Spending some time soaking in a hot tub can be a relaxing and enjoyable experience. However, it can also come with certain risks, such as the development of hot tub folliculitis. This condition, also known as Pseudomonas aeruginosa folliculitis, is a common skin infection caused by bacteria that thrive in warm, moist environments such as hot tubs and swimming pools.


What is hot tub folliculitis 

Hot tub folliculitis is caused by the Pseudomonas aeruginosa bacteria, which can enter the skin through hair follicles or tiny cuts or abrasions. This can lead to the development of small red bumps or pustules on the skin, usually in areas that were submerged in the water, such as the legs, buttocks and back. Symptoms typically appear within a few hours to a few days after exposure and can last for several weeks.


What can cause this?

Contaminated water is the most common cause of hot tub folliculitis. Bacteria can thrive in warm water that is not properly maintained or disinfected. When people soak in the contaminated water, the bacteria can enter their skin, causing the infection. Other factors that can increase the risk of developing hot tub folliculitis include:


  1. Spending prolonged periods in the water – the longer you stay in the hot tub, the more likely you are to be exposed to bacteria and other contaminants.
  2. Using a hot tub that is not properly maintained – hot tubs require regular cleaning and maintenance to ensure that the water is safe and free of contaminants.
  3. Wearing swimsuits or wet clothing for an extended period – wet clothing or swimsuits can trap bacteria against the skin, increasing the risk of infection.
  4. Having an open wound, cut, or scratch on the skin – any break in the skin can provide a point of entry for bacteria, increasing the risk of infection.
  5. Having a weakened immune system – individuals with a weakened immune system are more susceptible to infections, including hot tub folliculitis.

Symptoms to watch out for 

The symptoms of hot tub folliculitis typically appear within a few days of exposure to contaminated water and can include red, itchy bumps or small pus-filled blisters around the hair follicles. The affected area may be tender or sore to the touch and may become more extensive over time. In some cases, the bumps may resemble acne and the affected area may become scaly or dry. 


Symptoms of hot tub folliculitis usually clear up within a few days to a few weeks without medical treatment, although in some cases, prescription antibiotics may be necessary. If you experience persistent symptoms or have a weakened immune system, it is essential to seek medical attention.


How can you avoid hot tub folliculitis?

Preventing hot tub folliculitis requires proper maintenance and hygiene of the hot tub. Hot tubs be maintained at a disinfectant level of at least 2 parts per million (ppm) of free chlorine or 4 ppm of free bromine. pH levels should be kept between 7.2 and 7.8 and the water should be circulated and filtered properly to ensure that bacteria and other contaminants are removed.


It is also important to shower with soap and water before and after using a hot tub. This can help remove any bacteria or other contaminants that may be present on your skin. If you have long hair, it is recommended that you tie it back or wear a swim cap to prevent it from getting wet and potentially introducing bacteria into the water.


If you own a hot tub, it is important to  properly maintain and clean it. This may include draining and refilling the water on a regular basis, as well as regularly cleaning the filters and other components of the system.


Hot tub folliculitis is a common skin infection that can be prevented by properly maintaining and disinfecting hot tubs and practicing good hygiene. Learn more about hot tub safety when using your hot tub with the family.