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A number of spas are offering a pedicure using the fish species, Garra rufa (“Doctor Fish”) which feeds on dry skin (ichthyotherapy). It has been advocated for the treatment of psoriasis. The fish is native to the countries in the Eastern-Mediterranean (mainly Turkey) where it is mostly found in fresh water warm springs and in rivers. This fish has no teeth, so just feeds on the desquamating skin by nibbling at that dead or unhealthy skin, giving the ‘pedicure’. It is particularly popular in the Kangal hot springs area in Turkey where it is widely used to treat psoriasis and atopic dermatitis.
In 2011, there were 279 fish spas in 119 local authorities across the UK (ref). It is not known how common it is elsewhere, but it does appear to be less interest in it now than previously. The Google Trends graph for the number of searches for ‘fish pedicure’ suggest a declining interest:
Most of the commentary on the efficacy of a fish pedicure and all the support for it is based on the novelty, marketing, testimonials and anecdotes. There is a book published in German about it. The reaction in some of the anecdotes is that it is not for the ‘squeamish’ and almost all are very positive about how effective it is. Some comment on the soothing micromassge from the feeding action of the fish.
It was first raised in a 1985 article in The Lancet as a possible treatment for psoriasis. An initial uncontrolled study in 2000 showed some promising results. A later study in Austria has looked at the effects of Garra rufa on psoriasis in more detail. It was a retrospective review with no control group and reported 70% reduction in psoriasis severity after three weeks of the ichthyotherapy.
Safety:
The fish pedicure is banned in several USA states by the registration boards of cosmetology (or equivalent) and in some local regions in other countries for hygiene reasons as concerns raised regarding infection control as the fish can not be ‘sterilized’ nor discarded after each treatment due to cost. The water can be sterilized and any cuts or breaks in the skin should preclude any one from having the treatment, so the risk of infection is very low if proper attention is paid to hygiene.
In 2011 a working group in Scotland recommended:
The fish spa working group concluded that those with weakened immune systems or underlying medical conditions, including diabetes and psoriasis, are likely to be at increased risk of infection and so fish pedicures are not recommended for such individuals. The working group advised that operators of fish spas should not promote treatment to these groups.
The Center for Disease Control (USA) lists these possible reasons as to why some states ban them:
- The fish pedicure tubs cannot be sufficiently cleaned between customers when the fish are present.
- The fish themselves cannot be disinfected or sanitized between customers. Due to the cost of the fish, salon owners are likely to use the same fish multiple times with different customers, which increases the risk of spreading infection.
- Chinese Chinchin, another species of fish that is often mislabeled as Garra rufa and used in fish pedicures, grows teeth and can draw blood, increasing the risk of infection.
- 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 the fish is not native to the United States.
- Fish pedicures do not meet the legal definition of a pedicure.
- Regulations specifying that fish at a salon must be contained in an aquarium.
- The fish must be starved to eat skin, which might be considered animal cruelty.
Ten states in the USA have now banned them. In the UK, the Health Department published these guidelines on: Guidance on the management of the public health risks from fish pedicures.
Two cases have been reported of infection developing following a fish pedicure. One was a Staphylococcus aureus infection and the other was a Methicillin-resistant Staphylococcus aureus infection.
External Links:
Live fish used to give pedicure (Podiatry Arena)
Zoonotic Disease Pathogens in Fish Used for Pedicure (Podiatry Arena)
Related Topics:
The Science of Pedicures: Countering the Crisis in Nail Salons | Death by Pedicure: The Dirty Secrets of Nail Salons | Kangalfische, heilendes Peeling im Wasser: Schöne, gesunde Hände + Füße durch Knabberfische | Master The Secret Art of Medical Pedicures
Other Alternative Practices:
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