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Fish pedicures unlikely to cause infection

Following months of research the Health Protection Agency says the risk of infection from having a fish pedicure is very low but they aren't for everyone
WebMD UK Health News
Medically Reviewed by Dr Roger Henderson

18th October 2011 - Having dozens of little minnow-like fish nibble at your toes isn't everyone's idea of a relaxing beauty treatment but the number of fish spas in the UK has continued to rise since the first one opened in 2010.

The growth in popularity has also led to a growth in concerns about just how safe they are. Following a number of enquiries to the Health Protection Agency (HPA) from local environmental health officials, a multi-agency working group was established to look into the treatment.

The HPA scientists concluded that the risk of infection associated with Garra rufa fish pedicures is likely to be very low. However, they don't recommend them for anyone with a weakened immune system or underlying medical condition, including diabetes and psoriasis, as they are likely to be at increased risk of infection.


To date, the HPA has been made aware of a handful of cases of infection in people who had recently had a fish pedicure. However, foot infections can spread in a variety of environments, and the agency was unable to say categorically where individual cases of infection were picked up.

During a treatment customers place their feet in tanks of warm freshwater containing dozens of toothless Garra rufa fish, which are also known as doctor or nibble fish. They suck and gently nibble away at dry and dead skin. The end result is said to leave your feet feeling refreshed and healthy.

Fish tank water has been shown to contain a number of microorganisms. Therefore, in a fish spa setting there is the potential for transmission of a range of infections, either from fish to person (during the nibbling process), water to person (from the bacteria that can multiply in water), or person to person (via water, surrounding surfaces and fish).

However, the HPA says overall risk of infection is likely to be very low, if appropriate standards of hygiene are adhered to.

Good hygiene

Dr Hilary Kirkbride, consultant epidemiologist at the HPA, said in a prepared statement: "Provided that good standards of hygiene are followed by salons, members of the public are unlikely to get an infection from a fish spa pedicure, however the risk will be higher for certain people.

"This is why we feel it’s important for salons to ensure the client has no underlying health conditions that could put them at risk, and that a thorough foot examination is performed, to make sure there are no cuts, grazes or existing skin conditions that could spread infection.

"Anyone considering a fish pedicure can help reduce the risk of infection - both to themselves and others - by taking simple precautions. Allowing any cuts or infections you may have on your feet or legs to heal before having the treatment, and waiting at least 24 hours after having a leg wax or shaving, will minimise your chances of catching anything. If you do experience any ill effects after the treatment, you should visit your GP."

Dr Paul Cosford, Director of Health Protection Services at the HPA, added: "As with any beauty salon, it’s really important that strict standards of cleanliness are followed, to ensure that the risk of infection is kept to a minimum. If a member of the public is concerned about the level of cleanliness of a salon they visit, they should report this to their local Environmental Health department."

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