Garra rufa also known as Doctor Fish, a small species of cyprinid fish have been integrated into a spa treatments since the early 21st century. They feed on the skin of the patients and used to treat psoriasis. There are many benefits of Fish Spa such as, removing dead skin, heals cracks in the feet, gives micro massage, reduces stress and strain, improves blood circulation, makes skin smooth and soft, reduce pain in the leg, releases medicinal enzyme on the feet and helps new skin to grow.

Fish spa is banned in several states of the U.S.A and Canadian provinces as cosmetology regulators believe that the practice of using Doctor Fish to treat skin diseases is unsanitary. According to the wall street journal, “cosmetology regulations generally mandate that tools need to be discarded or sanitized after each use. But epidermis-eating fish are too expensive to throw away”

However, health experts have warned that fish foot spa could spread diseases such as Human Immunodeficiency Virus (HIV) and Hepatitis C.

“People who have diabetes, psoriasis or a weak immune system should not participate in this kind of treatment as they are particularly vulnerable” The Government’s Health Protection Agency warned explaining that the risk of infection for users of the beauty craze in which hundreds of small fishes eats the dead skin from the customers’ feet is ‘low but could not be completely excluded’.

The Government’s Health Protection Agency says that tank waters contains micro-organisms and believes that complications may arise from bacteria being transmitted by the fishes from the spa water or from one customer to another.

If a customer is infected with a blood-borne infections or virus like HIV/AIDS or hepatitis and contaminates the water with blood, there is a big risk of the virus from being passed on.

A spokesman added that they have issued guidance because there are a growing number of fish spas. When the correct hygiene procedures are followed, the risk of catching an infection is low. However, there is still a risk of transmission of a number of infections including viruses like HIV and hepatitis.

They recommended ensuring that spa water is changed after each client to avoid the spreading of infections and viruses although the equipment cannot be conventionally decontaminated because it may harm the fish.

“Provided that good standards of hygiene are followed by salons, members of the public are unlikely to get an infection from a fish spa pedicure, however the risk will be higher for certain people.” Said Dr. Hilary Kirkbride a consultant epidemiologist at the HPA

“Salons should first check their clients have no underlying health conditions that could put them at risk, and thoroughly examine their feet to make sure there are no cuts, grazes or infectious skin conditions.”Dr. Kirkbride added.

The HPA’s director, Dr. Paul Cosford advice the public to report to their local environmental health department if they are concerned about the level of cleanliness of the salon they visit.