Fish pedicures are a type of cosmetic treatment in which a person soaks their feet in water while a specific type of toothless fish eats away dead skin. Due to health and ethical concerns, they are illegal in parts of the United States, Canada, and Europe.

In Turkey, where the practice originates, there are hot springs that naturally contain these fish. People have visited these springs to treat skin conditions since the early 1900s.

Some people import these fish to offer the treatment in beauty clinics. However, there have been numerous cases of fish pedicures giving people infections.

In this article, we look at what fish pedicures involve, their potential benefits and risks, and more.

Fish pedicures are a type of foot treatment that aims to give people soft skin. They are also known as fish spa treatments or ichthyotherapy.

During the pedicure, a person soaks their feet in a basin of water, in which tiny “doctor fish,” or Garra rufa, are swimming. The fish will eat dead skin off the person’s feet.

In some locations, it is possible to bathe in waters that naturally contain G. rufa. These freshwater fish originally come from the Middle East. In Turkey, some live in hot springs that have become popular health resorts.

During a fish pedicure, a person first rinses their feet in warm water. Then, they sink their feet into a vat of water full of G. rufa fish. They soak their feet in the fish-filled tank, allowing the fish to nibble dead skin off their heels, soles, and toes.

Afterward, the person removes their feet from the tank, and a spa technician dries them with a towel. The technician may remove any remaining dead skin and perform other aspects of the pedicure, such as trimming or filing the toenails.

As with traditional pedicures, fish pedicures exfoliate the feet and can diminish calluses. This can leave the skin feeling softer and improve the appearance of the feet. Some people claim that G. rufa can also help treat skin conditions, such as psoriasis.

A small, older study looking at the benefits of bathing in the Kangal Fish Spring in Turkey found that psoriasis symptoms significantly improved after the participants bathed in the springs twice daily for 21 days. The treatment also led to longer periods of remission than topical steroids.

However, this was a very small study, and the scientists do not know why bathing in these springs helped. Although it may be due to the G. rufa fish, other factors — such as exposure to minerals in the spring water or UV light from the sun — could also play a role.

Researchers have identified a few risks to getting fish pedicures at a spa. These include:

Bleeding

G. rufa fish have no teeth, so their nibbling does not usually cause bleeding. However, they are also expensive, and are a protected species in Turkey. This means that many companies offering fish pedicures tend to get their fish from East Asia instead.

This can be risky due to the presence of another species of fish called the Cyprinion macrostomus, which looks very similar to G. rufa fish. These fish, which people call chin chin fish, will also eat dead skin, but they have teeth. This means that they can break the skin and cause bleeding.

Infections

A 2019 study notes that fish pedicures have the potential to spread zoonotic diseases. These are infections that originate in animals and then spread to humans.

According to a 2020 review, the overall risk of infection overall appears to be very low. However, in G. rufa that come from fish spas, researchers have identified microbes that cause illness in both humans and fish. These include:

• Aeromonas veronii
• Aeromonas hydrophila
• Vibrio cholerae
• Shewanella putrefaciens
• Mycobacterium marinum
• Mycobacterium goodii

The authors of this study speculate that the growth of these microbes is likely due to the poor health of the fish, particularly during transit.

However, the Centers for Disease Control and Prevention (CDC) point out that it is difficult to maintain hygienic conditions in human-made fish spas.

For instance, properly cleaning and sanitizing basins between pedicures is challenging, as many of the methods for doing this would harm the fish. Many fish pedicure spas also use the same fish for multiple clients.

It is unclear whether these risks also apply to G. rufa living in natural hot springs.

Death

Although rare, there have been cases where infections that people got from fish pedicures ultimately caused death.

Due to this risk, anyone with a compromised immune system, diabetes, or another serious health condition should never get fish pedicures.

Yes, fish pedicures are illegal in some states, including:

• California
• Florida
• Maine
• Massachusetts
• New Hampshire
• New Jersey
• New York
• Texas
• Washington

They are also illegal in Mexico, some countries in Europe, and some Canadian provinces.

Opponents of fish pedicures argue that the practice is unethical because importing the fish for pedicures can lead to them:

• experiencing stress and cramped conditions while in transit
• dying in transit
• becoming exposed to toxins during pedicures
• contracting diseases

Additionally, the fish will only eat human skin if they do not have access to any other source of food.

G. rufa are omnivorous and eat plankton as well as algae. If plankton is not available, the fish will look for alternatives.

In the context of human-made fish spas, operators intentionally do not feed the fish so that they will eat dead skin.

This can also occur naturally. In a hot spring, for example, it is too hot for plankton to grow, so the fish that live there will seek out other foods, such as dead skin.

Another issue surrounding fish pedicures is their potential impact on the environment.

Due to overfarming, Turkey has made G. rufa a protected species, but there are other nations that have not. Overfarming one species of fish can deplete their numbers. This, in turn, affects ecosystems and other animals higher up the food chain.

Additionally, G. rufa are not native to North America. If they end up in nearby waterways, they may disrupt the ecosystem and cause harm that is difficult to reverse. The Fish and Wildlife Service notes that the risk of this happening is unknown.

There are many safe alternatives to fish pedicures that people can use to treat dry skin on the feet.

Home remedies include:

• soaking the feet in a tub of hot water and then buffing them with a pumice stone
• applying exfoliating foot creams, wearing socks, and sleeping through the night with the socks on
• using an electric dry skin and callus remover

Alternative treatments include:

• regular pedicures, which use warm foot soaks, scrubs, and pumice stones to remove dead skin
• professional foot peels, which use acids to exfoliate dead skin from the feet
• treatment by a podiatrist or chiropodist, who can remove dead or hard skin with special tools

Fish pedicures are a controversial type of foot treatment. During the pedicure, a person sits with their feet in a basin of water. Doctor fish, or G. rufa, eat the dead skin on their feet.

Fish pedicures may pose a risk of causing infections, and some people argue that they are cruel. Overfarming G. rufa may also have a negative impact on the environment.

Some research focusing on hot springs where these fish live naturally suggests that they may offer some benefits to people with psoriasis. However, the evidence overall is weak, and more research is necessary. Anyone who is considering getting a fish pedicure should discuss this with a doctor first.

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