Psoriasis symptoms on your feet can be bothersome and difficult to treat. You may be tempted to scrub away your plaques and scales, but this often does more harm than good. Picking at scales may cause bleeding and increase your risk of infection. Fish pedicures have become a topic among members of MyPsoriasisTeam as they discuss ways to remove dead skin cells and manage their psoriasis symptoms.

“Can you remember a few years ago when there was a trend for fish pedicures? The idea was to dip your toes into a tank of little fish that nibbled the dead skin,” one member shared. Another responded, “I do recall the fish/foot thing! I was shocked back then, but maybe now it’s worth a try?”

With the growing popularity of fish pedicures in recent years, you may be interested in trying one for your psoriasis. In this article, we’ll break down what they are and whether they’re safe and effective for people with inflammatory skin conditions like psoriasis.

What Does a Fish Pedicure Do?

Ichthyotherapy — or a fish pedicure — is a type of pedicure that uses Garra rufa fish that eat dead skin cells and exfoliate the skin. They’re also known as “doctor fish” for their reported healing and skin-rejuvenating properties. This skin treatment originated at the Kangal Fish Spring in Turkey, where it was first used to treat a shepherd’s foot injuries in the early 1900s.

Since then, the Turkish Ministry of Health has designated the spring as a certified thermal health center. Kangal Fish Spring offers a three-week-long treatment for people with psoriasis to help their symptoms.

Fish pedicures have become increasingly popular in tourist destinations around the world and in the U.S. According to one government report, spas and salons started offering fish pedicures in the U.S. and Europe between 2008 and 2009.

During a fish pedicure, you put your feet into a tub of water with the fish. They quickly begin nibbling on your feet and eat the dry, dead skin. Anecdotal reports from people who have tried fish pedicures say they can help soften calluses and increase circulation in the feet.

Can Fish Pedicures and Baths Help Psoriasis Symptoms?

There’s no reliable research on how fish pedicures affect the skin. There are some very small studies that have looked into whether fish baths, through a larger treatment plan called ichthyotherapy, can help psoriasis symptoms. While these studies have reported some positive results, larger studies are needed to confirm the findings and determine whether fish baths and fish pedicures are safe. Current research is not strong enough to support fish baths and fish pedicures as a treatment for psoriasis symptoms.

The Journal of Dermatology cites an older study of 87 people with psoriasis who were treated with a fish bath for 21 days. A fish bath is different from a fish pedicure in that people bathe entirely, up to their necks, in the water with fish. In the study, only 14 people stayed for the entire 21 days, and eight of them had improvements in their skin. Furthermore, this was not a controlled study that only looked at the effect of fish baths on psoriasis symptoms. The study authors note that other factors, like selenium in the water, exposure to ultraviolet radiation from the sun, and a reverse Koebner phenomenon, may have contributed to changes in people’s symptoms.

Another study investigated the use of two-hour-long fish baths in addition to three to five minutes of ultraviolet A (UVA) light therapy for treating psoriasis in 67 people. Participants experienced a 71.7 percent reduction in their PASI scores. Many participants also reported that they had better outcomes after the therapy compared to other treatments, and that they had less-severe psoriasis relapses. However, it’s unclear whether the skin benefits could be attributed to the fish bath or the UVA light therapy. This was also a controlled environment that would be different from a commercial fish spa.

While some of these results might seem promising, they do not prove that fish baths offer any skin benefits. There’s no research that has found any long-term benefits (beyond a few weeks) of fish pedicures for psoriasis symptoms.

Safety and Ethical Concerns With Fish Pedicures

Although there was an initial boom in the popularity of fish pedicures, many health officials have safety concerns. The Centers for Disease Control and Prevention (CDC) reports that several states have banned fish pedicures for many reasons, including that they can be unsanitary. They also noted that fish pedicures technically aren’t considered pedicures under the legal definition. Always talk to your healthcare provider before trying a new therapy for your psoriasis, since it could cause side effects and worsen your psoriasis.

Fish Pedicures Might Be Unsanitary

Unlike regular pedicures, which use tubs with disposable liners, the tubs used in fish pedicures can’t be cleaned properly between customers. Fish spa owners would have to change out the fish and water after every pedicure, which can quickly become expensive.

Additionally, the fish themselves can’t be cleaned or disinfected to prevent the spread of bacteria. Instead, it’s more likely that owners will use the same fish several times with different customers, putting the customers at risk of infection.

Using the Wrong Type of Fish Can Increase the Risk of Infection

There’s also a chance that the fish spa owners use the wrong fish. Garra rufa can be mistaken for another type of fish known as Chinese chin chin, which can grow teeth and bite customers hard enough to draw blood. Open cuts allow pathogens (viruses or bacteria) to enter the body more easily, increasing the risk of infection.

There Are Ethical Concerns With Fish Pedicures

Some experts have also reported ethical concerns with the Garra rufa fish. To force them to eat dead human skin, which is not their food of choice, many spas and salons starve their fish.

There’s also a concern about getting them safely into the U.S. — they’re not a native species, so the fish are flown in from overseas. The fish may not survive the journey, which can be deemed unethical. If they’re released into the wild, they can become a threat to native plants and animals.

Risk of Infections and Complications From Fish Pedicures

Case studies have found that a few individuals developed skin infections or toenail problems after having fish pedicures. Although these reports describe single cases, they show that there’s a risk of complications from fish pedicures, especially if you have cuts in the skin or are immunocompromised.

Here’s a summary of case reports involving infections and complications from fish pedicures:

• One person became infected with Mycobacterium marinum, a bacterium similar to tuberculosis that infects fish and can be transferred to humans if they’re bitten.
• Another person developed a Staphylococcus aureus infection on their feet that caused the formation of crusts and scales, along with skin itching, burning, and a puslike discharge.
• An individual developed onychomadesis (a noninfectious separation of the nail from the nail bed).

Note that nail problems are common in people with psoriasis — fish pedicures may put you at an additional risk of uncomfortable nail symptoms or make them worse. It’s also worth noting that people with impaired immune systems (like those taking immunosuppressive medications) or other underlying health conditions, such as diabetes or cardiovascular disease, should avoid fish pedicures due to the risk of infections.

Considering a Fish Pedicure? Talk to Your Doctor First

Before trying a fish pedicure to ease psoriasis symptoms like skin peeling from your toes, it’s important to talk with your dermatologist or healthcare provider. They can help you weigh the potential benefits against the risks — especially if you have a weakened immune system, cracked skin, or other health conditions that increase your risk of infection.

Ask your provider about safer, more effective options that fit your specific treatment plan.

If you’re still considering a fish pedicure, keep these precautions in mind:

• Check local laws. Fish pedicures are banned in many U.S. states, Mexico, and some European countries due to safety and animal welfare concerns.
• Look for proper hygiene. Ask when the fish tanks were last cleaned and whether the fish are reused. Be cautious — the tubs and fish can’t be fully sterilized between uses.
• Skip the pedicure if you have any open wounds, cracked skin, or foot infections.
• Afterward, wash your feet well with warm water and soap to lower your risk of infection.

While fish pedicures may seem like a novel or natural way to smooth your skin, they come with potential risks, including infection, nail problems, and ethical concerns. Always consult your care team before trying new treatments, and look for evidence-backed options that support your long-term skin and overall health.

Join the Conversation

On MyPsoriasisTeam, people share their experiences with psoriasis, get advice, and find support from others who understand.

Have you tried a fish pedicure for psoriasis on your feet? Let others know in the comments below.