Are Fish Pedicures Safe and Are There Benefits?

In a fish pedicure, Garra rufa nibble away dead skin on the feet, leaving behind softer, smoother skin. But the practice raises health and ecological issues, particularly around the difficulty of properly sanitizing between clients.

A fish pedicure consists of immersing the feet in a tank of water inhabited by small fish. These Garra rufa, sometimes referred to as doctor fish, consume dead skin from the feet, resulting in smoother soles, reduced calluses, and cleaner-looking cuticles.

These treatments are common in regions of the Middle East, where the practice began, and in some Asian countries. Garra rufa are indigenous to the Middle East and parts of Southeast Asia. They are permitted in some locations in the United States.

The procedure gained popularity because the fish can exfoliate and soften the feet without causing pain. The sensation of the fish nibbling can be ticklish but is generally not painful. Nevertheless, fish pedicures carry both medical and environmental hazards, and have been outlawed in several U.S. states and in parts of Canada and Europe.

Safety concerns

There are multiple reasons fish pedicures are often viewed as risky or unsafe. The main safety concerns include:

• Sanitizing tubs between customers is problematic because the fish must remain present during the treatment and cannot themselves be disinfected.
• Some Garra rufa are mistaken for a different fish species, Chinchin, which can develop teeth and bite, causing pain and elevating the chance of infection.
• There have been accounts of infections caused by pathogenic bacteria carried by the fish.
• Onychomadesis, a condition where toenails darken and detach, has been reported and is likely linked to trauma from the fish’s pressure on the nails.
• In at least one instance, a bacterial skin infection producing rough plaques on the skin was documented after a fish pedicure.
• There is a minor risk of blood-borne pathogen transmission between customers if a person with an open, bleeding wound contaminates the communal water.

Purported benefits

Claims about fish pedicures include reduced calluses, smoother skin on the feet, and removal of dry, rough patches. Equivalent results can be achieved with a human pedicure at a reputable salon or by using a pumice stone or foot scrub at home. Overall, the hazards associated with fish pedicures tend to outweigh their advantages.

One study reported a reduction in psoriasis symptoms among individuals who underwent ichthyotherapy (treatment with Garra rufa), but there are alternative therapies that do not carry the same risks.

Where it’s banned

Fish pedicures are prohibited in at least 14 U.S. states, including:

• Texas
• New York
• New Jersey
• California
• Washington
• Maine
• Massachusetts

They are also outlawed in Mexico, portions of Europe, and some areas of Canada.

Ethical concerns

There are additional ethical issues tied to fish pedicures.

• Because Garra rufa are not native to North America, many die during transport.
• If released into local waterways, they can become invasive and disturb native ecosystems.
• The fish will only eat dead skin when they are hungry, so they are often deprived of other food sources.
• In some regions, Garra rufa are intensely farmed to meet demand for pedicures.

The bottom line

Fish pedicures involve placing your feet in a basin inhabited by Garra rufa, a fish native to the Middle East. While they may produce softer feet and possibly reduce psoriasis symptoms for some, the medical and ethical concerns — including infection risk and challenges with sanitation between customers — generally outweigh the potential benefits.