Fish Pedicure: Exotic Spa Trend Or Hidden Health Hazard?

You enter a spa session to relax and pamper yourself. You sit comfortably and expose your feet for a pedicure. You let them be cleaned and sanitised before dipping them gently into a tub filled with lukewarm bluish green water that gets its tinge from a lighting effect.

You want your worries to wash away and be calm with the soothing experience of a foot massage or a pedicure. But hey! Hold on. You suddenly feel a nibbling sensation at your feet — a mild stinging around your soles and toes as shoals of colourful fishes come rushing to feed on the dead skin.

They swim around the ankles, edges, fingers and the top of your feet to bite and tickle in order to exfoliate the dry layer of skin, dark cuticles and rough patches or calluses. After completing this session, the feet are towel dried and a foot cream is applied.

If the concerned customer prefers, then a glittery or a solid nail colour of her choice is also added to spruce up her feet. Till here, fish pedicure sounds like a cosy, luxurious affair but the medical fraternity raises the alarm about the possible red flags looming over.

Piscean Pedicure

Fish pedicures have gradually become a popular as well as a bit controversial trend in the sphere of beauty treatments. It involves putting one’s feet down into a tank filled with small toothless fishes, typically the Garra rufa breed or ‘doctor fish’. These fishes nibble away dead skin cells, leaving a pair of feet softer and smoother to touch.

“Fish spas do provide a temporary cosmetic improvement to the skin’s texture and appearance. It’s like a quick fix solution that leaves behind a fresh, supple and shiny skin post exfoliation. The process is painless and can lead to a plump and pliable feel owing to the removal of dull, arid, flaky cuticles. The nibbling action also stimulates blood circulation, which might give the skin a momentary glow,” observes dermatologist Dr. Prachi B. Bodkhe from Envi Aesthetics.

“While it may sound like a fun, exotic spa experience, it’s essential to understand the potential risks, hygiene concerns and the long-term effectiveness of this routine before deciding to give it a shot,” opines Dr. Anuradha Sharma, medical adviser and skin expert at Fixderma India PVT. LTD, a leading cosmeceutical company.

Echoing her statement, Dr. Bodkhe further stresses that “for a skin with deeper concerns and to achieve better health outcomes in the long haul, one shouldn’t replace a consistent skincare routine with a glamorous and pleasurable fish spa indulgence.”

Safety Alert

The million-dollar question is whether fish spa can have side effects as many skin types are allergic to certain fishes. Also, if the water in the fish chamber or a particular basin is not hygienically maintained, can it cause diseases? While you immerse your feet in the water for a spa treatment, the ‘doctor fish’ may skillfully peel off the scrapes of parched, dead skin from your feet to uncover the plain soft skin beneath but how healthy or hygienic is this procedure?

“Fish spas or pedicures are not widely considered to be salubrious or safe as this type of therapy involves submerging your feet inside a tank or an aquarium where a school of fishes bites away the dead skin, triggering chances of inducing infections as the fishes are seemingly reused for several sessions with multiple other customers. Moreover, if the water reservoir is not cleaned properly after every session, the perils of bacterial contamination causing skin diseases and health issues persist. People, especially, with diabetes and low immunity levels are more vulnerable to get affected,” warns Dr Rishabh Raj Sharma, assistant professor of dermatology at NIIMS Medical College & Hospital.

Focusing light on the probable demerits of a fish spa, medical cosmetologist Dr. Harini Reddy states that “fish pedicures might be considered precarious due to two key reasons. Firstly, it’s difficult to sanitise the vessels (as well as the fishes) used for pedicuring hordes of people and secondly, there are very high possibilities of inflicting contagious infections like Mycobacteriosis, causing rough plaques on the skin.”

Contagious Spa

A lot of debate goes on regarding the fishes (e.g. Garra rufa or the red garra of the Middle Eastern and Southeast Asian breed) seemingly carrying harmful bacteria, which are not conducive to human health. The common query revolves around the needle of suspicion whether the same school of fishes is being repeatedly used for several spa sessions.

“There are maximum chances of staph (a group of bacteria causing skin eruptions) infections emanating from fish pedicures, which can even cause pneumonia, bone or joint infection in some cases. There is also a risk of blood-borne infections passing between customers. Reports confirm a few cases of Onychomadesis, a condition that leads to shedding of nails resulting in nail loss,” inputs Dr. Reddy, who’s also an aesthetic medicine expert and heads Manya Aesthetics skincare clinic.

Adding further, she says: “You see, the Garra rufa fish is often confused with another species of fish, which can grow teeth and bite, causing pain and increasing the skin infection. However, chances of potential infection always remain as most of the times the same shoal of fishes is applied more than once to a number of customers.”

2Admitting that the Garra rufa fish may carry dangerous bacteria and that using these fishes can cause immense health risks, Dr Sharma reasons that “since the same set of fishes is used for many pedicure sessions, there is evidently a significant risk of bacterial, viral or fungal transmission and cross-contamination between persons that makes the fish spas potentially unsafe.”

Legal Lens

“Fish spas are not absolutely illegal in India. Neither there are any strict rules or regulations to restrict them. Some states have, however, already imposed bans because of the concern for hygiene as well as to advocate animal welfare rights,” informs Dr Sharma.

Dr. Reddy apprises ahead that “though in India, there is no legit countrywide embargo on the fish spas, it is prohibited across 10 states of the USA, Mexico and in some parts of Europe.

Skin Treatment

The Garra rufa fish, also called nibble fish, is believed to have some healing abilities as it helps remove the dead skin, which might offer a ‘temporary relief’ from scaling in psoriasis. “The fish helps soften the thickened skin, making the feet feel plane, silky and smooth. Nevertheless, it won’t fill up the deep cracks,” notes Dr. Reddy.

While fish pedicures may provide an improved skin owing to exfoliation but that is only for a brief period. “Fish spa is not a medically recommended treatment for any chronic skin conditions. People are advised to rather opt for safer and more hygienic alternatives like chemical peels, scrubs or medicated creams,” she argues.

Dr Sharma shares that “sometimes fish spas are claimed to address skin diseases like psoriasis and eczema by removing the dead skin cells but it doesn’t deliver a medical cure. Also, such pedicure methods can worsen the skin issues because of infection risks. Dermatologists usually do not suggest fish pedicures for skin treatment.”

Doctor’s Verdict

Every individual has a different skin type and some are allergy-prone. A person should first consult a dermatologist before opting for fish pedicure for cosmetic reasons. “Yes, individuals with sensitive skin should discuss with a skin specialist prior to going for a fish spa session. As skin reactions also vary from person to person, taking professional advice can prevent allergies and consequent infections,” insists Dr Sharma.

“If you have a delicate skin or suffer any chronic skin condition, it’s then best prescribed to consult a qualified dermatologist ahead of diving into cosmetic skin treatments,” alerts Dr. Reddy.

“The medical expert can take a detailed look at your unique skin type, spot the potential allergies and suggest the perfect treatment options that fit your needs. Adopting this proactive approach can really help avoid any uncontrollable damaging reaction, irritation or even aggravating the existing skin issues. Getting professional guidance means you can be sure of your chosen treatment to be safe, effective and apt for your skin's specific needs,” she elaborates.

Benefits

Several hundreds of finning and floating fishes, primarily the Garra rufa species, are used for every single session of the spa treatment to feast on the dead skins. This type of fish is known for its character to peck and chew on the dead skin but is not harmful to healthy tissues. The treatment is touted as a soothing, natural, pain-free exfoliation regime, leaving the feet neat and rejuvenated. “This tidying up process is often called ichthyotherapy that avows to unveil benefits like enhanced blood circulation and speedy skin regeneration. However, there is not much evidence to support such claims,” reports Dr. Anuradha.