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September 2018

Onychomadesis Following a Fish Pedicure

Author Affiliations
  • 1Department of Dermatology, Weill Cornell Medicine, New York, New York
JAMA Dermatol. 2018;154(9):1091-1092. doi:10.1001/jamadermatol.2018.1827

A fish pedicure is a treatment in which the feet are immersed in a tub of water at a temperature of 25°C to 30°C that is filled with small fish called Garra rufa or “doctor fish.” Garra rufa are a nonmigratory, freshwater species that belong to the carp family (Cyprinidae) and are native to waters from the Persian Gulf to the eastern Mediterranean. In their natural habitat, suction assists them in sticking to rocks while they ingest plankton. Being omnivores, when there are insufficient plant sources, they will eat human skin. A town called Kangal was popular with people with psoriasis because it was observed that the resident Garra rufa fed on psoriatic plaques and spared normal skin.1 These subjective results were confirmed in a clinical trial that included 67 patients with psoriasis who underwent therapy with these fish for 3 weeks and experienced a 72% reduction in the Psoriasis Area Severity Index score compared with baseline, with no adverse effects.2

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