Other names for hot tub folliculitis are jacuzzi folliculitis, pseudomonas folliculitis, and hot tub rash. It is a skin infection with bacteria called Pseudomonas aeruginosa, and the cause is usually using a poorly maintained hot tub.

P. aeruginosa bacteria can multiply rapidly in wet, warm conditions. If contaminated water stays on the skin for too long, the bacteria can infect the hair follicles and cause an eruption of itchy bumps.

The rash may appear a few hours or days after exposure to the bacteria. While it often clears up without treatment, it can cause systemic symptoms, such as a fever, malaise, and fatigue.

In this article, we explore the causes and symptoms of hot tub folliculitis in more detail and describe what the rash looks like and how to treat it.

The main symptom of hot tub folliculitis is a rash of itchy bumps. The bumps may look similar to acne and may contain pus. They may be red or purple, and the skin may seem inflamed and feel tender.

The rash can form anywhere, but it usually appears on the abdomen or another area covered by swimwear. This is because the clothing keeps the infected water in contact with the skin for longer.

People with hot tub folliculitis may also feel ill and have fatigue or a high temperature.

The rash and other symptoms may develop 12–48 hours after contact with the contaminated water.

Learn more about folliculitis here.

Hot tub folliculitis may clear up without treatment within 5–10 days, and it is usually harmless in otherwise healthy people. If the rash lasts longer or it occurs with other symptoms, however, a person should receive medical advice.

For anyone with a health issue that affects their immune system or people with cystic fibrosis, contacting a healthcare professional is especially important. The bacteria P. aeruginosa can cause pneumonia in people with cystic fibrosis.

A doctor may prescribe a topical medication, such as silver sulfadiazine cream, to treat hot tub folliculitis. People can apply this twice a day. However, it is always best to follow a doctor’s guidance.

The American Osteopathic College of Dermatology also recommend using white vinegar to treat hot tub folliculitis. People can apply this to the affected area for 20 minutes at a time, two to four times a day.

Always apply treatment for the skin in the same direction as any hair growth, and leave the area uncovered. Also, avoid shaving or scratching the area to prevent further skin irritation.

If topical preparations do not treat hot tub folliculitis, a doctor may prescribe oral antibiotics.

To soothe the area and help it heal, a person can apply a warm compress for 15–20 minutes at a time, three to four times a day, or as often as necessary.

Once the rash has cleared, it may leave dark marks on the skin. These may be red or brown and take a few months to disappear.

Hot tub folliculitis results from a bacterial infection in hair follicles on the skin. The bacteria, called P. aeruginosa, multiply in hot temperatures and thrive in conditions found in poorly maintained hot tubs. The bacteria can survive in chlorinated water.

The bacteria grow in other warm, wet environments, such as:

  • contaminated pools
  • lakes and rivers
  • water slides
  • whirlpools

Research shows that nylon bath poufs and towels can also harbor the bacteria.

A doctor diagnoses hot tub folliculitis by examining the skin and asking about the person’s medical history and any recent exposure to hot tubs and pools.

The rash can look similar to:

  • acne
  • psoriasis
  • other types of folliculitis
  • other bacterial infections, such as a staph infection
  • chemical rashes

To prevent a misdiagnosis, a doctor may swab the skin and send this sample to a laboratory for examination under a microscope. The analysis can confirm the type of infection.

Hot tub folliculitis is a skin infection that people acquire from prolonged exposure to contaminated water. The bacteria do not pass from person to person.

People can take steps to prevent hot tub folliculitis, such as:

  • removing swimwear right after getting out of a hot tub and putting it in the wash
  • showering with hot water and soap right after using a hot tub
  • making sure that swimwear is completely dry before wearing it again
  • checking that a public hot tub is serviced at least twice a day

People should take extra care or avoid hot tub use if they have:

  • areas of broken skin or open wounds
  • a health condition that affects their immune system
  • cystic fibrosis

People can keep their hot tubs clean and safe by:

  • using test strips to check pH and disinfectant levels
  • replacing the hot tub water regularly
  • thoroughly cleaning all parts of the pool regularly
  • following the manual’s instructions for replacing the water filter

The Centers for Disease Control and Prevention (CDC) recommend that hot tubs contain:

  • free chlorine, at 3–10 parts per million (ppm) or
  • bromine, at 4–8 ppm and
  • a pH of 7.2 to 7.8

To kill the bacteria in bath sponges, soak them in 1 gallon of water with three-quarters of a cup of chlorine bleach for at least 5 minutes. Then rinse them thoroughly before use.

Hot tub folliculitis is a bacterial skin infection that a person might develop from using a poorly maintained hot tub or pool. It causes itchy bumps on the skin, particularly in areas that swimwear covers.

The infection may clear up in a few days without treatment, but if it lasts 10 days or longer, contact a healthcare professional. The treatment may include topical medication or oral antibiotics.