You may not be a fish spa regular – but say you're on vacation in Bangkok, for example, where fish spas have become as popular as Thai massages. You've spent a day shopping and your feet could use some pampering. You might be more open to the idea of dipping your toes in such a spa just to see what the fuss is all about.
And that is where it pays to take pause and consider: Do you have blisters or cuts on your feet? This is because such wounds are entry points for micro-organisms to potentially enter your body.
"If the fish carry strains of bacteria and a user has open wounds on his feet, there is a theoretical risk that when the fish nibble on a user’s skin, these bacteria could be transmitted," said Dr Nisha Suyien Chandran, head and consultant with the Division of Dermatology at National University Hospital.
"The same can occur if the fish have open wounds on their own skin," added Dr Chandran.
It might not be smoother, softer feet you're bringing home. In fact, your holiday souvenirs could inadvertently include bacterial and fungal infections. "Possible skin infections include staphylococcus and microsporum infections," said Dr Eileen Tan from Eileen Tan Skin, Laser and Hair Transplant Clinic.
WHAT ARE THE POTENTIAL HEALTH RISKS?
In a Daily Mail article published in 2011, UK health experts warned that the risk of hepatitis infection and even HIV was "low but could not be completely excluded".
How real is this risk closer to home? Not terribly likely, fortunately.
"If a user is infected with a blood-borne infection such as HIV and has open wounds on his feet, there is a theoretical risk that the infected blood could enter the water and subsequently infect another user, should this user also have open wounds on his feet. This risk, however, is theoretical and very low," said Dr Chandran.
The experts that CNA Lifestyle spoke to, including the Ministry of Health (MOH), have not seen any cases of infection or disease contracted from a fish spa.
In Singapore, fish spa operators no longer require a licence under the new Massage Establishments Act, which was revised last November.
WHEN TO AVOID THE FISH
Fish spas have been banned in some parts of the United States, including Florida, Texas, New Hampshire and Washington. The Centers for Disease Control and Prevention (CDC) in the US conceded that the fish pedicure tubs cannot be sufficiently cleaned between customers when the fish are present. Neither can the fish be disinfected or sanitised between customers.
If your intention is to rid your feet of dead skin, you may be better off using a pumice stone instead. This is especially so if you have diabetes and a weakened immune system, or if you suffer from an inflammatory skin condition such as eczema and psoriasis, advised MOH.
Just shaved or removed your leg hair in the last 24 hours? Skip the fish treatment. The elderly, pregnant or the very young should also give it a miss, said Dr Chandran.