Summer days and nights invite us to relax, so what could be better than a nice soak in the hot tub after an afternoon of gardening, golfing, or hiking? No harm, right? Not necessarily. Occasionally, you may find an unexpected surprise in the days that follow – an itchy rash.
“Hot tub” folliculitis (folliculitis is inflammation of the hair follicle) is a rash that develops after exposure to a hot tub or whirlpool that has been contaminated by bacteria. The rash can be incredibly itchy. While hot tub folliculitis is not entirely uncommon, it can be quite distressing to the unknowing victim. The condition usually manifests as itchy pink bumps or pustules on the skin in areas covered by a bathing suit. Generally, the rash develops within 48 hours after exposure, but, occasionally, it can develop several days later.
The cause of the contamination is usually due to the bacterium called Pseudomonas, and the rash is formally referred to as Pseudomonas folliculitis. The elevated temperature of the water in the hot tub provides an ideal environment for bacterial growth, if chlorine levels in the water are inadequate. Other factors that contribute to acquiring this infection include length of time spent in the hot tub and number of hot tub users (eg, large amounts of users at hotels and other public facilities).
Hot tub folliculitis is a condition that will generally resolve on its own in a few days to weeks. Discomfort associated with the condition can be soothed with the application of cloths soaked in vinegar and applied directly to the affected area for 15 minutes at a time. For really extensive cases, treatment with topical or oral antibiotics can be considered, but this is generally not needed. It is best to thoroughly clean any pools or hot tubs thought to be contaminated and keep chlorine levels in check to avoid a recurrence of this infection.