Fish pedicures are unlikely to transmit HIV or hepatitis C to people with uncompromised immune systems, according to a U.K. Health Protection Agency (HPA) statement. Fish pedicures—which involve submerging feet in a tank of warm water filled with tiny fish that nibble off dead skin—have become popular in the United Kingdom, but there have been health concerns. Water isn’t always changed between customers, and equipment can’t be sterilized because of possible harm to the fish. Although Florida, Texas, New Hampshire and Washington have banned fish pedicures and the United Arab Emirates says fish pedicures could pose a transmission risk, the U.K. statement maintains that the risk is very low if standards of hygiene are applied. However, the U.K. statement also says people with weakened immune systems or underlying medical conditions, including diabetes and psoriasis, have increased risks.

To read the HPA statement, click here.