Everything You Need to Know About Fish Pedicures

Woman getting a fish pedicure

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If you book yourself in for a pedicure, you expect the beautician to use a pumice stone or file to remove hard patches and calluses from your feet. However, for those with a strong stomach, there is another way to achieve silky smooth soles. Fish pedicures employ hundreds of tiny toothless carp (Garra rufa) to nibble the dead skin from your feet and were hugely popular in North America and Europe towards the end of the 2010s. 

In addition to improving the appearance and feel of your skin, fish spas are often credited with alleviating the symptoms of psoriasis and eczema. However, while they are still prevalent in places like Southeast Asia, their popularity has waned in the West due to health and animal welfare concerns. In this article, we give you the facts so that you can make up your own mind about this controversial beauty treatment

How It Works

Known colloquially as doctor fish, Garra rufa is native to Turkey and several Middle Eastern countries including Syria, Iran, and Iraq. They are used almost exclusively for fish pedicures because of a survival tactic that enables them to thrive on dead scales and skin whenever their preferred food is scarce. Usually, the fish are kept in a communal tank at the spa; then when a customer arrives, around 100 of them are transferred into an individual foot bath.

After removing your shoes and socks, your feet should be rinsed thoroughly and inspected for any cuts or infections before you immerse them in the warm water of the fish tank. The Garra rufa are attracted by the vibration of your feet entering the water, and will immediately congregate around any patches of hard or dead skin to feed. Because they have no teeth, their nibbles should feel ticklish rather than painful, though accounts vary from person to person. 

Most fish pedicures last for between 15 and 30 minutes and may be followed by a traditional pedicure. 


Legend has it that the Turks have been using Garra rufa for exfoliation for at least 400 years. However, fish pedicures only became commercially popular in the mid-2000s, when they were introduced at resorts in Turkey, Japan, and Croatia. The first American fish spas opened in 2008, and in 2010, the craze spread to the UK. A year later, there were nearly 280 fish pedicure services in operation in the UK, many of them inspired by the industry’s cheap set-up costs.

However, the fish spa trend took a knock later in 2011, when testing on a batch of 6,000 Garra rufa imported from Indonesia showed that the fish were infected with Streptococcus agalactiae, a bacteria that is potentially harmful to those suffering from chronic conditions and/or immunodeficiency. This discovery prompted in-depth investigations by Britain’s Health Protection Agency (HPA) and America’s Centre for Disease Control and Prevention (CDC). 

Health Concerns

Although Garra rufa fish are toothless, anecdotal reports show that it is possible for them to break the skin if they nibble too long in one spot. This fact combined with the possibility of customers entering the pedicure with a cut or abrasion led the HPA to determine that there is an extremely low risk of blood-borne diseases being transmitted from one fish spa user to the next. Bacterial infections are also possible, especially if you have eczema, psoriasis or broken skin. 

Although scientifically possible, there have been very few proven cases of infection as a result of a fish pedicure. However, the HPA recommends that people with conditions including diabetes, blood-borne viruses, a compromised immune system or dermatitis (on the feet or legs) should avoid fish spas. In addition, the agency suggests that those who suffer from the conditions fish spas are expressly meant to help (namely psoriasis and eczema) should also abstain. 

In 2018, international media covered the story of a woman whose toenails stopped growing after contracting a condition known as onychomadesis at a fish spa. The CDC states that fish pedicures cannot be considered entirely hygienic because while most cosmetology procedures demand that tools be sanitized or discarded after each use, this is obviously not possible when the tools are live fish. Consequently, fish pedicures have been banned in at least 10 U.S. states. 

Animal Welfare Controversy

Animal rights groups including PETA and the RSPCA have spoken out against fish spas for several reasons. Firstly, the demand for Garra rufa fish has led to them being over-harvested in the wild: in Turkey, legislation has been introduced to protect them from commercial exploitation. Second, the practice of exporting the fish in water-filled plastic bags is considered inhumane, with many of them dying en route. 

Once the fish arrive at their destination, they are starved in between treatments to emulate the conditions that would prompt them to eat dead skin (or more likely, scales) in the wild. The RSPCA voiced concerns over the effect that constantly moving the fish from tank to tank might have on their life expectancy. Like all fish kept in captivity, doctor fish need their water temperature and quality to remain consistent. Lastly, exposure to the chemicals that customers may have on their feet in the form of lotion or sunscreen is also likely to be detrimental.

Where to Go and What to Look For

Ultimately, it would seem that there are safer and more ethical ways to achieve soft feet. However, if you are keen to experience a fish pedicure for yourself, there are still places that you can do so in North America thanks to companies like Garra Spas that have store-front locations throughout the states where they practice isn’t banned. Many European cities also offer fish spa services, and in Asia, the pedicures are still popular. 

Although there’s no way to guarantee that the fish at your chosen spa are well-treated, there are ways to minimize the risk to your own health. Make sure that the company follows basic hygiene procedures, including rinsing your feet thoroughly before the pedicure and checking for cuts and abrasions both before and after. Advanced filtration systems including UV sterilization cut the risk of bacterial infection to almost zero. 

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