Abstract
Ichthyotherapy or fish pedicure is a unique form of biotherapy in which the species Garra rufa or doctor fish is used to exfoliate the skin and potentially aid in healing diseases, such as psoriasis. The practice has gained popularity since its origins in Kangal Fish Spring in Turkey; however, safety concerns, especially among immunocompromised patients, remain. This article reviews the studied dermatological benefits of ichthyotherapy and theorized mechanisms of action. Included are cases examining both infectious and noninfectious complications of this procedure. This review highlights the need to educate susceptible patients about possible adverse effects and the need for more studies assessing this procedure.
Highlights
BackgroundIchthyotherapy, known as fish pedicure or fish spa, is a form of biotherapy in which the hands, feet, and whole body are immersed in a pool or tub of water filled with the fish Garra rufa which feed on dead human skin (Figure 1)
Ichthyotherapy or fish pedicure is a unique form of biotherapy in which the species Garra rufa or doctor fish is used to exfoliate the skin and potentially aid in healing diseases, such as psoriasis
Ichthyotherapy originated in Kangal Fish Spring in Turkey, a spring located in Kangal, a district of the Sivas province
Summary
Ichthyotherapy, known as fish pedicure or fish spa, is a form of biotherapy in which the hands, feet, and whole body are immersed in a pool or tub of water filled with the fish Garra rufa which feed on dead human skin (Figure 1). Ozcelik et al argued that the fish spa at Kangal hot spring should not be considered as ichthyotherapy, but rather a form of balneotherapy or the use of thermal mineral water to heal disease. He argues that the use of fish to remove squamae mainly serves to enhance the absorption of antioxidants and immunomodulatory minerals, which leads to improvement in a patient’s disease [6]. In 2015, Vanhooteghem et al reported a case of fish pedicure-induced Aeromonas sobria superficial necrotic bullous dermatitis in a 64year-old patient with previously undiagnosed type II diabetes, successfully treated with three weeks of oral ciprofloxacin [18]. No other noninfectious complications have been reported with ichthyotherapy
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