Woman's toenails fall off after fish pedicure, researchers say

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A woman began to lose her toenails after a "fish pedicure", a ticklish spa craze popular in China and the United States, according to a study published Tuesday in JAMA Dermatology.

Garra rufa, or "doctor fish", pick dead skin from a spa visitor's feet in April 2006 in Hakone, Japan.

A woman in her 20s reportedly lost all of her toenails after allegedly getting a so-called "fish pedicure", a treatment touted by many as rejuvenating for a person's feet. 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 may be a fun way to exfoliate rough heels, but experts are now warning that the procedure may pose an infection risk.

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The fish's voracious feasting is said to help treat conditions such as psoriasis as well as beautify the skin, lending them the nickname of "Doctor Fish".

Dr. Sheri Lipner, the woman's doctor and an assistant professor of dermatology at Weill Cornell Medicine, stated that this was most likely a result of fish traumatization to the woman's toenails. 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. However, people with onychomadesis usually experience spontaneous regrowth of their nail within 12 weeks, according to a 2017 report in the journal Cutis.

The popularity of fish pedicures peaked about 10 years ago, but they are still trendy today, the report said. It's a typical byproduct of hand-foot-and-mouth disease, a viral infection common in children that appears as a rash on the hands and feet, so it's unclear how the infection was spread through the fish pedicure. Lipner was not able to identify the fish species involved in this case.

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. They hit their peak in popularity in the U.S. around a decade ago, but have since been banned in at least 10 states, including NY, largely because of health concerns. 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. Dr. Lipner continued that her patient's case could be the first incident where onychomadesis occurred due to a fish pedicure. And though proponents of fish pedicures have argued they can properly sanitise the fish and tubs between uses, research has shown that disease-causing bacteria can be readily found in both the tubs and fish used in these spas.

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