Earlier this year, a young woman from NY came to the dermatologists at Weill Cornell Medicine hospital because six of her toenails had begun detaching from her foot for no apparent reason six months prior.
The patient didn't have any typical risk factors for toenail problems - such as an injury to the nails, or a family history of nail disorders - but she did report that she had a fish pedicure a few months before her nail problems started. Fish pedicures involve a person placing their feet in a warm tub of water while having small fish nibble on them. These fish typically eat plankton, but if plankton aren't available, they will eat dead human skin.
Soon, sessions with the rebranded "doctor fish" were also being hailed as a treatment for improving eczema, rough skin, circulation, and cleanliness.
"I do not recommend fish pedicures for any medical or aesthetic goal", Lipner said.
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"I do not recommend fish pedicures for any medical or aesthetic objective", Lipner said. Onychomadesis only temporarily stops nail growth, which usually resumes within 12 weeks, according to a 2017 study of the condition. Lipner notes that our toenails only grow 1mm a month on average, while an entire nail can take as long as 18 months to be replaced. "I am not convinced at all that the fishes caused the problem", Dr. Antonella Tosti, the Fredric Brandt Endowed Professor of Dermatology at the University of Miami Miller School of Medicine, told CNN.
Tosti, a former president of the European Nail Society, said the woman's problem could be caused by something much more mundane: overlapping toes in a certain type of shoe.
Now it's those trendy fish pedicures that are shrouded in horror.
But while there's no way to know for sure what caused the patient's toenail issues, there have been some concerns about fish pedicures in the past. Dr. Lipner continued that her patient's case could be the first incident where onychomadesis occurred due to a fish pedicure.
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While Lipner believes that the woman's problems stemmed from the physical impact of the fish biting at the nail, she noted that there have been past reports of infections associated with fish pedicures, too. In 2011, the Vancouver Island Health Authority also banned it, saying that there were bacterial risks because the fish could not be sterilized. And though proponents of fish pedicures have argued they can properly sanitise the fish and tubs between uses, research has shown that disease-causing bacteria can be readily found in both the tubs and fish used in these spas.
Their use has been banned in some states in the USA - at least 10, by Lipner's count.
"We will have to wait quite a while to see the outcome", she said.
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