Fish Pedicures: Do they pose any risk of infection?

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Fish pedicures became popular in the UK around 2011. The novel beauty treatment involves placing your feet in a fish tank where a school of toothless Garra rufa fish nibble away dead skin.

This type of treatment is thought to have been used for years in the Far East and Turkey. It found popularity as a spa treatment in the UK thanks to lots of high-profile media coverage.

Following the dramatic rise in the popularity of fish pedicures, there was a growing concern about the possibility that fish spas were a hotbed for a number of infections. This triggered the Health Protection Agency (HPA) to carry out an investigation into the safety of the practice.

Can you get an infection from a fish pedicure?

Possibly, but the chances are quite slim.

A simple Google search provides numerous horror stories about fish pedicures going horribly wrong. Anecdotal reports of skin being broken, toenails falling off and infections being caught don’t make for pleasant reading.

Let’s take a look at what the HPA report has to say about the possibility of contracting an infection:

  • Fungal infections

The HPA recognized that fungi can survive on inanimate surfaces for quite some time. This means that fungal infections, such as those causing athlete’s foot and verrucas, can be transferred between clients if they come into contact with areas where others have walked barefoot. However, this risk is no greater than the risk posed at leisure centers and other shared bathing facilities.

  • Blood-borne viruses

The risk of contracting a blood-borne virus (BBV), such as HIV or hepatitis, at a fish spa is extremely low. There are stories of fish spa clients bleeding into the tank during treatment, however, it is thought that any contamination would not remain in the fish’s mouths.

  • Bacterial infections

The HPA investigation looked at several different types of harmful bacteria. The majority were classified as low risk, including salmonella and legionnaires disease. That being said other types of bacteria may pose a slightly greater risk to certain members of the public.

A bacteria known as Staphylococcus aureus could infect the skin of people with eczema or psoriasis, whereas Mycobacterium marinum could be transferred to the skin through an open wound and can result in the formation of granuloma. Shaving prior to a fish pedicure may increase the risk of this type of infection.

  • Parasitic infections

Humans can contract fish-borne infections from eating undercooked fish. The HPA concluded that a parasitic infection could only be feasibly caused by a fish pedicure if someone either drank the fish water or ate the fish.

What to look for when attending a fish spa

The HPA investigation allowed them to produce a set of guidelines for spa owners to manage the risk to public health. If you wish to attend a spa for a fish pedicure you may want to check that they have suitable safety precautions in place.

  1. The flooring in the spa should be clean, non-slip, and non-absorbent.
  2. Fish spa staff may wish to examine your feet for cuts before and after a session.
  3. The spa should provide you with information on any potential contraindications prior to your treatment.

Some examples of potential contraindications include, but are not limited to, the following:

  • recent leg waxing or shaving;
  • open cuts to the feet or lower leg area;
  • foot infections, such as athlete’s foot or verrucas;
  • skin conditions, such as eczema or psoriasis.

The spa should ask you to sign a form to confirm that you have read and understood this information.

How should I keep my feet healthy?

It’s important to take good care of our feet. Poor foot health can impair our ability to take proper care of ourselves and remain healthy.

However, it is not necessary to attend a spa in order to maintain good foot health. There are simple practices you can do at home to keep your feet looking and feeling fine:

  • Try and keep your feet clean and dry.
  • Gently remove hard or dead skin with a pumice stone or foot file.
  • Change your socks every day.
  • Wear flip-flops when attending any communal changing areas.
  • Clip your toenails regularly but take care when doing so. Cutting toenails too short or at an angle can lead to ingrown toenails.
  • Wear comfortable and well-fitting shoes.

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Tom Perry, M.D., attended Tulane University and graduated Magna Cum Laude with a B.S. degree in Parasitology. He received his M.D. degree in 1983 from the University of Virginia School of Medicine, where he gained extensive research experience, including studies conducted through the National Institutes of Health.