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'Fish Pedicure' Causes Woman to Lose Her Toenails

04 July 2018

If you've been thinking about getting one of those fish pedicures, this might make you think twice: a woman's toenails fell off after getting one.

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

The report, published in the journal JAMA Dermatology, describes a woman in her 20s who is believed to have contracted an infection called onychomadesis from a fish pedicure.

In the new case, it's not exactly clear how fish pedicures might cause onychomadesis, but it's likely that trauma from the fish biting multiple nails caused the nails to stop growing, the report said.

The woman visited her dermatologist after her months of her toenails falling off.

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However, routine use of the fish for pedicures is another matter, she said, and may often cause more harm than good. Spas can also mistake the toothy chinchin fish, which draws blood, for the doctor fish, further increasing the risk of infection, the Centers for Disease Control and Prevention said.

Lipner said the woman's nails may grow back - but it'll take as long as 18 months.

She said the case could be the first documented instance of onychomadesis ever caused by fish. It could be due to lingering microbes from whomever's feet were there last, versus the fish itself.

"First, tubs and fish can not be adequately sanitized between people", Lipner said, "with the same fish typically reused for several persons".

In the United Kingdom, "the salons themselves were really popular here; they sprung up very rapidly", said Amanda Walsh, a senior scientist with the Emerging Infections and Zoonoses team of Public Health England.

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That raises the odds for infections transmitted between customers, and "several bacteria capable of causing disease in humans were isolated in batches of Garra rufa and waters from 24 fish spas", she said. The culprit was found to be a streptococcal bacteria, a strain that is associated with fish like tilapia, according to David Verner-Jeffreys, a senior microbiologist at the Centre for Environment, Fisheries and Aquaculture Science in the UK.

Fish pedicures have boomed since the first US fish spa opened in Virginia in 2008, Lipner claims in the paper, due to what she calls "unfounded claims" that the treatment leaves feet smoother and less pungent, removes bacteria and fungus and increases circulation.

Despite the name, "fish pedicures do not meet the legal definition of a pedicure", the CDC says.

Lipner would not reveal where the woman got the pedicure, but noted the treatment has been banned in at least 10 states, largely due to health concerns.

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'Fish Pedicure' Causes Woman to Lose Her Toenails