Fish pedicures are unlikely to cause infection, according to a report released in October from the U.K.’s Health Protection Agency (HPA)  titled “Guidance on the Management of Public Health Risks from Fish Pedicures.” “Provided that good standards of hygiene are followed by salons, members of the public are unlikely to get an infection from a fish spa pedicure, however the risk will be higher for certain people,” says Dr. Hilary Kirkbride, consultant epidemiologist at the HPA. “We feel it’s important for salons to ensure the client has no underlying health conditions that could put them at risk and that a thorough foot examination is performed to make sure there are no cuts, grazes, or existing skin conditions that could spread infection.

“Anyone considering a fish pedicure can help reduce the risk of infection — both to themselves and others — by taking simple precautions. Allowing any cuts or infections you may have on your feet or legs to heal before having the treatment and waiting at least 24 hours after having a leg wax or shaving will minimize your chances of catching anything. If you do experience any ill effects after the treatment, you should visit your GP.”

Adds Dr. Paul Cosford, director of health protection services at the HPA: “As with any beauty salon, it’s really important that strict standards of cleanliness are followed to ensure that the risk of infection is kept to a minimum.”

For salons that offer the fish pedicure, the report has a lot of suggestions for minimizing health risk. This includes washing (with soap) and drying the client’s feet before letting her put them in the fish soak and having the client fill out a written form prior to the service to see if she’s aware of any contraindications to the service. Also, the report recommends having the salon staff trained in the basic care and welfare of fish.

Clients with weakened immune systems or underlying medical conditions, including diabetes and psoriasis, are likely to be at increased risk of infection, so fish pedicures are not recommended for these individuals.

Note that several states, including Texas, Washington, and Florida, have banned fish pedicures, so be sure to check with your state board or licensing authority if you are considering adding this service. You can read the report in its entirety by clicking here.