Six months prior, the woman had dunked her feet in a tub of water filled with tiny fish called Garra rufa that will eat dead human skin when no plankton are around. It wasn’t until later on that she noticed her nails beginning to shed.
“I think that this is probably more common than we think,” said the report’s author, Dr. Shari R. Lipner, an assistant professor of dermatology at Weill Cornell Medicine and director of the nail division.
“We don’t see the [nail] shedding until months after the event, so I think it’s hard for patients and physicians — especially if they’re not even aware that fish pedicures can do this — to make that connection,” she said.
This phenomenon, known to doctors as onychomadesis, usually results in the nail falling off long after an initial event (such as an injury) arrests nail growth. In her report, Lipner describes this as a “relatively common physical examination finding” that has been linked to infections, medications, autoimmune and heritable conditions.
Lipner said the patient had no other medical history that she could link to her abnormal toenails. Although there’s no definitive test for fish-nibble-induced toenail loss, “I think we’re fairly sure that it was the fish pedicure,” she said.
“I am not convinced at all that the fishes caused the problem,” Dr. Antonella Tosti, the Fredric Brandt Endowed Professor of Dermatology at the University of Miami Miller School of Medicine, wrote in an email.
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.
“This is not uncommon in women with a Greek foot … who wear high heels and pinpointed shoes,” Tosti said, referring to feet whose second toes are longer than the first, like Greek statues.
Toenails usually grow at about 1 millimeter per month, Lipner said, so a nail can take up to a year to fully grow back.
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. However, the use of “doctor fish,” as they are also known, goes further back in other countries, such as Turkey.
Experts say they’re unsure how infections might be spread through fish pedicures. It could be due to lingering microbes from whomever’s feet were there last, versus the fish itself. Health experts have raised concerns that, in fish spas, the fish are recycled from person to person, and the tubs may not be properly cleaned between uses.
Their recommendations dealt with hygiene and infection control, “as would be required for other types of beauty salons.” But there were special contraindications for fish pedicures that needed to be considered; recent waxing or shaving, certain skin disorders and cuts on the feet or legs could increase one’s risk of infection, she said.
“I wouldn’t say it necessarily poses a significant risk to humans, but it did illustrate that they may be carrying things which are nasty both to fish and humans,” he added.
But in the UK, the fish spa fad didn’t stay around for very long. “It was a bit of a craze people got excited about, and then they moved on to the next thing,” said Verner-Jeffreys, who added that the concern surrounding fish spas is not just about human health.
“We did have some concerns about the welfare of these animals being transported around the world, often by people with limited experience,” he said. And healthy fish, he added, would mean “less problems all around.”
What’s in a name?
Their use has been banned in some states in the US — at least 10, by Lipner’s count.
While Garra rufa have been investigated as a treatment for psoriasis — though not in the context of a nail salon — Lipner stressed that this is not standard medical practice.
“I would be highly surprised if you found any dermatologist who recommends Garra rufa pedicures,” Lipner said.
“I think we can pretty definitively say that getting a fish pedicure is probably not the way to go to treat skin and nail conditions.”
News credit : Cnn