Safety and hygiene of ichthyotherapy with G. rufa fish.

Today, biotherapies (therapies using animals, plants or their secretions) are becoming increasingly popular. In medicine and cosmetology, leeches, fish, insect larvae, mucus from H. aspersa snail, bee products are used. Among them, ichthyotherapy - therapy with the use of Garra rufa (Heckel 1843), which is gaining popularity not only in the exotic resorts of Turkey, Iran and Jordan, but also in Poland, deserves attention. In view of the growing interest in ichthyotherapy, the question arises: Are cosmetic and therapeutic procedures using this vertebrate completely safe for humans? This question became a contribution to taking up this topic of study. Ichthyotherapy is the use of freshwater, sedentary benthopelagic fish of the cyprinid family, red garra (G. rufa), commercially referred to as "the doctor fish". This fish has a suction apparatus that allows removal of calloused epidermis in patients undergoing therapy. This treatment has been used mainly in cosmetics as so-called fish pedicure, but also in medicine. Scientific reports indicate that this fish may be helpful in treating some skin diseases, i.e. in alleviating the symptoms of psoriasis or atopic dermatitis. Treatments using the red garra have to be performed in full compliance with hygiene rules. In 2011, the British Health Protect Agency (BHPA) published the guidelines for carrying out treatments using these fish. It specified the indications and contraindications for performing the procedure, the way it should be performed, as well as the threats that could result from possible non-compliance with the principles of occupational health and safety during the procedures. Case studies of specific ichthyotherapy procedures performed in nine selected salons show that the awareness of people performing the procedures, as well as individuals undergoing ichthyotherapy is relatively low. Salons offering ichthyotherapy services, especially those located in tourist resorts, do not comply with health and safety rules, and thus expose those using the treatments to a potential risk of transmitting zoonotic infections from fish or water to humans. [ABSTRACT FROM AUTHOR]