A woman from Kent has travelled over 1700 miles and spent 2,500 on a fish treatment to help her psoriasis.
According to a report from the BBC, Samantha Grayston spent three weeks in a spa near Kangal in eastern Turkey. Every day she would immerse herself for up to four hours in warm waters rich in selenium and populated by what are known locally as Doctor Fish.
These fish are in fact two cyprinid species, Garra rufa and Cyprinion macrostomum, which nibble at the flaky skin common to psoriasis and eczema sufferers.
These fish are naturally found in rivers through much of Iraq, Israel, Jordan, Turkey and Syria.
They live in small muddy streams, rivers and lakes and also in hot pools where locals bathe, where there in an attempt to get the fish to treat their dermatological conditions.
There has been a fish spa hotel in the Kangal area for over 100 years and for the last twenty years it has been a treatment centre for over 3,000 psoriasis sufferers from all over the world.
The treatment is thought to work because of a combination of the hundreds of fish nibbling away the skin plaques and exposing them to the heat, highly mineralised water, the Jacuzzi effect of the water and the higher than usual UV concentration due to the high altitude.
Ms Grayston was quoted as saying that the treatment felt like fingers tapping her body as the fish nibbled away. She now expects the treatment to last up to 18 months and said: "My skin is looking absolutely brilliant for the first time ever all over my body.
"My skin is smooth. You can still see that I have psoriasis - but it's pink rather than red." She added that she could now go out without worrying about what people would see and how they would react.
Nibbling of dead skin cells is an unusual behaviour normally only seen in Garra rufa when food is scarce or unpredictable.
As the high temperature and mineral content of this water prevents much algae or phytoplankton growing, this is probably the reason the fish are turning to human skin cells - in essence these fish are hungry.
In southern Asia the Dr Fish treatment is becoming increasingly more popular and as a result, trade for them is increasing. People will pay between $10-20 each for these fish.
Trade in Garra rufa
Garra rufa is legally protected from commercial exploitation in Turkey, but has recently been bred in captivity.
The species is difficult to correctly identify and some dealers may have been selling other species in their place.
Recent media reports have shown chin chin fish being used as a cheaper alternative for fish pedicures.
These are the fry of large-growing Tilapia cichlids, and they have sharper teeth and grow much faster and larger than Garra rufa.
Some UK beauty centres have expressed an interest in bringing fish pedicures to this country and have sought approval from councils and tried to acquire fishes.
Emma Turner of Maidenhead Aquatics at Peterborough told Practical Fishkeeping: "We have had several enquiries from beauty spas based both in the UK and USA, and have declined the sale of these fish on ethical grounds every time"
"It is one thing for genuine psoriasis sufferers to visit these fish in their natural habitat, but it is completely unacceptable for them to be used as a beauty treatment in the confines of a spa. We feel there is no way that a beauty spa could provide a stable, stress-free environment."
Turner said that spas would be unlikely to ensure that the fish received a healthy balanced diet, as the fish would not show much interest in skin if well fed.
She said that there were also welfare issues relating to catching and moving the fish, and in maintaining the correct water conditions and temperatures in the treatment vessels.
Turner also said that the fish could be exposed to potentially harmful chemicals used in skin creams previously applied to the feet, and that it would be difficult to control intraspecific aggression by the fish.
"Although there may be the odd exception, in general, the vast majority of beauty spa workers will not have the time and knowledge to care for these fish properly. It is very concerning that Garra rufa are just being viewed as another tool in man's pursuit of beauty at any cost," she added.