Young Woman Loses Her Toenails After Getting A Fish Pedicure

Fish pedicures involve putting your feet in a tub of water filled with tiny fish called Garra rufa, which eat dead human skin.

Ultimately, the condition usually causes the nail to fall off, according to the new report, published today (July 3) in the journal JAMA Dermatology. Dermatologist and lead author Shari Lipner diagnosed the woman with onychomadesis, or a condition that halts nail growth at its root, likely caused by fish repeatedly biting the affected toes during the treatment.

Tosti, a former president of the European Nail Society, said the woman's problem could be caused by something much more mundane: overlapping toes in a certain type of shoe.

The study marks the first fish-related diagnosis of onychomadesis, but the pedicure poses more podiatric health risks, Lipner said.

"I do not recommend fish pedicures for any medical or aesthetic objective", Lipner said. The fish, which belong to the carp family and are native to the Middle East, normally eat plankton but will nibble on dead skin if no plankton is available. Toenails can take months to grow back, however, so she may need to wait a year before she can start rocking a great polish.

"While the mechanism of action is not entirely clear, it is likely due to the fish traumatizing the nail matrix", Sheri Lipner, an assistant professor of dermatology at Columbia University's Weill Cornell Medicine and the woman's doctor, told the website.

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. In addition, the fish themselves can not be sanitized between each customer's pedicure session, the CDC says.

The case, as far as Lipner knows, would be the first documented instance of onychomadesis ever caused by fish. Lipner was not able to identify the fish species involved in this case.

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. "It was a bit of a craze people got excited about, and then they moved on to the next thing", said Verner-Jeffreys, who added that the concern surrounding fish spas is not just about human health. As a result, people may see deep grooves that run horizontally across their nails - known as Beau lines - or they may see larger gaps where there is no nail, the AAD said. There other known causes of onychomadesis were ruled out, so it's thought that the fish pedicure is to blame.

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.

(Copyright © 2015. All Rights Reserved.)

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