Hot Tub Folliculitis

What is hot tub folliculitis?

Hot tub folliculitis is an infection of hair follicles caused by Pseudomonas aeruginosa, a type of bacteria. These bacteria grow in warm, moist environments (like hot tubs and swimming pools). The condition causes itchy red bumps around hair follicles.

Who does hot tub folliculitis affect?

Anyone who sits in a hot tub contaminated with bacteria may develop hot tub folliculitis. Children and people assigned female at birth (AFAB) are more likely to develop this condition.

What does hot tub folliculitis look like?

Hot tub folliculitis looks like widespread itchy, red bumps. It can develop on any body part exposed to bacteria-tainted water — even under your bathing suit. You might develop this condition on your:

• Face.
• Chest.
• Arms.
• Buttocks.
• Genitals.
• Legs.

Does hot tub folliculitis have other names?

Hot tub folliculitis is also known as pseudomonas folliculitis or hot tub rash.

How common is hot tub folliculitis?

Hot tub folliculitis is common. Infection can happen in public and private swimming pools, water parks, flotation tanks and other warm, moist environments. Researchers estimate that Pseudomonas aeruginosa is present in about two-thirds of hot tubs and swimming pools at any given time.

What causes hot tub folliculitis?

The cause of hot tub folliculitis is sitting in a hot tub or other warm, moist environment that contains Pseudomonas aeruginosa for a prolonged time.

What are the symptoms of hot tub folliculitis?

The most common symptom of hot tub folliculitis is an itchy red “rash” with inflamed hair follicles, which typically develops a few days after hot tub exposure. You might also have:

• Diarrhea.
• Eye pain.
• Fever.
• Headache.
• Nausea and vomiting.
• Sore throat.

Bumps (pustules) on your skin may develop yellow or greenish liquid (pus). Bumps may appear on the palms of your hands or soles of your feet as well.

Is hot tub folliculitis contagious?

Hot tub folliculitis isn’t contagious between people. A person with the condition can’t spread it to another person. But people who sit in a hot tub together may develop hot tub folliculitis after exposure to the same bacteria.

How do healthcare providers diagnose hot tub folliculitis?

Your healthcare provider will likely be able to diagnose hot tub folliculitis based on your history of water exposure and a skin exam.

There are no special diagnostic tests for hot tub folliculitis.

Does hot tub folliculitis need treatment?

There’s no specific treatment for hot tub folliculitis. The condition usually clears on its own within a week or two.

If the hot tub folliculitis persists or worsens, call your healthcare provider.

Will at-home treatments help get rid of hot tub folliculitis symptoms?

If your skin is itchy or inflamed (red), the following measures may help:

• An over-the-counter topical steroid (hydrocortisone skin cream) to help alleviate the itchiness and inflammation.
• Antibacterial ointments to prevent infection.

Are there complications of hot tub folliculitis?

Complications of hot tub folliculitis are rare. Occasionally, an infection may develop from scratching or picking the bumps.

Rarely, an abscess (collection of pus) may form within a pustule, requiring medical treatment. Some people experience changes in skin pigmentation (darkening) after hot tub folliculitis. This is also rare.

How long does it take to recover from hot tub folliculitis?

Most people feel better within a week. Anti-itch ointments or lotions help most people manage their symptoms.

How do I know if a hot tub is safe?

Pools and hot tubs need regular maintenance, including application of certain chemicals (chlorine) to keep them clean and healthy for users. But you can’t tell that a hot tub is clean and safe just by looking at it. If possible, ask the person who maintains the hot tub how often they clean and check it. A hot tub that’s monitored daily should be a safe choice.

How can I avoid getting hot tub folliculitis?

You can’t always know if Pseudomonas aeruginosa is present in a hot tub you’re using. But you can take steps to keep yourself safer:

• Don’t shave or use any hair removal methods (such as hair removal creams or wax) right before you get in a hot tub.
• Remove your bathing suit and take a shower as soon as you leave the hot tub.
• Wash your bathing suit before wearing it again.

What can I expect if I have hot tub folliculitis?

Your symptoms should ease in one to two weeks. If they don’t, contact your healthcare provider.

When should I see my healthcare provider if I have hot tub folliculitis?

It’s important to see your healthcare provider if the skin rash persists or worsens and you develop fever, nausea or vomiting.

If you develop an infection, you’ll likely need antibiotics to treat it.

How can I make sure my hot tub doesn’t cause hot tub folliculitis?

If you or someone else develops hot tub folliculitis after using a hot tub or swimming pool that you own, contact a hot tub or pool professional. You’ll need to thoroughly clean the tub or pool to prevent reinfection. A professional can also guide you in proper maintenance practices to help prevent bacteria from growing.

A note from Cleveland Clinic

Hot tub folliculitis is an infection of your skin’s hair follicles caused by Pseudomonas aeruginosa, a type of bacteria found in many hot tubs and pools. The condition often clears up on its own in one to two weeks without treatment. Call your healthcare provider right away if you develop fever or if symptoms worsen.