severe fungal infections. I also had trauma-induced discolouration and onycholysis – the separation of the nail plate from the underlying nail bed
To have any chance of healing the scar tissue that extended to the nail bed, of achieving new and un-yellowed keratin growth, she was going to begin by… yep, pulling my toenails off.
I’d actually seen her do this before. On her Amazon Prime TV show The Bad Foot Clinic, I’d watched Miss Yau and her GP husband Kenny take care of all types of podiatric complaints – warts, corns, webbed toes, bunions and verrucas. But the episode where a forceps-armed Marion removed all ten yellow toenails from the feet of a fungally infected soldier – close-ups and all – was the one that made me slap down my laptop lid in horror.
Perhaps, I should get a second opinion? ‘It probably developed from an athlete’s foot,’ Steven Thomas, a Harley Street podiatrist, suggested without seeing my Tolkien-esque trotters.
Athlete’s foot (medically termed tinea pedis) being a highly contagious fungal infection of the skin. The itchy, stinging and burning rash commonly starts between the toes, thriving in warm, damp environments, such as sweaty shoes and public showers.
Sure enough, in my teens and 20s I did suffer the nastiness of Athlete’s foot, so itchy and irritable I would scratch the skin between my toes to bleeding … then put my dirty, sweaty sneakers back on and let the raw and ruddy mess fester.
Repeated trauma to the toenails – from running, football or hiking, for example – can damage the nail and make it easier for the same fungi that cause athlete’s foot to invade.
Anyone who plays a trauma-prone sport, explains Mr Thomas, or spends long periods of time standing up – footballers, chefs, the military etc – is at risk.
If you catch a fungal toenail infection early, topical treatments – usually paint-on solutions – can be successful. Prescription lacquers such as ciclopirox work best, but they need to be applied diligently for months while a healthy nail grows out. ‘But as the nail gets more deeply infected and the nail thickens, the topical treatment will be unable to get underneath the whole nail or reach the nail bed,’ he warns.
More effective is oral medication; terbinafine (commonly prescribed as Lamisil) is a potent prescription antifungal to treat severe onychomycosis. The standard dose is a single 250mg tablet taken daily for six weeks to treat fingernail infections or 12 weeks for toenail infections.
Before prescribing terbinafine, doctors will often send nail clippings for testing to confirm the infection is fungal and arrange a blood test to check liver function, as the drug can – in rare cases – affect the liver.
Turns out, I was way beyond the oral medication stage. So, after a fortnight of preparation, applying various fungal washes and terbinafine and Daktarin cream to check for any allergies or side-effects, this middle-aged man put on his big-boy pants and lay back on Marion Yau’s bed.
A few pricks of local anaesthetic later and she was all tooled up: forceps (pliers), an ‘elevator’ implement and a surgical Scrivener blade. I was suddenly starring in my own Master And Commander nightmare.
After removal. A few pricks of local anaesthetic later and she was all tooled up: forceps (pliers), an ‘elevator’ implement and a surgical Scrivener blade
Actually, it really wasn’t so bad. Mainly because I refused to watch. Even when Miss Yau started scraping off the scar tissue and the debris from the nail bed, it didn’t hurt much.
Maybe a few stabs of discomfort when the surgical scraping dug extra deep. And I did wince when she kindly offered me the removed toenails as a souvenir. (I politely declined.)
Huge, cartoon-comical dressings were applied to each toe. Obediently, I dosed up with painkillers, changed into Velcro-strapped sandals (rejecting the recommended Crocs on stylistic grounds) and was sent home in an Uber.
Driving myself would be technically illegal, public transport treacherous, and I’d have looked pretty daft pedalling a Lime bike. If I curled up my toes, I could still walk, albeit like a duck.
Was it painful after the aesthetic wore off? The odd twinge. At night I doubled my dope dose, and slept through. Then, woke up and applied fresh bandages.
‘Now you have to be a little obsessive about cleanliness,’ Miss Yau warned.
For the next few months, washing, cleaning and re-dressing my toe – along with fresh socks and clean shoes – would become part of my daily routine, as habitual as brushing my teeth. I’d also return for four follow-up appointments, during which my toes would be treated with the Lunula Laser to help prevent the infection from returning and to encourage healthy nail growth.
I’d been wise to take action, Miss Yau tells me at our next meeting. ‘Infection anywhere in your body is bad. Leave your infected toenails too long and a secondary bacterial infection can develop,’ she says.
‘A nail that becomes thickened can then ulcerate underneath the nail bed, which is like pressure ulcers on a diabetic, and a risk of more serious complications.’
As we get older, we become more susceptible to infection, she continues, acknowledging my age (62) as a classic demographic for my condition. ‘We get drier skin, drier hair, drier and weakened nails. We take a lot more antibiotics, and that makes us susceptible also.
‘I have women come in and tell me that they haven’t shown their husband their feet for years,’ she adds. (Fungal toenails affect men and women equally.)
Fungal infection in toenails can spread to other extremities. On occasions, Miss Yau has had to operate on fingernails that have become badly infected by feet.
Fearing for my own man-sized manicure, I sat on my hands as she said this, and swiftly we moved into the laser room.
The Lunula Laser uses two specific wavelengths of light, violet and red, to kill off the fungal infection while stimulating nail growth, all without damaging the surrounding tissue.
You pop your feet into a light box and let the low-level laser beams do their magic. Then, more washing, more fungal cream and new dressings.
Still my toes looked a bit sad, pink and barren with stubborn blood stains where the scraping had occurred. More Ew.
Then, suddenly, after six or eight weeks… a nail! A waxing crescent in pale pink. Slightly translucent. Healthy looking. Definitely not black or yellow.
After 30 years of nicotine-toned, toughened flakiness, of poolside embarrassment and familial shame, I was rapidly developing almost-presentable, Birkenstock-worthy, post-hensile toes. Summer 2027 here we come!
