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Fish therapy


Also listed as: Ichthyotherapy
Related terms
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Related Terms
  • Dermatitis, doctor fish, eczema, Garra rufa, ichthyotherapy, Kangal fish, psoriasis.

  • During fish therapy, or ichthyotherapy, a type of fish called Garra rufa is used to help treat skin conditions, such as dermatitis, psoriasis, and eczema. These toothless fish, commonly called doctor fish, feed on dead skin cells. The therapy is considered painless, but there are little data available to clarify whether it is more or less effective than current treatments for these conditions. Some spas are also these fish to help soften clients' feet and improve their looks.
  • The fish are native to Kanga, Turkey. In their natural habitat, these bottom dwellers feed on small organisms that live on rocks.
  • The practice, which involves sitting with parts of the body immersed in warm water, originated in Turkey's highland hot springs.
  • Fish therapy is a popular mode of relaxation and pedicure in parts of Asia. It is very popular in Japan, Singapore, and Malaysia. The benefits are said to include smoother skin, relaxation, and better circulation, which they credit to the "micro-massage" clients receive as the fish feed. Aside from the feet, individuals can also receive treatment on their hands or other body parts. According to some reports, visitors describe the sensation as a tickle or a gentle nibbling feeling.
  • Fish therapy has recently been introduced to salons and spas in the United States, but it is only found in a few locations. In the United States, treatment typically lasts 15-30 minutes. According to some sources, tanks may be cleaned once daily. In the United States, spas are required to use individual containers of fish and water for hygienic reasons.
  • At least two U.S. states (Texas and Washington) have banned fish pedicures due to a potential risk of transmitting infections. Even if the tank water is cleaned, authorities are concerned that fish may theoretically carry pathogens from one client to another. However, reports of transmitted infections are lacking.

Theory / Evidence
  • Doctor fish (Garra rufa) are about 3-4 centimeters long. They feed on dead skin, removing dead skin cells that are softened by warm water. Clients report there is no pain. Instead they may feel a nibbling or tickling sensation when the fish feed. In their natural habitat, these bottom dwellers eat tiny organisms that live on rocks.
  • Proponents of fish therapy claim that in addition to removing dead skin cells, the fish also provide a micro-massage as they nibble, which may improve blood circulation.
  • One study by Oxford University researchers, published in 2006, found that psoriasis patients who received a combination of ultraviolet light and ichthyotherapy therapy for three weeks reported their symptoms improved with no adverse effects. More than 70% of the patients reported reductions in symptom severity. More than 85 percent reported that fish therapy was more successful than other treatments they had tried. However, additional research using fish therapy alone is needed before conclusions can be made.


Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (

  1. Natural Standard: The Authority on Integrative Medicine.
  2. Grassberger M, Hoch W. Ichthyotherapy as alternative treatment for patients with psoriasis: a pilot study. Evid Based Complement Alternat Med. 2006 Dec;3(4):483-8.

  • Fish therapy originated in Turkish hot springs, which is the native home of the doctor fish. However, the fish are also transported and kept at spas and other private facilities. They are then placed in warm pools of water, where clients can immerse their bodies for treatment. Some salons offer treatment for the hands, feet, or full body.
  • Some facilities use individual containers of warm water and fish instead of pools.
  • Spa treatments generally last 15-30 minutes in the United States.

Copyright © 2011 Natural Standard (

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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