This year thousands of people will visit the Turkish resort of Kangal, only to be eaten alive. Why? Because its spa waters are home to a special kind of creature that thrives on a diet of flaky skin: doctor fish. It seems that doctor-fish treatment in combination with UV light may offer a new way to help people with the skin disease psoriasis.

The doctor fish, Garra rufa, belongs to the minnow and carp
family and are natural inhabitants of Kangal's hot pools. They are bottom-dwellers that normally feed by sucking algae-containing slime from rocks. With water temperatures at 35 °C food is scarce, but luckily humans enjoy the hot pools and our flaky skin makes an attractive meal for the hungry G rufa.

This is particularly good news for people with psoriasis, an incurable skin condition affecting about 2% of the population. Psoriasis causes red, raised patches of skin covered with white scales of dead skin and there is no effective long-term treatment.

Last year, however, a study by Martin Grassberger and Werner Hoch of the Medical University of Vienna reported that doctor fish used in combination with UV light can clear up psoriasis very effectively. The treatment kept symptoms at bay for around eight months.

So what makes the combination so potent?

Many psoriasis sufferers report that their skin improves in sunlight, due to the effects of UV light. Grassberger and Hoch speculate that by nibbling away excess flakes, doctor fish allow UV to penetrate deeper into the skin. They call this new kind of treatment ichthyotherapy (from the Greek word ichthus, meaning fish).

It might seem surprising in a high-tech world that a humble fish may offer the best treatment for a skin disease, yet ichthyotherapy is just one of a growing number of so-called biotherapies, using living organisms to treat human diseases.

In maggot therapy, for example, sterile maggots clean dead tissue from wounds. In hirudotherapy, leeches encourage the regrowth of blood vessels after surgery. Then there's helminthotherapy, which involves the deliberate infection of patients with parasitic worms to treat autoimmune diseases such as Crohn's disease. Researchers are even investigating the therapeutic potential of bacteriotherapy: the transfer of bacteria from the faeces of a healthy person into the bowels of patients with conditions such as ulcerative colitis. Whatever next?

Courtesy of the New Scientist 14 July 2007 p 52.
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