After fish pedicure, woman loses her toenails

Tiny fish called Garra rufa eat dead human skin making for a sort of pedicure

A NY woman lost her toenails after developing a condition believed to have been brought on by a fish pedicure, according to the dermatologist who treated the issue. Despite being in good health with no prior history of nail disorders, some of her toenails showed a separation and gradual disappearance of the underlying nail bed.

Their use has been banned in some states in the USA - at least 10, by Lipner's count. Although often due to injury, it has been linked to infections, as well as certain medications and autoimmune disorders.

Fish pedicures involve having small fish nibble on a person's feet while they soak in a tub of warm water.

"First, tubs and fish can not be adequately sanitized between people", Lipner said, "with the same fish typically reused for several persons".

There were reports of a patient with a Staphylococcus aureus infection after a fish pedicure.

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. Following her pedicure, most of her toenails on both feet stopped growing and began to fall off, a condition known as onychomadesis. "Therefore, we will have to wait quite a while to see the outcome", she said.

The woman's toenails will likely return, but it will take a long time as nails only grow about one millimeter a month on average.

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"Being omnivores, when there are insufficient plant sources, they will eat human skin", Shari Lipner, assistant professor of dermatology at Columbia University's Weill Cornell Medicine and report's author wrote. There other known causes of onychomadesis were ruled out, so it's thought that the fish pedicure is to blame.

What she had done, though, was have a fish pedicure six months before. In 2011, the Vancouver Island Health Authority also banned it, saying that there were bacterial risks because the fish could not be sterilized.

Despite the name, "fish pedicures do not meet the legal definition of a pedicure", the CDC says. 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.

One skin expert not involved with the case said the report raises cause for concern.

While Garra rufa have been investigated as a treatment for psoriasis - though not in the context of a nail salon - Lipner stressed that this is not standard medical practice.

The popularity of fish pedicures peaked about 10 years ago, but they are still trendy today, the report said.

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