• Infections

What You Need to Know About Hot Tub Folliculitis

As the summer rolls around, you’ll naturally want to spend more time relaxing in the pool or hot tub.

But this could lead to an itchy and bumpy rash that may leave you feeling uncomfortable and even concerned about your health. 

Luckily, this rash — known as hot tub folliculitis — is a common condition that typically resolves on its own. However, knowing how to treat it will help you avoid further complications.

In this article, we’ll take a closer look at everything you need to know about hot tub folliculitis, including the best practices for treatment and prevention.

What Exactly is Hot Tub Folliculitis?

Hot tub folliculitis — also known as a hot tub rash infection or pseudomonas folliculitis — is a skin infection that occurs when bacteria infect the hair follicles.

It's often linked to the bacteria Pseudomonas aeruginosa, which thrives in warm, moist environments like a poorly maintained hot tub, swimming pools, and spas. 

When you use a dirty hot tub or pool, bacteria can get stuck in your hair follicles. This can lead to inflammation and cause an itchy, bumpy rash.

Commonly affected areas include the torso, buttocks, legs, arms, and groin area.

Symptoms of hot tub folliculitis

If you’ve contracted hot tub folliculitis, symptoms may develop within a few hours or days after exposure to the contaminated water. Common signs to watch out for include:

• Itchy, red bumps around the affected area

• Pus-filled blisters that are tender, painful, or crusty 

• Mild fever and chills 

• Skin tenderness

• Swelling in the affected area

Common Causes of Hot Tub Folliculitis

Hot tub folliculitis is commonly caused by a bacterial infection. The bacteria is usually found in water and soil, thriving in warm water environments.

Other factors that can cause the bacteria to multiply include:

• Hot tubs, pools, and spas that aren’t properly chlorinated or disinfected

• Poor maintenance of water quality and pH balance

• Stagnant water 

• Contaminated water filters and surfaces

• Frequent use of public hot tubs

• Prolonged exposure to contaminated water

• Wearing swimwear that hasn’t been properly cleaned after a previous use

• Poor personal hygiene, including failing to shower after swimming 

These factors can increase the risk of bacteria becoming trapped in the hair follicles and causing an infection.

Treatment Options for Hot Tub Folliculitis

Self-care and home remedies

In most cases, hot tub folliculitis can be resolved by using home remedies to alleviate symptomatic discomfort. These may include:

• Gently washing the affected area with soap and water

• Applying a warm compress to soothe any itchiness

• Avoiding using hot tubs, pools, or spas until your infection has cleared

• Wearing loose and breathable clothing to reduce irritation

• Avoiding scrubbing the affected area 

With these remedies, hot tub folliculitis typically resolves within a week or two. If your symptoms don’t improve, seek professional medical treatment.

Topical treatments

Topical treatments can be used alongside home remedies to alleviate the discomfort caused by a hot tub rash.

Common treatment options include over-the-counter (OTC) creams — especially those containing bacitracin or polymyxin B — which can help reduce bacterial growth.

You can also use a mild hydrocortisone cream to help reduce inflammation, itching, and redness. 

Always use these products as directed by your healthcare provider or pharmacist to avoid any adverse reactions.

Oral medication

For more severe cases of hot tub folliculitis, your doctor may recommend oral medications such as:

• Antihistamines — like diphenhydramine (Benadryl) and cetirizine (Zyrtec) — to help relieve itching and discomfort

• Pain relievers — such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) — to minimize inflammation

Over time, these medications can help cure hot tub folliculitis and prevent reinfection.

Medical procedures

In severe cases where pus-filled blisters or abscesses have formed and do not heal on their own, a minor medical procedure may be required.

During this procedure, a healthcare provider makes a small incision in the affected area and drains it manually. This should only be performed by qualified professionals to avoid any complications.

Can Hot Tub Folliculitis Be Prevented?

Preventing folliculitis can be challenging, particularly because it’s hard to know if bacteria are present in the water. 

However, you can implement the following strategies to reduce your risk:

• Avoid shaving or using any hair removal methods right before swimming

• Remove your swimsuit and take a shower as soon as you leave the swimming pool or hot tub 

• Wash your swimsuit between uses

• Make sure your swimwear is completely dry before using it again

• Limit your time in the hot tub to reduce the risk of skin irritation

If you clean and maintain your own hot tub or pool, you can also take the following measures to prevent bacteria from growing in the water:

• Testing the water regularly to ensure it has the correct levels of chlorine (around one-five parts per million) and a proper pH balance (usually between 7.2 and 7.8)

• Performing regular shock treatments — where you add a high dose of chlorine to the water — to kill bacteria

• Cleaning and replacing filters regularly

• Draining, refilling, and cleaning your pool or hot tub according to the manufacturer’s guidelines

Implementing these strategies can help keep you safe from a bacterial infection that could contribute to hot tub folliculitis.

Should You See a Doctor About Hot Tub Folliculitis?

While hot tub folliculitis can resolve without medical treatment or intervention, there are some instances that may require a doctor’s consultation. 

If you are experiencing any of the following, speak to your doctor as soon as possible:

• A rash that doesn’t improve within a week and seems to worsen

• High fever or other symptoms of a systemic infection, such as a sore throat or swollen lymph nodes

• An infection that appears to be spreading beyond the initially affected area

• Severe pain or discomfort that isn’t relieved by OTC treatments

These symptoms may be an indication of a more severe infection that requires professional medical care.

Your doctor will evaluate your condition and recommend a more effective treatment plan based on your diagnosis.

Where Can You Learn More About Folliculitis and Similar Conditions?

While LifeMD doesn’t provide medical care for conditions like hot tub folliculitis, we can help you manage any unpleasant symptoms you may be experiencing.

A team of medical professionals can assist you with medications, prescriptions, and advice to cope with painful or uncomfortable symptoms caused by folliculitis.

Make your appointment and take control of your health — all from the comfort of your own home.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

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