(WCMH) – A study released Tuesday claims a woman’s toenails fell off because she had a fish pedicure several months prior.

Fish pedicures involve putting your feet in a tub of water filled with tiny fish called “garra rufa.” The fish eat dead human skin right off your feet.

But the study, published in the journal JAMA Dermatology, claims one woman who got one started noticing something wrong with nails several weeks after the treatment. Six months later, her toenails fell off.

“I think that this is probably more common than we think,” said the report’s author, Dr. Shari R. Lipner. “We don’t see the [nail] shedding until months after the event, so I think it’s hard for patients and physicians — especially if they’re not even aware that fish pedicures can do this — to make that connection.”

The image below appears in her case report.

The report’s author says the woman had no other medical history that could be linked to her condition. Dr. Lipner believes the woman’s problems stemmed from the physical impact of the fish biting at the nail.

However, another expert disagrees claiming the woman’s toenails could have fallen off because of overlapping toes inside her shoes.

“I am not convinced at all that the fishes caused the problem,” Dr. Antonella Tosti, the Fredric Brandt Endowed Professor of Dermatology at the University of Miami Miller School of Medicine. “This is not uncommon in women with a Greek foot … who wear high heels and pinpointed shoes.”

Experts have said in the past that fish pedicures may carry a risk of infection. That’s because in some fish spas, the fish are recycled from person to person, and the tubs may not be properly cleaned between uses, CNN reports.