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Doctor fish is the name given to two species of fish: Garra Rufa and Cyprinion Macrostomus. Other nicknames include nibble fish, kangal fish, little
dermatologists and doctorfishen; in non-medical contexts, Garra rufa is called the reddish log sucker.
They live and breed in the outdoor pools of some Turkish spas, where they feed on the skin of patients with psoriasis. The fish are like combfishes in that they only consume the affected and dead areas of the skin, leaving the healthy skin to grow, with the outdoor location
of the treatment bringing beneficial effects. The spas are not meant as a curative treatment option, only as a temporary alleviation
of symptoms, and patients usually revisit the spas every few months. Some patients have experienced complete cure of psoriasis
after repeated treatments, but due to the unpredictable nature of the disease, which is strongly influenced by endogenous factors, this may simply be regression towards the mean.
Garra rufa occurs in the river basins of the Northern and
Central Middle East, mainly in Turkey, Syria, Iraq and Iran. It is legally protected from commercial exploitation in Turkey due to concerns of overharvesting for export. Garra rufa can be kept in an aquarium at home; while not strictly a "beginner's fish", it is quite hardy. For treatment of skin diseases, aquarium specimens are
not well suited as the skin-feeding behavior fully manifests only under conditions where the food supply is somewhat scarce
and unpredictable.

In 2006, doctor
fish spa resorts opened in Hakone, Japan, and in Umag, Croatia, where the fish are used to clean the bathers at the spa. There are also spas in resorts in Hainan, China, as well as Belgium, The Netherlands,South Korea, Singapore, Hungary from 2010 ,Slovakia, India, Thailand, Indonesia,Malaysia, and Hong Kong. In 2008, the first widely known doctor fish pedicure service was opened in the United States in Alexandria, Virginia and later in Woodbridge, Virginia. They are used to help treat patients suffering from various skin disorders, including psoriasis and eczema, since the fish will eat and remove any dead skin.
Garra Rufa is the original species of Doctor Fish used for
Fish Spa Therapy Treatment. These fishes are able to work together as a team to improve skin conditions through
natural exfoliation removing dead skin cells by constantly nibbling on the skin areas while producing enzyme secretions to
allow newer skin to regenerate.
This enzyme secretions are currently being studied and researched by medical insititues. Their strong nibbling
ability has been the signature of this treatment since 400 years ago in the Turkish Kangal Springs.

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