Hot Tub Folliculitis
Hot tub folliculitis, sometimes called "hot tub rash", is a skin infection caused by a type of bacteria called pseudomonas aeruginosa. This germ thrives in warm, wet environments and can grow in hot tubs, whirlpools, spas, and heated pools that are not properly cleaned or disinfected.
How do you get it hot tub folliculitis?
You can get hot tub folliculitis by soaking in or being exposed to contaminated water. The warm water opens your pores and allows the bacteria to infect your hair follicles (the tiny openings in the skin where hair grows). The longer you spend in the water, the higher your risk.
What does hot tub folliculitis it look and feel like?
Symptoms usually appear 8 to 48 hours after exposure. You may notice:
- Itchy, red bumps or small pus-filled blisters (pustules).
- Bumps most commonly on the trunk (chest, back, sides), buttocks, and areas covered by a swimsuit. (The head and neck are usually spared.)
- Mild tenderness or discomfort at the rash sites.
- Occasionally, low-grade fever or fatigue.
Hot Tub Folliculitis vs. Herpes
Hot tub folliculitis and herpes can both cause bumps or irritation in the genital or butt/thigh area. This (and the fact that sex happens in hot tubs!) causes some people to mistake hot tub folliculitis for an STI (or vice versa.) Here's a quick rundown of how they differ:
Hot Tub Folliculitis
- Usually appears after hot tub or pool use.
- Causes itchy or tender red bumps/pimples.
- Often centered around hair follicles.
- Common on butt, thighs, chest, or back.
- Usually spread across larger areas.
- Often clears on its own within days to two weeks.
Herpes
- Causes painful blisters or sores.
- May start with burning, tingling, or itching.
- Usually appears in smaller localized clusters.
- Common on genitals, anus, buttocks, or mouth.
- Can recur in the same area.
- Spread through skin-to-skin contact and is contagious even without visible sores.
Herpes testing can be conducted by taking a swab of a fresh sore or blister, or via blood test.
How is hot tub folliculitis it treated?
In most cases, hot tub folliculitis goes away on its own within 7 to 10 days without treatment. To help with comfort and healing:
- Keep the affected skin clean and dry.
- Avoid scratching or picking at the bumps.
- Cool compresses or over-the-counter anti-itch creams may help with itching.
- Avoid using the hot tub or pool until the rash has fully cleared.
If the rash is severe, widespread, or does not improve after 10 days, your doctor may prescribe an antibiotic (such as ciprofloxacin) to help clear the infection.
When should you call your doctor?
Contact your doctor if you experience any of the following:
- The rash is getting worse or spreading.
- You develop a high fever.
- The bumps become very painful, swollen, or drain pus.
- The rash does not improve within 10 days.
- You have a weakened immune system.
Related Terms
How can you prevent hot tub folliculitis?
- Make sure hot tubs and pools are properly maintained with correct chlorine or bromine levels.
- Shower with soap and water immediately after using a hot tub, pool, or spa.
- Remove your swimsuit and wash it after each use.
- Avoid hot tubs that look cloudy, slimy, or have a strong odor.
- If you own a hot tub, test and adjust the water chemistry regularly according to the manufacturer's instructions.
Remember: Hot tub folliculitis is not spread from person to person — it comes from the contaminated water. If multiple people who used the same hot tub develop a rash, the water source should be tested and treated.
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