Red garra

This article is about the freshwater fish used for treating skin diseases in Turkey. For the species sometimes called "doctor fish" in the UK, see Tench. For the fish known as the "surgeonfish", see Acanthuridae.

Red garra
Scientific classification
Kingdom:	Animalia
Phylum:	Chordata
Class:	Actinopterygii
Order:	Cypriniformes
Family:	Cyprinidae
Genus:	Garra
Species:	G. rufa
Binomial name
Garra rufa (Heckel, 1843)
Subspecies
G. rufa turcica G. rufa obtusa G. rufa rufa
Synonyms
Discognathus crenulatus Heckel 1846-49 Discognathus lamta non Hamilton 1822 Discognathus obtusus Heckel 1843 Discognathus rufus Heckel 1843 Garra lamta non Hamilton 1822 Garra rufa crenulata Heckel 1844 Garra rufa gymnothorax Berg 1949 Garra rufus Heckel, 1843

Doctor fish is the name given to two species of fish: Garra rufa and Cyprinion macrostomus. Other nicknames include nibble fish, kangal fish, and doctorfishen; in non-medical contexts, Garra rufa is called the reddish log sucker. They live and breed in the outdoor pools of some Turkish spas, where they feed on the skin of patients with psoriasis. The fish are like combfishes in that they only consume the affected and dead areas of the skin, leaving the healthy skin to grow, with the outdoor location of the treatment bringing beneficial effects. The spas are not meant as a curative treatment option, only as a temporary alleviation of symptoms, and patients usually revisit the spas every few months. Some patients have experienced complete cure of psoriasis after repeated treatments, but due to the unpredictable nature of the disease, which is strongly influenced by endogenous factors, this may simply be regression toward the mean.

Occurrence

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.

Spa resorts

Some spas provide large fish ponds with thousands of doctor fish in it

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, Thailand, Indonesia, Malaysia, Philippines, Hong Kong, Bucharest (Romania), Barcelona (Spain) and France. 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. They are used to help treat patients suffering from various skin disorders, including psoriasis and eczema, since the fish will eat and remove any dead skin.

Legal status

The practice is banned in several American 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

• Ichthyotherapy

External links

• - 'Garra Rufa Care Information'
• BBC News - 'Fish pedicure' a feet treat
• Smile FIsh Spa - 'Dr Fish in Scandinavia'

• 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