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Hot tub folliculitis ( Pseudomonas folliculitis ), or "hot tub rash," is a bacterial skin condition you 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.
Hot tub folliculitis is caused by the bacteria Pseudomonas aeruginosa, which infects the hair follicles. The bacteria is commonly found in recreational water and natural sources of water, such as lakes and rivers. It is also frequently caused by Staphylococcus aureus and the fungus Aspergillus Nigus.
This article covers the symptoms and causes of hot tub folliculitis. It also discusses how it is diagnosed, treatment options, and prevention tips.
Pseudomonas aeruginosa cannot 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 or Polymyxin B spray. For widespread, resistant cases of hot tub rash, the oral antibiotic Cipro (ciprofloxacin) can be prescribed.
Numerous factors may influence an individual’s risk of developing P. aeruginosa folliculitis from an environmental exposure. These risk factors include changes to cutaneous flora, female gender, length of exposure, and skin trauma. It would be impractical to recommend all women avoid extended hot tub use. Additionally, patients with unhealed thermal burns of skin are not likely to use hot tubs or public pools. Thus, counseling should be directed to those with diabetes, immunocompromised states, or trauma of the skin. These populations can be educated on the risk of infection with extended submersion in public pools or hot tubs.
The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.
The authors have declared that no competing interests exist.