Woman's toenails fall off after fish pedicure, researchers say

Tiny fish called Garra rufa eat dead human skin making for a sort of pedicure

Tiny fish called Garra rufa eat dead human skin making for a sort of pedicure

According to a case report published by the patient's doctor in JAMA Dermatology, the woman's toenails stopped growing and started falling off months after getting a fish pedicure in NY.

Fish pedicures have boomed since the first US fish spa opened in Virginia in 2008, Lipner claims in the paper, due to what she calls "unfounded claims" that the treatment leaves feet smoother and less pungent, removes bacteria and fungus and increases circulation.

During a fish pedicure, people immerse their feet in a tub of water that contains small, freshwater fish called Garra rufa, which are native to the Middle East, according to the Centers for Disease Control and Prevention.

Ultimately, the condition usually causes the nail to fall off, according to the new report, published today (July 3) in the journal JAMA Dermatology.

The woman's toenails will likely return, but it will take a long time as nails only grow about one millimeter a month on average, Lipner said.

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For one, the fish are often used on more than one person, making the risk of transmitting infections a real possibility. These fish typically eat plankton, but if plankton aren't available, they will eat dead human skin. Dermatologist and lead author Shari Lipner diagnosed the woman with onychomadesis, or a condition that halts nail growth at its root, likely caused by fish repeatedly biting the affected toes during the treatment. "I am not convinced at all that the fishes caused the problem", Dr. Antonella Tosti, the Fredric Brandt Endowed Professor of Dermatology at the University of Miami Miller School of Medicine, told CNN. There were reports of a patient with a Staphylococcus aureus infection after a fish pedicure.

Tosti, a former president of the European Nail Society, said the woman's problem could be caused by something much more mundane: overlapping toes in a certain type of shoe.

The report doesn't specify where the woman had her pedicure, for the sake of protecting her anonymity, but it's worth noting that the pedicures have been banned in many states in the USA, but they remain popular in China.

Their use has been banned in some states in the USA - at least 10, by Lipner's count. 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. "It was a bit of a craze people got excited about, and then they moved on to the next thing", said Verner-Jeffreys, who added that the concern surrounding fish spas is not just about human health. "Therefore, we will have to wait quite a while to see the outcome", she said.

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