In new guidance of public health, they said the risk of infection for users of the increasingly popular treatment, in which dozens of tiny fish nibble dead skin from customers' feet, is ‘low but could not be completely excluded’.
Fish foot spa pedicures could spread diseases such as HIV and hepatitis C, health experts have warned.
The Health Protection Agency said those with diabetes, psoriasis or a weak immune system are particularly vulnerable and should not take part in the beauty craze at all.
The agency says fish tank water contains micro-organisms and believes problems could arise from bacteria being transmitted by the pedicure’s garra rufa fish, from the spa water itself or from one customer to another if the water is not changed.
If a user is infected with a blood-borne virus like HIV or hepatitis and bleeds in the water, there is a risk the diseases could be passed on.
According to the agency’s guidance, the risk is ‘extremely low’ but it ‘cannot be completely excluded’.
An agency spokesman said: ‘We have issued this guidance because there are a growing number of these spas.
‘When the correct hygiene procedures are followed, the risk of infection is very low.
‘However, there is still a risk of transmission of a number of infections — this does include viruses like HIV and hepatitis.’
The HPA has recommended that spa water is changed after each client.
The equipment cannot be conventionally sterilised because the process could harm the fish, of which there are about 200 in every tank.
The pedicures - which have long been popular in Asia where the fad began - have been banned in some U.S. states, including Florida, Texas, New Hampshire and Washington, due to fears that infections could spread through open wounds.
The trend, which is meant to leave clients with smooth and attractive feet, has spread to beauty salons across the country and there are now around 280 fish spas in the UK.
A spokeswoman for HIV charity the Terrence Higgins Trust said: ‘The risk of picking up infections is minimal but people must be careful where they choose to go.’
But a woman who runs a chain of the foot spa centres said health chiefs were ‘scaremongering’.
Dr Hilary Kirkbride, consultant epidemiologist at the HPA, said: ‘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.’
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