Monday, June 10, 2013

Doctor Fish: What seems to be the problem?

By Erin Miller

Walking through a touristy district of Bangkok, Thailand, I saw a sign that read “Fish Massage: Only $300 Baht For 30 Minutes!” As always, my imagination ran wild. I pictured a carp, sprawled out across
a massage table, cucumbers over his eyes, a steaming, damp towel over his forehead, relaxing as two Thai ladies massage his little fish spine and fins.

Laughing at myself and this outrageous mental image, my eyes wandered downward to a large fish tank surrounded by a wooden bench. I peered into the water, and it was teeming with small fish. Sitting on the bench were four people, their pant cuffs rolled up to their knees on their glowing legs that dangle in the water, watching amused as hundreds of fish pecked at every inch of their submerged skin.

I was told, in broken English by the women working the tank, that these are “Doctor Fish,” whom for only $5 US, will expertly eat all of the dead skin cells off of my legs and feet, leaving them remarkably silky and smooth. I was slightly curious, but as I looked at her and at the eight legs that were already dangling in the tank, I decided it was much too unusual. Besides, it was dinner time and I would rather be eating fish than have fish eating me.

I never gave it another thought until, many months later and hundreds of miles away, I encountered the same thing in Siem Reip, Cambodia. Suddenly I found myself wondering, “What kind of fish are these, and do they really eat dead skin cells?”, “Why?” and “If these fish live in the lakes and streams here, is it safe to swim or will I be eaten alive?!”

As it turns out, Doctor Fish are not doctors at all…shocking, right?! They are actually a species of toothless fish known as Garra rufa. They are also referred to as nibble fish or the reddish log sucker. They are native to river basins of the Middle East, mainly Turkey, Syria, Iraq, and Iran. According to many “fish spa” websites, the discovery of Doctor Fish consuming dead skin was actually made in the 1800's, in the natural hot springs in Turkey. Since that initial discovery, they have been used to treat psoriasis and many other skin ailments. By 2006, the idea of using “doctor fish” for smoother, healthier skin had caught on and the little fish made their way to health spas throughout Europe and Asia. Their new found popularity has caused the Turkish Government to legally protect the Garra rufa due to concern of over harvesting and commercial exploitation.

So, why do doctor fish have a penchant for dead skin cells? The answer is as shocking as finding out they are not doctors. They don't naturally have a penchant for human skin! In nature, Garra rufa feed on aufwuchs (small plants and animals that encrust rocks and other hard surfaces). In thermal waters, these food sources are scarce leaving the ravenous little fish desperate for anything to eat. People’s legs offer a perfect surrogate by offering a buffet line ridden with dead skin cells for the taking. To promote fish feedings, spa owners simply underfeed the fish.

After digging up this information, I began to wonder, “Can that possibly be safe?” Turns out, I'm not the only one wondering. Fish Spas have been banned in many parts of the US, Canada and Europe, over hygiene and health concerns. The CDC (Center for Disease Control), warns of the lack of ability to maintain proper hygiene in aquariums, the risk of spreading disease by using the same fish for multiple patrons, and oddly enough, the lack of ability to sanitize fish between uses! The Health Protection Agency in the UK, while admitting that the chance of risk is low, admits “there is the potential for transmission of a range of infections, either from fish to person (during the nibbling process), water to person (from the bacteria that can multiply in water), or person to person (via water, surrounding surfaces and fish).”

I kind of wish I'd never researched the Doctor fish; now, every time I pass a “Fish Spa” I just see hundreds of starving Garra rufa, swimming in a cesspool of dead skin cells and disease. This is not what I had originally envisioned at all...but then again, my original vision of a carp relaxing with cucumber slices on his eyes wasn’t spot on either. So, if you find yourself with reoccurring skin issues, my recommendation is to visit a real doctor!

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Erin Miller and her husband, Carl, have grabbed life by the horns and are living every day to the fullest.  After an extended trip to southeastern Asia, they almost immediately took off on a through hike of the Pacific Crest Trail, and are currently 400 miles into the trip.  They each write a quick and highly entertaining daily journal of their current adventure with pictures if you would like to follow along


  1. It's funny, I just recently heard about this also! One of my friends tried to convince me to try it, but the thought of fish sucking on my feet and lower legs turned me off. Plus, I was scared they would tickle haha! Good to know that infection is possible, in case I change my mind on a whim in the future. Now I know for sure I won't be trying this out EVER.


  2. Great article. This practice has been around for some time, though more recently other -- presumably easier to acquire -- species have been thrown into the mix. You can now find "fish massage" tanks filled with anything from Chinese algae eaters (Gyrinocheilus aymonieri) to cichlids.


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