Not so Appyfeet

You may have noticed them. I certainly have.

A new type of shop seems to be springing up.

Those shops full of water tanks. A bit odd, but not that weird. But there are people with their feet in the tanks. A bit more odd.

Oh, and did I mention that those water tanks are full of skin-eating fish.

Now, before you get nervous and think that these shops are selling the opportunity to have your foot eaten off by piranhas, I’ll give you a little bit of background into these establishments.

These shops supposedly give you the “Ultimate Fish Pedicure”. They have big tanks of fish called Garra rufa fish, often known as “Doctor fish”. These fish have no teeth and nibble away at dry skin.

Foot Picture 1

Appy Feet, the largest provider of these fish pedicures in Britain, say

“Although these little Minnow size fish have no teeth, they certainly have a big impact! When you immerse your feet into the warm water these curious little dermatologist will get to work by gently nibbling off any dead hard skin, leaving you pampered, healthy and glowing.

All over the world nibble fish centres are springing up and people are taking advantage of a totally organic pedicure. The fish will only work on unhealthy or dead skin, the healthy skin is left untouched.” –

The price works out at £10 for 15 minutes or £20 for 35 minutes in the tank. They also offer a hand spa for £5 for 5 minutes or £10 for 15 minutes.

Foot Picture 2

There are a few problems though, the main one being the issue of disease transmission.

In the US, these spas and salons are banned for being “unsanitary”. In order to keep these places sanitary, the fish need to be thrown away after each use.

I called the Manchester branch of Appy Feet and asked them what their protocols for disease prevention were, to see if they followed this sanitation recommendation.

The person on the phone told me that they used a water filter, a UV filter and fresh water pumping through the tanks all the time. Seeing as it’s the fish that would need to be replaced after each use, this doesn’t seem like an adequate compromise.

Also, these aren’t just promoted as a cosmetic or relaxation device. It’s claimed by some that these can help with a load of dermatological illnesses, including eczema and psoriasis.

There is precisely one pilot study that I could find when searching “Garra rufa” on PubMed. It gained a positive result. However, it was a pilot study. It had no control group and only involved 67 patients. And it was used in combination with UVA therapy. It’s a little hard to derive much meaning from this then.

To conclude, these fish pedicure establishments have the potential to pass on disease – for a fee!

And, if you’ve been told to go there because they can cure psoriasis or another dermatological illness, I wouldn’t advise it. There’s close to no evidence to support it’s use.

I think I’d rather stick with my Crappy Feet.

Published by Rhys

Computer Science graduate, from Oxford Brookes University. Originally from Cardiff.

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  1. I asked my podiatrist about these fish centres last week, while at my annual feet check-up/tidy-up. Her view was that they were probably harmless if you had nothing particularly wrong with your feet, but you should stay clear if you had any cuts, wounds or damaged skin (or are in an at-risk category, such as diabetics). She intended to try the experience, but purely as a research exercise!

    Several of her patients had visited a fish therapy centre, with a generally neutral-to-slightly-positive response, but there was nothing the fish could do that the podiatrist couldn’t do better.

  2. I was udner the impression that there is some benefit from full body immersion in relation to Psoriosis.

    This of course is probably not very convincing.

    I’ve seen them offered at Chirpractors and other Alt Med clinics- thats really the main sign they’re bogus.

  3. I would hardly use policy of the United States government as any measure of sound or objective regulation. Particularly when it comes to anything to do with medicine.

    The only thing needed to reuse these fish between clients would be the proper amount of time. Fish are cold blooded, so the chance of them acquiring a human disease and transferring it is near nill to zero. This chance is lessened even further due to the fact that as living organisms they have their own immune systems that negate disease. A helpful analogy here would be the difference between wood and plastic cutting boards. If you cut up a chicken each on both and only wiped them with a rag and hot water, the next day the wood cutting board would be almost bacteria free while the plastic one will have an increased amount of bacteria.

  4. Sorry to post twice with an obvious point, but I meant to include the fact that human diseases, particularly fungi, require the environmental conditions of the host to survive and given enough time would die on the fish.

  5. I’ve gone to a few of these places in Seoul, most of which were cafes or bars with tanks built into the floor. I didn’t see any sign of customers there being interested in curing diseases. Instead, they were mostly young people enjoying the rather weird sensation of having your feet nibbled by dozens of tiny fish.

    It probably has some mild exfoliating effect, but it’s a pity they’re marketing this as a medical treatment, since it’s a genuinely fun novelty.

  6. Hi Rhys

    I’ve recently put in an ASA complaint about fish-related medical claims made on a website. I found the same PubMed article and a couple more (don’t think there was an abstract with them) by doing a search for ‘doctor fish’. As you found, lack of evidence.

    Have you found any evidence for the existence of a chemical compound called diathanol? It’s claimed to be a fish salivary enzyme which helps skin regrowth but with an -ol ending and no record of it in the big list of enzymes I’m a bit suspish. Also, I’ve only ever found mention of the word on sites flogging fish spas 😉

    I can dig out the text of my complaint if you like, should have it floating around somewhere.

    P.S. I have just noticed that your blog has moved – I was trying to work out how to send a comment about your “rel nofollow” post which I’ve just used again and wanted to send further grateful thanks, then spotted that the site had moved 😀

  7. you could have them battered and fried like whitebait after they’ve nibbled at your toes..

    completely eliminates the risk of disease transmission between customers, whilst also providing a tasty snack for you to munch on afterwards.

  8. There’s one of these in my city centre too and I’ve wondered about it for a while now, regarding the hygiene issues. A friend told me she’d gone in to ask about it and was told that all feet are washed and checked by the staff before going in the tanks- she wasn’t allowed to do it that day because she had a popped blister on her heel. This is a very reassuring response and I hope that all such spas are adhering to these kind of checks. I would think that the likelihood of anyone with a fungal infection spreading it through these tanks is pretty low, well, as long as it was visible like athlete’s foot. Could any fungal spores that were washed off into the water survive and reattach to another foot at least 10 minutes later?Or, if eaten by the fish, could they stay on the fish’s “lips” for long enough to transmit to another foot? As for other diseases, would dead skin actually contain them? Now that I’ve posed these questions, I’ll admit that I have no idea of the answers. I’d say it’s unlikely though. However, if the spa isn’t washing or checking their customers’ feet then all sorts of open wounds, dirt, bacteria and general ickiness could get in there and spread. I doubt that there is any sort of ‘Foot Fish Certificate’ or official governing group so perhaps this can only be judged on a spa to spa basis.
    My main concern, however, is for the fish. What kind of a life is that!? Living in a boring, empty tank, now and then being divebombed by giant hands and feet (though I suppose any size hands and feet are pretty out of the ordinary for a fish) and only having dead skin to eat. Is this a nutritionally balanced diet for an animal whose natural diet (says wikipedia) is aufwuchs- a mix of animal and plant matter that encrusts on hard surfaces? In looking up what garra rufa fish eat I found this article-

    Quite interesting and since I was semi joking with the ‘poor fish’ bit, I actually feel pretty bad for them now.

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