Fish Therapy Has Many Possible Applications For Skin Diseases
February 18, 2019 at 4:07 p.m.
By Max [email protected]
Currently the fish is employed to perform pedicures. As such, it consumes dead skin on people’s feet and leaves newer skin exposed – thus the name “doctor or nibble fish.”
Fish pedicures fortunately have not been implicated in any associated illnesses, but there have been a number of outbreaks of bacterial infections related to nail salon foot baths. They have resulted in wound problems, septicemia, boils and scarring. Because of these problems, more than 10 states have banned the use of fish pedicures. Banning is based on at least one of the following reasons:
• The fish pedicure tubs cannot be sufficiently cleaned between customers when the fish are present.
• The fish themselves cannot be disinfected or sanitized between customers. Due to the cost of the fish, salon owners are likely to use the same fish multiple times with different customers, which increases the risk of spreading infection.
• Chinese Chinchin, another species of fish that is often mislabeled as Garra rufa and used in fish pedicures, grows teeth and can draw blood, increasing the risk of infection.
• According to the U.S. Fish and Wildlife Service, Garra rufa could pose a threat to native plant and animal life if released into the wild because the fish is not native to the United States.
• Fish pedicures do not meet the legal definition of a pedicure.
• The fish must be starved to eat skin, which might be considered animal cruelty.
Description
Doctor fish is the name given species of Garra rufa. The species occurs in the river basins of the Northern and Central Middle East, mainly in Turkey, Syria, Iraq and Iran. Although Garra rufa are native to various Middle Eastern countries, they are largely concentrated within the river beds and hot springs in Turkey. It is thought that their unique healing properties were discovered in Turkey, which is where they were granted the nickname.
Doctor Fish Spas
During the 1960s health spas were built near the habitat of the Garra rufa so that visitors could benefit from the foot therapy. In 2006, doctor fish spas opened in Hakone, Japan, and in Umag, Croatia, where the fish are used to clean the bathers. There are also spas in resorts in China, Belgium, the Netherlands, South Korea, Singapore, Bosnia-Herzegonia, Hungary, Slovakia, India, Thailand, Cambodia, Indonesia, Malaysia, the Philippines, Hong Kong, the Czech republic, Spain, France and Norway. The procedure is legal in Quebec, with a few clinics in Montreal. In 2010, the first UK spa opened in Sheffield, England.
Ichthyotherapy
According to Wikipedia, ichthyotherapy can be defined as the use of freshwater or marine organisms as agents of skin wound/condition cleansing. The name comes from the Greek name for fish – ichthys.
The history of such treatment in traditional medicine is sparsely documented. There is widespread use of such fish in India, particularly in rural areas. The benefits were first observed in Kangal, Turkey; therefore, it is also called the Kangal fish.
Patients suffering from psoriasis have benefited from the doctor fish treatment, which involves lying in the ponds and letting the fish eat the scales and loose skin on the affected areas. In fact, such is the popularity of the treatment for skin conditions that Kangal became a health resort.
In one published study, 67 patients diagnosed with psoriasis underwent three weeks of ichthyotherapy in combination with short term ultraviolet A sunbed radiation at an outpatient treatment facility. Patients were required to stay in treatment tubs for two hours a day. Each patient was allocated a personal bathing tub, and the fish only came in contact with a single patient. The study, of course, was limited by the relatively small number of patients treated and by lack of a control group. Randomized trials would be needed to compare the ichthyotherapy treatment with controls and to assess treatment with standardized health-related quality of life questionnaires.
The study cited is certainly not definitive. However, in light of the widespread distribution of psoriasis and the fact that there is no cure, makes the finding promising.
Possible Mechanisms
Of Action
Several mechanisms have been suggested regarding the observed efficacy of ichthyotherapy. One obvious mechanism is the physical contact with the fish, which feed on the desquamating skin, thus leading to a rapid reduction of the scales of psoriasis. The fish seem to prefer affected instead of healthy skin.
Another suggested mechanism could be that the simultaneous removal of scales by the fish facilitated the penetration of UV rays to the dermis. This exposure of lesions may explain the better outcome of combined ichthyotherapy/UVA treatment when compared to the poor results of UVA sunbed treatment alone.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He can be reached by email at maxsherman339@ gmail.com.
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Currently the fish is employed to perform pedicures. As such, it consumes dead skin on people’s feet and leaves newer skin exposed – thus the name “doctor or nibble fish.”
Fish pedicures fortunately have not been implicated in any associated illnesses, but there have been a number of outbreaks of bacterial infections related to nail salon foot baths. They have resulted in wound problems, septicemia, boils and scarring. Because of these problems, more than 10 states have banned the use of fish pedicures. Banning is based on at least one of the following reasons:
• The fish pedicure tubs cannot be sufficiently cleaned between customers when the fish are present.
• The fish themselves cannot be disinfected or sanitized between customers. Due to the cost of the fish, salon owners are likely to use the same fish multiple times with different customers, which increases the risk of spreading infection.
• Chinese Chinchin, another species of fish that is often mislabeled as Garra rufa and used in fish pedicures, grows teeth and can draw blood, increasing the risk of infection.
• According to the U.S. Fish and Wildlife Service, Garra rufa could pose a threat to native plant and animal life if released into the wild because the fish is not native to the United States.
• Fish pedicures do not meet the legal definition of a pedicure.
• The fish must be starved to eat skin, which might be considered animal cruelty.
Description
Doctor fish is the name given species of Garra rufa. The species occurs in the river basins of the Northern and Central Middle East, mainly in Turkey, Syria, Iraq and Iran. Although Garra rufa are native to various Middle Eastern countries, they are largely concentrated within the river beds and hot springs in Turkey. It is thought that their unique healing properties were discovered in Turkey, which is where they were granted the nickname.
Doctor Fish Spas
During the 1960s health spas were built near the habitat of the Garra rufa so that visitors could benefit from the foot therapy. In 2006, doctor fish spas opened in Hakone, Japan, and in Umag, Croatia, where the fish are used to clean the bathers. There are also spas in resorts in China, Belgium, the Netherlands, South Korea, Singapore, Bosnia-Herzegonia, Hungary, Slovakia, India, Thailand, Cambodia, Indonesia, Malaysia, the Philippines, Hong Kong, the Czech republic, Spain, France and Norway. The procedure is legal in Quebec, with a few clinics in Montreal. In 2010, the first UK spa opened in Sheffield, England.
Ichthyotherapy
According to Wikipedia, ichthyotherapy can be defined as the use of freshwater or marine organisms as agents of skin wound/condition cleansing. The name comes from the Greek name for fish – ichthys.
The history of such treatment in traditional medicine is sparsely documented. There is widespread use of such fish in India, particularly in rural areas. The benefits were first observed in Kangal, Turkey; therefore, it is also called the Kangal fish.
Patients suffering from psoriasis have benefited from the doctor fish treatment, which involves lying in the ponds and letting the fish eat the scales and loose skin on the affected areas. In fact, such is the popularity of the treatment for skin conditions that Kangal became a health resort.
In one published study, 67 patients diagnosed with psoriasis underwent three weeks of ichthyotherapy in combination with short term ultraviolet A sunbed radiation at an outpatient treatment facility. Patients were required to stay in treatment tubs for two hours a day. Each patient was allocated a personal bathing tub, and the fish only came in contact with a single patient. The study, of course, was limited by the relatively small number of patients treated and by lack of a control group. Randomized trials would be needed to compare the ichthyotherapy treatment with controls and to assess treatment with standardized health-related quality of life questionnaires.
The study cited is certainly not definitive. However, in light of the widespread distribution of psoriasis and the fact that there is no cure, makes the finding promising.
Possible Mechanisms
Of Action
Several mechanisms have been suggested regarding the observed efficacy of ichthyotherapy. One obvious mechanism is the physical contact with the fish, which feed on the desquamating skin, thus leading to a rapid reduction of the scales of psoriasis. The fish seem to prefer affected instead of healthy skin.
Another suggested mechanism could be that the simultaneous removal of scales by the fish facilitated the penetration of UV rays to the dermis. This exposure of lesions may explain the better outcome of combined ichthyotherapy/UVA treatment when compared to the poor results of UVA sunbed treatment alone.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He can be reached by email at maxsherman339@ gmail.com.
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