Young Woman Loses Her Toenails After Getting A Fish Pedicure

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Earlier this year, a young woman from NY came to the dermatologists at Weill Cornell Medicine hospital because six of her toenails had begun detaching from her foot for no apparent reason six months prior.

The freakish beauty practice has people rest their feet in tubs of lukewarm water while tiny fish called Garra rufa nibble at their toes - exfoliating the skin by sucking off dead cells. These fish typically eat plankton, but if plankton aren't available, they will eat dead human skin.

A photo showing onychomadesis on the first, second, and third toe of each of the patient's feet.

Fish pedicures may be a fun way to exfoliate rough heels, but experts are now warning that the procedure may pose an infection risk.

After having the fish pedicure, the woman said her toenails stopped growing and then started falling off.

"Being omnivores", the fish "will eat human skin", wrote case report author Dr. Shari Lipner, a dermatologist at Weill Cornell Medicine in New York City. Onychomadesis only temporarily stops nail growth, which usually resumes within 12 weeks, according to a 2017 study of the condition. Although there's no definitive test for fish-nibble-induced toenail loss, "I think we're fairly sure that it was the fish pedicure", she said.

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.

Lipner said the woman's nails may grow back - but it'll take as long as 18 months.

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That raises the odds for infections transmitted between customers, and "several bacteria capable of causing disease in humans were isolated in batches of Garra rufa and waters from 24 fish spas", she said.

This is the first reported case of a fish pedicure causing the toenails to fall off, so it's not necessarily common. In addition, the fish themselves can not be sanitized between each customer's pedicure session, the CDC says.

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 U.S., but they remain popular in China.

At least 10 states in the US have banned the treatment because of its potential health hazards, the CDC said, though 2011 Health Protection Agency guidelines considered the risk of bacterial infection from fish spas to be "very low" but not completely avoidable.

In 2011, an investigation by the UK's Fish Health Inspectorate found a bacterial outbreak among thousands of these fish, which had been transported from Indonesia to United Kingdom pedicure spas. But there were special contraindications for fish pedicures that needed to be considered; recent waxing or shaving, certain skin disorders and cuts on the feet or legs could increase one's risk of infection, she said.

Several spas in the USA and Canada offer fish pedicures but they are controversial.

"We will have to wait quite a while to see the outcome", she said.

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