
A case report in the journal JAMA Dermatology describes how an unnamed woman in her 20s contracted onychomadesis from the pedicure - which causes nails to shred.
The patient didn't have any typical risk factors for toenail problems - such as an injury to the nails, or a family history of nail disorders - but she did report that she had a fish pedicure a few months before her nail problems started.
Fish pedicures involve putting your feet in a tub of water filled with tiny fish called Garra rufa, which eat dead human skin. The fish used in this treatment are toothless carp fish, which are plant eaters and eat the dead human skin.
Soon, sessions with the rebranded "doctor fish" were also being hailed as a treatment for improving eczema, rough skin, circulation, and cleanliness.
Fish pedicures may be a fun way to exfoliate rough heels, but experts are now warning that the procedure may pose an infection risk.
Dr. Shari R. Lipner, an assistant professor of dermatology at Weill Cornell Medicine, wrote a report on the young woman's case in JAMA Dermatology. Dr. Lipner was convinced that her patient has no other previous health issues that would explain what happened with her toenails.
In the new case, it's not exactly clear how fish pedicures might cause onychomadesis, but it's likely that trauma from the fish biting multiple nails caused the nails to stop growing, the report said.
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"This is not uncommon in women with a Greek foot ... who wear high heels and pinpointed shoes", Tosti said, referring to feet whose second toes are longer than the first, like Greek statues.
"I do not recommend fish pedicures for any medical or aesthetic objective", she told Gizmodo.
"I do not recommend fish pedicures for any medical or aesthetic goal", Lipner said.
But while there's no way to know for sure what caused the patient's toenail issues, there have been some concerns about fish pedicures in the past.
Toenails usually grow at about 1 millimeter per month, Lipner said, so a nail can take up to a year to fully grow back. 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.
Indeed, in 2012, researchers in the United Kingdom intercepted shipments of Garra rufa fish bound for U.K. spas and tested them for bacteria.
"We did have some concerns about the welfare of these animals being transported around the world, often by people with limited experience", he said. They hit their peak in popularity in the USA around a decade ago, but have since been banned in at least 10 states, including NY, largely because of health concerns.
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