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Is there something fishy going on in fish spas?

Is there something fishy going on in fish spas?

I have recently read a lot of articles about fish pedicures. What are they?

You might have seen a lot of fish pedicure centres in Malaysia. They are not like your regular nail salon pedicure, in which a pedicurist washes and scrapes off the dead skin of your feet and around your nails with instruments.

A fish pedicure is also known as a fish spa. Here, the fish involved are the Middle Eastern and Turkish freshwater fish called Garra rufa. They are also called “doctor fish”. These fish have no teeth.

Since the beginning of this century, the Garra rufa have been used in spa treatments for psoriasis patients. Psoriasis is a disease where the patient has flaky skin.

In this treatment, the patient immerses himself in a bathtub of these fish, and allow the fish to feed on their upper skin layer to help peel it off. The fish spa does not cure psoriasis as there is no cure for it. However, it does alleviate symptoms.

This fish has also been used for patients with eczema. Since then, spas for people without skin problems have latched onto this treatment. But their safety is still being widely debated.

Wait. A fish spa involves the fish actually eating my skin? Isn’t that like what a piranha does?

Not at all. Piranhas are flesh-eating fish that nibble deeper than just the surface of your skin.

The Garra rufa removes dead skin on top of your stratum corneum, or the outer layer of your skin. This is similar to what a traditional pedicurist does – removing dead skin with a foot file or a scrubber. Only, the fish does this in a far more efficient and comprehensive manner.

Traditional pedicurists tend to concentrate more on the area around your nails, and perhaps the calluses on your soles, but tend to neglect other areas. The fish will bite every part of your submerged feet. The word “bite” is very subjective as well, because these fish have no teeth.

A fish spa is not painful either. I, for one, find the sensation very pleasant – once you get over the slight ticklishness of it.

Yes, but are fish spas safe?

That is what the debate is all about now. The US Centre for Disease Control and Prevention (CDC) has published that there have been no illnesses reported from fish spas, but that is back in 2012.

There, however, are many American states, and even Canadian, that ban this sort of spa treatment. Some of reasons for this include:

• The fish pedicure tubs cannot be sufficiently cleaned between customers.

• The fish cannot be “disinfected” or “sanitised’ between customers. Salon owners are likely to use the same fish multiple times with different customers, which increases the risk of spreading infection.

•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.

• The fish must be starved to eat skin, which might be considered animal cruelty.

But please note that even traditional pedicures and manicures have issues about safety sometimes. The pedicurist may use the same instruments between customers and spread infections, especially if blood was involved. The pedicurist may fail to sanitise those instruments. The pedicurist may also damage your skin and nail bed.

Like with any sort of procedure, there is always a risk that you have to take.

Do fish spas spread diseases? What type?

The British Health Protection Agency recently published that fish spa pedicures could spread diseases such as HIV and Hepatitis C, and that patients with a weak immune system, such as those having diabetes or psoriasis, are particularly vulnerable. They however conceded that the risk is extremely low, but could not be completely excluded.

The reasons for the possible disease spread are exactly what has been warned by the US CDC – the fact that many salons do not change the water between customers because it is not financially viable or easily possible.

So if a customer who has HIV and Hepatitis C (which are blood borne diseases) bleeds into the water, there is a risk for this to be passed – especially if the next user has a cut or open wound for the viruses to seep into.

Note that the same infections can be transmitted if the pedicurist does not sterilise his instruments between one user and another. The Health Protection Agency has recommended that the water be changed between customers.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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