Table of ContentsView AllTable of ContentsSymptomsCausesRisk FactorsDiagnosisTreatmentWhen to Call a ProviderPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Risk Factors
Diagnosis
Treatment
When to Call a Provider
Prevention
Hot tubfolliculitis(Pseudomonas folliculitis), or “hot tub rash,” is abacterial skin conditionyou can get from using an improperly maintained hot tub or swimming pool. It causes a red, itchy, and bumpy rash anywhere from a few hours to a few days after being in the water.
This article covers the symptoms and causes of hot tub folliculitis. It also discusses how it is diagnosed, treatment options, and prevention tips.
Hot Tub Rash Symptoms
A hot tub folliculitis rash is itchy, bumpy, and red. While it looks likeacne, the rash will come on faster than pimples do. When it first appears, hot tub folliculitis looks like small bumps (papules) that are bright to dark red. As the rash gets worse, the bumps get bigger—up to 3 centimeters in diameter.
The bumps can also be filled with fluid (pus) and can form around hair follicles. Some bumps may stay as small papules or superficial small pustules. While the most common symptom is a rash, other symptoms of hot tub folliculitis may include:
A hot tub folliculitis rash can show up anywhere on the body that has come in contact with contaminated water. However, the lesions most often appear on parts of the body that have been exposed to wet clothing and swimsuits.
This photo contains content that some people may find graphic or disturbing.See PhotoHot tub folliculitis.Joel Carillet / Getty Images
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
What Causes Hot Tub Rash?
Hot tub folliculitis is not contagious and will not spread through skin-to-skin contact. It is unlikely that there would be enough bacteria on a person’s skin to contaminate someone else.
As the name suggests, hot tub folliculitis is common in hot tubs where the chlorine or pH levels aren’t properly maintained. However, there are other potential sources including:
Pseudomonas: How Serious Is Bacterial Infection?
Who Is at Risk?
Anyone can get hot tub folliculitis, but children tend to get it more often than adults.Some people are more likely to get it than others, including:
These tests can be ordered if there is any doubt as to what is causing the rash. Hot tub folliculitis looks similar to other skin conditions such as:
Treating Hot Tub Rash
Pseudomonas aeruginosacannot survive on healthy skin, so the rash usually resolves on its own after seven to 10 days. Treatment, if needed, can include home or over-the-counter (OTC) remedies, or prescription medications. However, hot tub rash often clears up on its own within 10 days.
Until then, several home remedies may help relieve symptoms and speed up healing. Ask your healthcare provider before trying any of these home treatments for hot tub rash:
If home care isn’t doing the trick, or if your rash is severe, your healthcare provider may prescribe a topical antimicrobial such as gentamicin cream orPolymyxin Bspray. For widespread, resistant cases of hot tub rash, the oralantibioticCipro (ciprofloxacin) can be prescribed.
When to Call Your Provider
You should call your healthcare provider if:
Lasting Skin EffectsA hot tub folliculitis rashmay leave darkened (hyperpigmented), areas of skin after it has completely healed. They should fade over time, but it can take up to 18 months. You can ask your healthcare provider about treatments that can help fade discolored areas more quickly.You also should not pop folliculitis bumps. Doing so can lead to infections or cause damage to your skin.
Lasting Skin Effects
A hot tub folliculitis rashmay leave darkened (hyperpigmented), areas of skin after it has completely healed. They should fade over time, but it can take up to 18 months. You can ask your healthcare provider about treatments that can help fade discolored areas more quickly.You also should not pop folliculitis bumps. Doing so can lead to infections or cause damage to your skin.
A hot tub folliculitis rashmay leave darkened (hyperpigmented), areas of skin after it has completely healed. They should fade over time, but it can take up to 18 months. You can ask your healthcare provider about treatments that can help fade discolored areas more quickly.
You also should not pop folliculitis bumps. Doing so can lead to infections or cause damage to your skin.
Hyperpigmentation and Scarring
Showering after coming in contact with contaminated water does not prevent hot tub rash infection, but there are a few things you can do to lower your risk:
Common Recreational Water Illnesses and How to Prevent Them
Summary
Hot tub folliculitis can cause a rash but it’s usually not serious. If the rash does not clear up on its own after about a week, you may need treatment for it. Since the rash can also look like other skin conditions, you should let your provider know if the rash isn’t getting better with time and treatment.
The best way to avoid hot tub rash is to make sure the water you’re swimming in (like a pool or hot tub) is clean and regularly maintained. It’s also helpful to clean off after spending time in the water.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Osteopathic College of Dermatology (AOCD).Hot tub folliculitis.Teraki Y, Nakamura K.Rubbing skin with nylon towels as a major cause of pseudomonas folliculitis in a Japanese population.J Dermatol.2015 Jan;42(1):81-3. doi:10.1111/1346-8138.12712Nagoba BS, Selkar SP, Wadher BJ, Gandhi RC.Acetic acid treatment of pseudomonal wound infections–a review.J Infect Public Health. 2013 Dec;6(6):410-5. doi:10.1016/j.jiph.2013.05.005U.S. Centers for Disease Control and Prevention.Facts about hot tub rash.Additional ReadingHlavsa MC, Cikesh BL, Roberts VA, et al.Outbreaks associated with treated recreational water - united states, 2000-2014.MMWR Morb Mortal Wkly Rep. 2018 May 18;67(19):547-551. doi:10.15585/mmwr.mm6719a3Lutz JK, Lee J.Prevalence and antimicrobial-resistance of Pseudomonas aeruginosa in swimming pools and hot tubs.Int J Environ Res Public Health. 2011 Feb;8(2):554-64. doi:10.3390/ijerph8020554MedlinePlus.Hot Tub Folliculitis. U.S. National Library of Medicine.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Osteopathic College of Dermatology (AOCD).Hot tub folliculitis.Teraki Y, Nakamura K.Rubbing skin with nylon towels as a major cause of pseudomonas folliculitis in a Japanese population.J Dermatol.2015 Jan;42(1):81-3. doi:10.1111/1346-8138.12712Nagoba BS, Selkar SP, Wadher BJ, Gandhi RC.Acetic acid treatment of pseudomonal wound infections–a review.J Infect Public Health. 2013 Dec;6(6):410-5. doi:10.1016/j.jiph.2013.05.005U.S. Centers for Disease Control and Prevention.Facts about hot tub rash.Additional ReadingHlavsa MC, Cikesh BL, Roberts VA, et al.Outbreaks associated with treated recreational water - united states, 2000-2014.MMWR Morb Mortal Wkly Rep. 2018 May 18;67(19):547-551. doi:10.15585/mmwr.mm6719a3Lutz JK, Lee J.Prevalence and antimicrobial-resistance of Pseudomonas aeruginosa in swimming pools and hot tubs.Int J Environ Res Public Health. 2011 Feb;8(2):554-64. doi:10.3390/ijerph8020554MedlinePlus.Hot Tub Folliculitis. U.S. National Library of Medicine.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Osteopathic College of Dermatology (AOCD).Hot tub folliculitis.Teraki Y, Nakamura K.Rubbing skin with nylon towels as a major cause of pseudomonas folliculitis in a Japanese population.J Dermatol.2015 Jan;42(1):81-3. doi:10.1111/1346-8138.12712Nagoba BS, Selkar SP, Wadher BJ, Gandhi RC.Acetic acid treatment of pseudomonal wound infections–a review.J Infect Public Health. 2013 Dec;6(6):410-5. doi:10.1016/j.jiph.2013.05.005U.S. Centers for Disease Control and Prevention.Facts about hot tub rash.
American Osteopathic College of Dermatology (AOCD).Hot tub folliculitis.
Teraki Y, Nakamura K.Rubbing skin with nylon towels as a major cause of pseudomonas folliculitis in a Japanese population.J Dermatol.2015 Jan;42(1):81-3. doi:10.1111/1346-8138.12712
Nagoba BS, Selkar SP, Wadher BJ, Gandhi RC.Acetic acid treatment of pseudomonal wound infections–a review.J Infect Public Health. 2013 Dec;6(6):410-5. doi:10.1016/j.jiph.2013.05.005
U.S. Centers for Disease Control and Prevention.Facts about hot tub rash.
Hlavsa MC, Cikesh BL, Roberts VA, et al.Outbreaks associated with treated recreational water - united states, 2000-2014.MMWR Morb Mortal Wkly Rep. 2018 May 18;67(19):547-551. doi:10.15585/mmwr.mm6719a3Lutz JK, Lee J.Prevalence and antimicrobial-resistance of Pseudomonas aeruginosa in swimming pools and hot tubs.Int J Environ Res Public Health. 2011 Feb;8(2):554-64. doi:10.3390/ijerph8020554MedlinePlus.Hot Tub Folliculitis. U.S. National Library of Medicine.
Hlavsa MC, Cikesh BL, Roberts VA, et al.Outbreaks associated with treated recreational water - united states, 2000-2014.MMWR Morb Mortal Wkly Rep. 2018 May 18;67(19):547-551. doi:10.15585/mmwr.mm6719a3
Lutz JK, Lee J.Prevalence and antimicrobial-resistance of Pseudomonas aeruginosa in swimming pools and hot tubs.Int J Environ Res Public Health. 2011 Feb;8(2):554-64. doi:10.3390/ijerph8020554
MedlinePlus.Hot Tub Folliculitis. U.S. National Library of Medicine.
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