Doctor Fish

An overview of Doctor Fish and what they may be able to do for psoriasis.

What happens when you take some ordinary carp and put them in an environment where there’s no normal food? You get “Doctor Fish” (also known as “Nibble Fish,” “Kangal Fish,” or “Doctorfishen”).

That’s basically what’s going on in a spa (or several spas, it’s hard to tell) in Turkey, and perhaps a few more in Germany. Make a pool of water from a hot spring, and stock it with fish which can tolerate the temperature. But, due to either the temperature, or the dissolved minerals (or both), few algae or other microorgansisms grow in the pool, which these bottom-feeding carp would normally eat.

Add some psoriasis patients, and suddenly there’s a food source: the flakes. The fish go for them probably because they’re easier to eat than normal skin. And the warm water (about 35°C, or 95°F) softens them up, too (the flakes, that is — I don’t know whether or not it softens the fish).

The “Doctor Fish” are actually two distinct species: Cyprinion macrostomus and Garra rufa (also known as “Strikers” and “Lickers,” respectively, apparently due to their behaviour in the spa pools). Both species normally inhabit waterways in the Tigris-Euphrates basin in Western Asia, but their wild populations are in decline.

As far as I can tell, there is nothing particularly “unique” about these fish. There are plenty of species of fish which can tolerate high-temperature water. Ordinary guppies, for example, can live at up to 100°F (38°C), although they don’t particularly enjoy it. And Salt Creek Pupfish live at even higher temperatures (112°F, 44°C). It’s fairly obvious that the Tigris and Euphrates rivers aren’t very hot — the fish at the spas have probably simply become acclimated (not “evoled”) to the environment (the fact that people in Germany are offering the fish for sale testifies to this, as well).

There’s quite a bit of misinformation available about these fish, some of it completely absurd (one web site states that the fish secrete dithranol from their mouths!). It appears, though, that the reality of the situation is that getting rid of excess scale (which the fish do well) allows sunlight, the hot water itself, or other treatments to reach the live dermis, where just about any therapy needs to get to be effective.

November 16, 2003, Update: Due to receiving many emails in the last month on this one subject, from Germany, the British Isles, the U.S., and elsewhere, I’d like to answer all of the inquiries here. Everything I know about purchasing Doctor Fish or where to go for treatment is on this page. If you cannot find a distributor or spa to your liking within the below links, I cannot help you further. There probably are other resources on the web, I just haven’t found them yet. When I do, they will be listed below, also. I have no business or personal relationship with anyone listed here, or anyone not listed here, with regard to Doctor Fish. I have no Doctor Fish of my own to sell or to use as therapy.