[7][8][9] Other members of the G. rufa complex are G. barreimiae, G. elegans, G. ghorensis, G. longipinnis, G. nana, G. persica, G. rossica and G. sahilia, but these were generally recognized as valid species many years ago.

[citation needed] In 2008, two widely known doctor fish pedicure services were opened in the United States in Fairfax County, Virginia,[10] and in Milwaukee, Wisconsin.

[15] Garra rufa seen in the spa and aquarium trade mostly originate from commercial facilities in Israel and to a lesser degree Turkey.

[6] Since Israeli and many (but not all) Turkish populations of "G. rufa" now are recognized as G. jordanica and G. turcica instead, this leads to questions over the true identity of most of the fish seen in the trade.

[6] 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 can be scarce and unpredictable.

[citation needed] When used as a prelude intended to enhance the effects of ultraviolet light expoure in psoriasis treatment, fish pedicure is known as ichthyotherapy.