Fish Pedicures: This Trend Is More Than a Little ‘Fishy’

What a fish pedicure is + why it’s not safe
Fish Pedicures: This Trend Is More Than a Little 'Fishy'

How badly do you want smoother, fresher-smelling feet? For the promise of glowing, baby-soft footsies, would you place them into a cool basin of pint-sized, flesh-eating fish?

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Though not a new phenomenon, the “fish pedicure” is a growing trend in the spa world.

Patrons place their feet in water tubs containing carp-like fish called Garra rufa (or “doctor fish”), which are native to the Middle East. In turn, the fish go to work snacking on the person’s dead skin cells.

It’s important to note that sloughed skin isn’t usually on the menu for these fish, which prefer plankton and plant sources; they only eat human skin when they can’t find anything better.

Those favoring the treatment argue that the fish soften callouses, help lighten dark cuticles and increase circulation. However, experts say the health risks, both to humans and to the fish, outweigh any potential benefits. As a result, the fish pedicures have been banned in 10 U.S. states, Mexico and parts of Europe.

5 risks of a fish pedicure

According to dermatologist Shilpi Khetarpal, MD, “Even though this trend may seem natural or interesting to some people, it poses significant risk.” Here are five reasons she says you should avoid fish pedicures:

1. Potential infections. Cost constraints make it more likely that salon owners will use the same fish multiple times with different customers, which increases the risk of spreading infection.

“The Garra rufa are imported, purposely starved and then often shared by different patrons,” Dr. Khetarpal says. “There’s no effective way to disinfect the tubs or the fish themselves. Many spas will simply reuse the fish.”

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She cites European tests conducted in 2011 of imported Garra rufa fish, which unearthed bacterial strain Streptococcus Agalactaie group B.

“This bacteria can cause pneumonia, bone and joint infection and blood stream infections,” she says.

2. Nail trauma. Generally, these fish nibble at dry, dead skin while leaving healthy skin and nails intact. But recently, a woman in her 20s reported severe toenail injuries after a fish pedicure.

The scariest part? She didn’t feel any pain during the pedicure to warn her of injury; damage to the nail matrix wasn’t visible until the nails attempted to grow out – 3 to 6 months later.

In this case, the biting fish caused trauma that stopped nail plate production in multiple toenails. The woman was diagnosed with what doctors call onychomadesis, a condition that causes nails to shed, which often results in nail loss.

“Even though the fish are not targeting the nail bed, they chew on the cuticle, which can affect the stem cells in the nail plate,” Dr. Khetarpal says. “It’s a slow process, but often you see lifting of the nail.”

3. Blood-drawing fish swap. Here’s another twist. You may not even be sharing the tub with Garra rufa but rather another cheaper, more aggressive fish variety called Chin-Chin.

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These Chinese fish look similar but they grow teeth. As a result, they can bite and draw blood. This further raises the risk for infection.

4. Inhumane practice. Besides all the risks to humans, this practice may be considered inhumane to the fish; it requires starving the Garra rufa to make them feed off of people’s dead skin.

5. Environmental concerns. According to the U.S. Fish and Wildlife Service, Garra rufa could pose a threat to native plant and animal life if released into the wild because these fish are not native to the United States.

Fish pedicures for psoriasis?

In particular, fish therapy (also called ichthyotherapy) has held promise for people with certain skin conditions, especially psoriasis.

It began in Kangal, a small town in Turkey. This place became popular with people with psoriasis when they noted how the local Garra rufa fish naturally cleaned the plaques while sparing normal skin. As word spread, researchers conducted a few small studies that noted positive results in controlling psoriasis tied to the use of the fish.

In a study of 67 patients over three weeks, people noted a 72 percent reduction in the Psoriasis Area Severity Index (PASI) score without any adverse effects. Another study of 87 patients had similar findings, with marked improvement over three weeks of treatment and longer remission periods.

Researchers concluded that there are potential benefits for psoriasis patients in the use of Garra rufa fish. However, the Centers for Disease Control (CDC) warns that this is only when the fish are used in their native environment or a controlled medical setting under a dermatologist’s supervision – and never in a spa setting.

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