What is a fish pedicure?
During a fish pedicure, also known as a fish spa treatment, patrons place their feet in a tub of water filled with small fish called Garra rufapdf iconexternal icon. Garra rufa are sometimes referred to as “doctor fish” because they eat away dead skin found on peoples’ feet, leaving newer skin exposed.
Garra rufa are native to the Middle East, where they have been used as a medical treatment for people with skin diseases, like psoriasis.
Several published case reports describe illnesses resulting from fish pedicures (see below).
Why have some states banned the use of fish pedicures?
Each state has the authority to ban fish pedicures. Some states have banned the use of fish pedicures.
Reasons for the bans include the following:
- The fish pedicure tubs cannot be sufficiently cleaned between customers when the fish are present.
- The fish themselves cannot be disinfected or sanitized between customers and there is no effective way to disinfect the tubs. Because of the cost of the fish, salon owners are likely to use the same fish multiple times with different customers, which increases the risk of spreading infections.
- Chinese Chinchin, another species of fish that is often mislabeled as Garra rufa and used in fish pedicures, grows teeth and can draw blood, increasing the risk of infection.
- According to the U.S. Fish and Wildlife Service,pdf iconexternal icon Garra rufa could pose a threat to native plant and animal life if released into the wild because the fish is not native to the United States.
- Fish pedicures do not meet the legal definition of a pedicure.
- Some state regulations specify that fish at a salon must be contained in an aquarium.
- The fish must be starved to get them to eat skin, which might be considered animal cruelty.
Methicillin-resistant Staphylococcus aureus foot infection after fish pedicureexternal icon. Sugimoto K, Frei R, Graber P. Infection. 2013 Oct;41(5):1013-5. doi: 10.1007/s15010-013-0437-8.
Fish pedicure-induced foot mycobacteriosis infection due to Mycobacterium marinum: a first case reportexternal icon. Vanhooteghem O, Theate I. Eur J Dermatol. 2017 Jun 1;27(3):299-300. doi: 10.1684/ejd.2017.2976.
Periungual Mycobacterium marinum infection following a fish manicureexternal icon. Vanhooteghem O, Theate I, De Schaetzen V. Skin Appendage Disord. 2021 Aug;7(5):393-396. doi: 10.1159/000514853.
Staphylococcus aureus infection of the feet following fish pedicureexternal icon. Veraldi S, Nazzaro G, Çuka E.Infection. 2014;42(5):925-926. doi:10.1007/s15010-014-0622-4
- Verner-Jeffreys DW, Baker-Austin C, Pond MJ, Rimmer GSE, Kerr R, Stone D, Griffin R, White P, Stinton N, Denham K, Leigh J, Jones N, Longshaw M, Feist SW. Zoonotic disease pathogens in fish used for pedicure [letter]. Emerg Infect Dis. 2012;18(6).
- Health Protection Agency Fish Spa Working Group. Guidance on the management of the public health risks from fish pedicuresexternal icon. London: Health Protection Agency; 2011.
- US EPA. Recommended Cleaning and Disinfection Procedures for Foot Spa Basins in Salonsexternal icon.
- Shih T, Khan S, Shih S, Khachemoune A. Fish Pedicure: Review of Its Current Dermatology Applicationsexternal icon. Cureus. 2020;12(6):e8936. Published 2020 Jun 30. doi:10.7759/cureus.8936