Hot Tub Folliculitis

All About the Common Skin Infection

Woman sunbathing on lounge chair at poolside
CaiaImage/Getty Images

Hot tub folliculitis is a type of folliculitis that emerges anywhere from a few hours to a few days after using an improperly maintained hot tub or swimming pool. Hot tub folliculitis is one of several different types of folliculitis, which is defined as the inflammation of hair follicles typically caused by a bacterial or fungal infection.

What Causes Hot Tub Folliculitis?

Hot tub folliculitis is a bacterial infection of the hair follicles caused by the bacteria Pseudomonas aeruginosa.

The rash is not spread through personal contact with infected lesions. These bacteria thrive in warm water; even in water that is sufficiently chlorinated. They are commonly found in whirlpools, hot tubs, water slides, physiotherapy pools and even loofah sponges.

Children tend to be more at risk for contracting hot tub folliculitis, likely because they stay in the water longer. It can also occur from wearing a wet bathing suit that was not thoroughly washed and dried prior to use, or staying in a wet bathing suit for too long.

Symptoms and Appearance of Hot Tub Folliculitis

Hot tub folliculitis manifests as a rash that is itchy, bumpy and red. It resembles acne. It usually consists of several small, red papules or wheals that are a half centimeter to 3 centimeters in diameter. The papules also have central pustules. Pus-filled blisters can also form around hair follicles. The rash can erupt anywhere on the body that has come in contact with contaminated water.

Lesions most often appear on parts of the body that have been exposed to wet clothing and swimsuits.

Diagnosis and Treatment of Hot Tub Folliculitis

A doctor should be able to diagnose hot tub folliculitis just by looking at it and knowing that the patient has recently used a hot tub. Additional testing usually isn't necessary.

However, if the typical treatment protocol doesn't clear up the rash, a skin sample may be taken to determine the cause.

Pseudomonas aeruginosa cannot survive on healthy skin, so the rash usually resolves on its own after 7 to 10 days. The rash may leave hyper-pigmented lesions that fade over time. The rash typically responds well to home remedies*. Apply a warm, damp washcloth or compress to the infected area several times a day. This will help relieve any pain and help the area drain. Over-the-counter anti-itch medicines can also help ease discomfort.

Because the rash is relatively benign and self-resolving, hot tub folliculitis doesn't require a specific treatment method. However, more severe cases can be treated with topical or systemic antibiotics. Health care professionals prescribe topical treatments, such as Gentamicin cream and Polymyxin B spray. Ciprofloxacin is an oral antibiotic used to treat widespread, resistant cases.

How to Prevent Hot Tub Folliculitis

Showering after coming in contact with contaminated water does not prevent infection, but there are a few things you can do to lower your risk of contracting hot tub folliculitis.

After using a hot tub or swimming pool, change out of your wet bathing suit and into clean, dry clothing.

Make sure that the hot tubs and swimming pools you use are clean. If you have a pool or hot tub, clean and chlorinate it regularly. Make sure the water filtration system is continuously working to eliminate dead skin. Frequently monitor disinfectant levels and change water as needed.

*Consult your doctor before trying any at-home remedy.

Sources

Mayo Clinic Staff. Folliculitis. Retrieved March 25, 2016, from http://www.mayoclinic.org/diseases-conditions/folliculitis/basics/definition/con-20025909 

Oakley, A. (2015, February 01). Spa pool folliculitis. Retrieved March 25, 2016, from http://www.dermnetnz.org/acne/spapool-folliculitis.html

Continue Reading