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Doctor fish is the name given to the species of fish Garra rufa. Other nicknames include nibble fish, kangal fish, physio fish, and doctorfishen; in non-medical contexts, Garra rufa is called the reddish log sucker. They live and breed in the pools of some Turkish river systems and hot springs. Modernly, they have been integrated as a spa treatment, where they feed on the skin of patients with psoriasis. While the doctor fish treatment has been shown to alleviate the symptoms of psoriasis, they are not meant as a curative treatment, as no cure for psoriasis currently exists. The use of the fish as a spa treatment for the wider public is still widely debated on grounds of efficacy and validity, as the treatment is not shown to have either positive or negative effects.
Garra rufa occurs in the river basins of the Northern and Central Middle East, mainly in Turkey, Syria, Iraq and Iran. It is legally protected from commercial exploitation in Turkey due to concerns of overharvesting for export. Garra rufa can be kept in an aquarium at home; while not strictly a "beginner's fish", it is quite hardy. For treatment of skin diseases, aquarium specimens are not well suited as the skin-feeding behavior fully manifests only under conditions where the food supply is somewhat scarce and unpredictable.
The misleading information perpetrated by those who utilize Garra rufa in profitable ventures is that the Garra rufa actually eat dead skin but this is not strictly true, the filtration systems of tanks that have been analyzed have been shown to capture the skin.
During their activities of foraging they slough off dead skin. They are simply looking for food which in the wild consists of aufwuchs. In both marine and freshwater environments the algae – particularly green algae and diatoms – make up the dominant component of aufwuchs communities. Small crustaceans, rotifers, and protozoans are also commonly found in fresh water and the sea, but insect larvae, oligochaetes and tardigrades are peculiar to freshwater aufwuchs faunas.
Spa resorts 
In 2006, doctor fish spa resorts opened in Hakone, Japan, and in Umag, Croatia, where the fish are used to clean the bathers at the spa. There are also spas in resorts in China, Belgium, the Netherlands, South Korea, Singapore, Bosnia-Herzegovina, Hungary, Slovakia, India, Pakistan Thailand, Cambodia, Indonesia, Malaysia, Philippines, Hong Kong, Bucharest, Prague (Czech Republic) and Sibiu (Romania), Madrid (Corralejo Fuerteventura Dr Fish) and Barcelona (Spain), France, Bahrain, and Trondheim (Norway). In 2008, the first widely known doctor fish pedicure service was opened in the United States in Alexandria, Virginia, and later in Woodbridge, Virginia. In 2010 the first U.K. spa opened in Sheffield.
Legal status 
The practice is banned in several of the United States and Canadian provinces as cosmetology regulators believe the practice is unsanitary, with the Wall Street Journal claiming that "cosmetology regulations generally mandate that tools need to be discarded or sanitized after each use. But epidermis-eating fish are too expensive to throw away". The procedure is legal in Quebec, with a few clinics in Montreal.
Before being outlawed in most U.S. states, the novelty of fish pedicures was viewed as a possible revenue enhancer for struggling nail salons, which had experienced less "luxury spending" from their regular clients during the recession. One New Hampshire salon owner who was shut down had assured local health authorities that she cleaned out fish tanks between pedicures and would never use the same group of fish with two different customers on the same day. The state government still ruled the practice to be unsanitary.
TV journalist John Stossel has ridiculed state laws against fish pedicures, arguing that they represent a case of the government becoming a "Nanny State", where individuals no longer can make their own decisions about their well-being. He participated in an illegal fish pedicure on his Fox Business Network program to illustrate his point.
See also 
- "Search Results for: Garra rufa". Global Biodiversity Information Facility. Retrieved 28 June 2010.
- Zicha, Ondřej (2009). "BioLib - Garra rufa". BioLib. Retrieved 28 June 2010.
- Kangal Fish is named after the rivulet Kangal in Anatolia, Turkey. (foto)
- physiofish.de: Garra-Rufa-Zucht (in german)
- "A medical study conducted by Martin Grassberger and Werner Hoch of the Medical University of Vienna, Austria, reported that exfoliation by doctor fish, Garra rufa, native to the hot springs at Kanghal, Turkey, when used in combination with ultraviolet (UV) light can clear the appearance of psoriasis. The treatment kept symptoms at bay for about eight months." Source: New Scientist. 7/14/2007, Vol. 195 Issue 2612, p52-52. 1p.
- "Lost Paradise lines up new attractions". Gulf Daily News. Retrieved 11 July 2012.
- Slack, Martin (10 March 2010). "Step right in – the Doctor Fish will see you now". Yorkshire Post. Retrieved 4 July 2010.
- Ban on Feet-Nibbling Fish Leaves Nail Salons on the Hook
- Galipeau, Silvia (8 July 2010). "Piscipédicurie: inusitée, controversée et non réglementée". La Presse. Retrieved 8 July 2010.
- "My First Fish Pedicure (And Why It Poses No Threat to American Nail Salon Jobs)" Boston Herald
- Wall Street Journal
- Mediaite: John Stossel Gets His Feet Nibbled
- BBC News - 'Fish pedicure' a feet treat
- BBC Video - Flesh-eating fish used to treat feet
- Reuters - Turkish "doctor fish" nibble at Japanese market
- NPR - Flesh-Eating Fish Perform 'Pedicures'
- UK Guardian article
- UK Telegraph article Health Risk from Fish Pedicures
- Doctor fish (Garra rufa) at Wikimedia Commons
- Doctor fish (Garra rufa) at Wikispecies
- Doctor fish (Garra rufa) at Integrated Taxonomic Information System
- Doctor fish (Garra rufa) at Encyclopedia of Life
- Doctor fish (Garra rufa) at BioLib
- Doctor fish (Garra rufa) at Global Biodiversity Information Facility
- Doctor fish (Garra rufa) at Animal Diversity Web
- Doctor fish (Garra rufa) at FishBol
- Doctor fish (Garra rufa) at FishBase
- Doctor fish (Garra rufa) at Ocean Biogeographic Information System