What is Hot Tub Folliculitis?

Hot tub folliculitis, or “hot tub rash,” is a bacterial skin infection that occurs hours to days after using a poorly maintained hot tub or swimming pool.germ Pseudomonas aeruginosa Infected hair follicles, especially where the swimsuit comes in contact with the skin.

Treatments for hot tub folliculitis range from at-home or over-the-counter medications to prescription medications in severe cases, but common-sense precautions can prevent the infection. This condition is also called Pseudomonas folliculitis.

hot tub folliculitis symptoms

The hot tub folliculitis rash is itchy, bumpy, and red. It is similar to acne, but the rash appears faster.

When it first appears, hot tub folliculitis causes large, small, granular bumps called papules. These pimples are bright red to dark red.

As the rash develops, the bumps become larger and softer and may be up to 3 cm in diameter. Papules have a central pustule, and pus-filled blisters may also form around the hair follicle.

The rash can break out anywhere on the body that comes in contact with contaminated water. Injuries most commonly occur on body parts exposed to wet clothing and swimwear.

Both male and female nipples can become infected and become swollen and tender. This is not common, but some people with hot tub folliculitis often experience discomfort and may experience other symptoms, such as:

  • fever
  • fatigue
  • headache
  • sore throat
  • nausea
  • swollen lymph nodes

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Hot tub folliculitis is caused by bacteria Pseudomonas aeruginosa (P. aeruginosa), it infects the upper part of the hair follicle. This is the same microbe that causes otitis externa or swimmer’s otitis.

These bacteria thrive in warm water, especially poorly maintained recreational water.Longer immersion in contaminated water Pseudomonas, The greater your chances of getting hot tub folliculitis.

Water can appear clear and clean but still contain Pseudomonas germ.

As the name suggests, the most common cause of hot tub folliculitis is that the chlorine or pH levels in the hot tub are not properly maintained. However, there are other potential sources:

  • Whirlpool and treatment pool
  • Swimming pools, especially those used by multiple people
  • a warm lake, river or stream
  • water slide
  • Contaminated inflatable pool toys
  • bath sponge

It can also be caused by wearing a wet swimsuit without washing and drying it thoroughly before wearing it, or wearing a wet swimsuit for too long.

Other often overlooked causes of hot tub folliculitis are loofahs, nylon bath bags and others that may contain Pseudomonas germ.Consider this possibility if you develop a rash but are not in a hot tub or swimming pool, or if you have a recurring case.

Anyone can get hot tub folliculitis, but some people are more susceptible than others:

  • people with compromised immune systems
  • People with eczema, dermatitis, or a recent shave or waxing, all of which damage the skin’s protective barrier
  • Toddlers and older adults who tend to play in the water for extended periods of time

The rash is not spread through personal contact with infected lesions.


A healthcare provider should be able to diagnose hot tub folliculitis by looking at it and knowing that the patient has used a hot tub recently. Usually no additional testing is required.

However, if home remedies and your healthcare provider’s care don’t clear the rash, a skin sample may be taken to determine the cause. This can be done by taking a sample of fluid from the blister or by taking a small skin biopsy.examine the sample under the microscope to look for Pseudomonas germ.

These tests can also be ordered if there is any doubt about what is causing the rash. Hot tub folliculitis can look similar to other skin conditions, such as:

  • acne
  • contact dermatitis
  • Other types of folliculitis
  • other types of bacterial infections, such as Staphylococcus aureus
  • insect bites
  • nodular scabies


Pseudomonas aeruginosa Does not survive on healthy skin, so the rash usually resolves on its own after 7 to 10 days. Until then, some home remedies may help relieve symptoms and speed healing.

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Talk to your healthcare provider before trying any of the following:

  • Applying a warm, damp washcloth or compress to the infected area several times a day can relieve pain.
  • Over-the-counter itching medications, such as 1% hydrocortisone, can also help relieve discomfort. Ask your healthcare provider or pharmacist for advice.
  • Diluted white vinegar compresses are sometimes recommended because acetic acid (the acid in vinegar) has been shown to kill Pseudomonas. General guidelines call for applying a mixture of half water and half vinegar as a dressing to the affected area for 15 minutes twice a day.

Because the rash is relatively benign and resolves on its own, hot tub folliculitis usually does not require specific treatment.

If home care doesn’t work, or your rash is severe, your healthcare provider may prescribe a topical antimicrobial, such as gentamicin cream or polymyxin B spray. In cases of widespread resistance, the oral antibiotic ciprofloxacin (ciprofloxacin) may be prescribed.

You should call your healthcare provider if:

  • Your rash does not improve after 14 days
  • your rash becomes increasingly painful or spreads
  • you have boils or large lumps
  • pain in your breast tissue or nipples
  • you feel sicker or have a fever

A hot tub folliculitis rash may leave areas of hyperpigmented (darkened) skin after it has fully healed. This should subside over time, but may take up to 18 months. If hyperpigmentation bothers you, talk to your healthcare provider about treatments that can help lighten the discolored areas more quickly.

Hyperpigmentation and scarring


Showering after exposure to contaminated water does not prevent infection, but there are a few things you can do to reduce your risk of getting hot tub folliculitis:

  • After using the hot tub or swimming pool, remove your wet swimsuit and change into clean, dry clothing as soon as possible. Sitting in wet clothes can increase your risk of a rash. Also wash your swimwear.
  • If you have a swimming pool or hot tub, clean and chlorinate regularly. Make sure the water filtration system is working continuously. Monitor disinfectant levels frequently and change water as needed.
  • Learn about the frequency of testing for public swimming or bathing facilities. Public swimming pools, hot tubs, therapy pools, waterslides, or other recreational bathing areas are often high-traffic and prone to contamination. The U.S. Centers for Disease Control and Prevention recommends testing water at least twice a day.
  • Disinfect or replace loofah and bath bag regularly. You can soak them in a diluted bleach and water mixture for 5 minutes, then rinse thoroughly.

Common recreational water diseases and how to prevent them

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Hot tub folliculitis is usually not a serious condition, although in some cases it can be serious and require treatment. It can cause embarrassment and anxiety in some people because infected skin can be unsightly, so home remedies can help speed healing.

The best weapon is prevention, which means knowing where you are swimming and how to maintain your facility, as well as changing and washing your swimwear after bathing.

Frequently Asked Questions

  • Is hot tub folliculitis contagious?

    No, hot tub folliculitis is not contagious and cannot be spread through skin-to-skin contact.germ Pseudomonas aeruginosa It is usually found in warm, poorly maintained water, and the longer a person spends in infected water, the easier it is to be exposed. It is impossible for one person to have enough bacteria on their skin to contaminate other people.

  • How long does it take for folliculitis to heal in a hot bath?

    Hot tub folliculitis usually takes 5 to 10 days to go away. In some cases, the area of ​​skin affected by folliculitis becomes reddish-brown and hyperpigmented (darker than the surrounding skin). When this happens, it can take a few months to go away completely.