Hot Tub Folliculitis

This an infection of the hair follicles caused by Pseudomonas aeruginosa. There is often a history of emersion in hot tubs, whirlpools or other sources of contaminated water. The rash that occurs is often worse if the skin is occluded by a bathing suit. The rash can present anywhere from a few hours to days after exposure, and consists of itchy red bumps and may progress to tender nodules filled with pus.

Hot tub folliculitis is self-resolving within 5 to 10 days but may leave a reddish-brown or hyperpigmented area that can take a few months to disappear. To help with the rash, white vinegar can be applied for 20 minutes, 2 to 4 times a day. Silver sulfadiazine cream used twice daily is another option. Oral antibiotics are given if the rash is severe or if topical treatments have failed.

To prevent hot tub folliculitis, it is recommended that bath water be changed frequently. Showering after exposure has not been found to reduce the rate of infection.

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Resources & Attributions

• Header image source: James Heilman, MD. CC BY-SA 3.0.