Hot Tub

Folliculitis is inflammation of the hair follicle caused by infection, chemical irritation, or physical injury. There are several different types of folliculitis, but a common type is called "hot tub" folliculitis, or pseudomonas folliculitis.

Hot Tub Folliculitis Cause

Hot tub folliculitis is an infection of the hair follicles caused by the bacteria Pseudomonas aeruginosa. This bacteria is commonly found in contaminated whirlpools, hot tubs, water slides, physiotherapy pools, or even loofah sponges. Children tend to get hot tub folliculitis more often, probably because they stay in the water longer. The rash is not spread by personal contact with infected lesions.

Hot Tub Folliculitis Rash

The rash of hot tub folliculitis consists of several small .5 - 3 cm red papules or wheals with a central pustule. The rash can erupt anywhere on the body that has been in contact with the contaminated water. Areas that are in contact with wet clothing tend to have more lesions. The rash usually resolves on its own in 7 to 10 days leaving a hyperpigmented lesion that resolves over months. Some people experience fatigue in the first few days of the rash, but fever is uncommon.

Picture of folliculitis on the leg
Hot Tub Folliculitis Treatment

Most cases of hot tub folliculitis resolve on their own and don't require specific treatment. If needed the following treatments may be effective:

Vinegar compresses applied for 20 minutes two to four times a day
Silver sulfadiazine cream (Silvadene) applied two times a day
Oral antibiotics such as ciprofloxacin are only needed in widespread or resistant cases

Hot Tub Folliculitis Prevention

Showering after contact with contaminated water does not prevent infection. The following measures should be considered when maintaining facilities that may be prone to water contamination:

• Continuous water filtration to eliminate dead skin
• Frequent monitoring of disinfectant levels
• Frequent changing of water