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Health authorities in Britain are afraid that trendy pedicures in which fish are used can spread HIV and hepatitis C.
UK tabloid The Sun reported that the country's Health Protection Agency said risks from the treatment in which fish nibble the client's feet "could not be excluded".
And it said that people with illnesses such as diabetes or psoriasis, or those with a weakened immune system, were especially vulnerable and should not indulge in the latest pampering craze.
Infections and bacteria might be passed on by the tiny garra rufa fish or through water used in the pedicure of a previous client.
Blood-borne viruses could be transmitted if an infected client bled in spa water that was re-used.
The report conceded that the risk was "extremely low".
An agency spokesman said: "We have issued this guidance because there is a growing number of these spas.
"When the correct hygiene procedures are followed, the risk of infection is low.
"However, there is still a risk of transmission of a number of infections, including viruses such as HIV and hepatitis."
Some parts of the US and Canada have banned fish pedicures.
Equipment cannot be sterilised because this would kill the fish.
After a six-month review, the agency said in its report that pedicure salons must follow "strict standards of cleanliness" and ensure that fresh water is used for each client.
They should also check customers for health conditions that might make them vulnerable to infection, and for cuts and grazes.
Hundreds of beauty salons, malls, hairdressers and fashion shops offer the treatment, which celebrities have been spotted enjoying.
A spokesman for HIV charity the Terrence Higgins Trust told the tabloid: "The risk of picking up infections is minimal but people must be careful about where they choose to go for a pedicure." - Staff reporter
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