Fish Pedicure Causes Woman’s Toenails to Fall Off

After a woman’s toenails unexplainably began to fall off, a doctor was able to pinpoint the cause — a fish pedicure.

According to a JAMA Dermatology report published Tuesday, the unorthodox spa treatment, which involves plunging feet in a tub of water filled with garra rufa, or “doctor fish,” was to blame for nail abnormalities that resulted in a 20-something woman’s toenails to eventually separate from their nail beds — a condition known as onychomadesis.

“To my knowledge, this is the first case of onychomadesis associated with a fish pedicure,” Dr. Shari Lipner wrote in the case study. “While the exact mechanism is unknown, it is likely that direct trauma caused by fish biting multiple nail units causes a cessation in nail plate production.”

The female subject in the report had claimed to receive a fish pedicure some months before beginning to notice the abnormal nail behavior. She had no family history of nail disorders and no medical problems that Lipner said could’ve been linked to the nail damage.

Fish pedicures peaked in popularity about 10 years ago, but they continue to trend in certain parts of the world. The treatment requires that feet stay immersed in lukewarm water while small freshwater fish feast on human skin to leave feet smoother, increase circulation and eliminate fungus and bacteria, as well as treat psoriasis and eczema. (A town in Turkey called Kangal was cited as a location popular with people who had psoriasis because the garra rufa fed on the plaques and left alone the normal skin.)

The report also detailed certain risks associated with fish pedicures, such as the transmission of infections because both the tubs and the fish cannot be adequately sanitized between people. About 10 states in the country have banned the service.

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