'Fish Pedicure' Causes Woman to Lose Her Toenails

Leslie Hanson
July 4, 2018

Garra rufa, or "doctor fish", pick dead skin from a spa visitor's feet in April 2006 in Hakone, Japan.

Ultimately, the condition usually causes the nail to fall off, according to the new report, published today (July 3) in the journal JAMA Dermatology. The woman said she had no history of any pain or trauma to her toes, no nail disorders or recent illnesses, and hadn't started any new medications.

Tosti, a former president of the European Nail Society, said the woman's problem could be caused by something much more mundane: overlapping toes in a certain type of shoe.

In fact, the Centers For Disease Control and Prevention has determined that Garra rufa pedicures can transmit infections because the water is often not changed between customers, and, as one would expect, the mouths of foot-chomping fish get pretty dirty.

She said the case could be the first documented instance of onychomadesis ever caused by fish. This nail shedding is called onychomadesis, and it usually results in the nail falling off after an injury stops nail growth.

The fish's voracious feasting is said to help treat conditions such as psoriasis as well as beautify the skin, lending them the nickname of "Doctor Fish".

Sheri Lipner, an assistant professor of dermatology, told Gizmodo: 'While the mechanism of action is not entirely clear, it is likely due to the fish traumatizing the nail matrix'.


Lipner is unaware of any other such cases linked to fish spas, whose popularity seem to have drawn from unfounded claims about their health benefits, according to her report. Dr. Lipner continued that her patient's case could be the first incident where onychomadesis occurred due to a fish pedicure.

"Unfortunately the water is sometimes contaminated with bacteria and other pathogens and the fish themselves can do more damage than good", Day said.

As for Lipner's patient, her nails will grow back, though it'll take time.

But while there's no way to know for sure what caused the patient's toenail issues, there have been some concerns about fish pedicures in the past. Lipner was not able to identify the fish species involved in this case.

"We will have to wait quite a while to see the outcome", she said. And though proponents of fish pedicures have argued they can properly sanitise the fish and tubs between uses, research has shown that disease-causing bacteria can be readily found in both the tubs and fish used in these spas.

At least 10 states in the USA have banned the treatment because of its potential health hazards, the CDC said, though 2011 Health Protection Agency guidelines considered the risk of bacterial infection from fish spas to be "very low" but not completely avoidable.

Other reports by Iphone Fresh

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