"I do not recommend fishpedicures for any medical or aesthetic objective", Lipner said.
Garra rufa, or "doctor fish", pick dead skin from a spa visitor's feet in April 2006 in Hakone, Japan. According to an American Medical Association report, a woman had this done, then shed her toenails.
Having fish eat dead skin off your feet may be a trendy (and ticklish) way to exfoliate, but so-called "fish pedicures" could pose health risks.
Dr. Shari R. Lipner, an assistant professor of dermatology at Weill Cornell Medicine, wrote a report on the young woman's case in JAMA Dermatology.
Months after her nails stopped growing and fell off, the woman went to visit her dermatologist, who ruled out other known causes of onychomadesis, including major illness or side effects from medications. This nail shedding is called onychomadesis, and it usually results in the nail falling off after an injury stops nail growth.
"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.
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.
Toenails usually grow at about 1 millimeter per month, Lipner said, so a nail can take up to a year to fully grow back. It's a typical byproduct of hand-foot-and-mouth disease, a viral infection common in children that appears as a rash on the hands and feet, so it's unclear how the infection was spread through the fish pedicure.
One skin expert not involved with the case said the report raises cause for concern.
For the sake of protecting her patient's anonymity, Lipner can't reveal where the woman got her pedicure. Additionally, the fish are sometimes recycled from person to person, and a bacterial outbreak among the fish was reported in a 2011 investigation by the UK's Fish Health Inspectorate. There were reports of a patient with a Staphylococcus aureus infection after a fish pedicure. "Therefore, we will have to wait quite a while to see the outcome", she said.
Indeed, in 2012, researchers in the United Kingdom intercepted shipments of Garra rufa fish bound for U.K. spas and tested them for bacteria.
At least 10 states in the US have banned the treatment because of its potential health hazards, the CDC said, though 2011 Health Protection Agency guidelines considered the risk of bacterial infection from fish spas to be "very low" but not completely avoidable.
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