FOLLICULITIS – noun \fə-ˌli-kyə-ˈlī-təs\ – inflammation of one or more follicles especially of the hair.
It’s a skin infection that produces an itchy rash with red bumps.
Pseudomonas Aeruginosa is a germ usually responsible.
Hot Tub Rash is a faster way to say it, easier than either folliculitis or pseudomonas aeruginosa! Let’s call our germ “Pseudo“; Pseudo is one of the most common bacterias in our modern society. It is naturally occurring nearly everywhere, and poorly maintained hot tubs present a particularly nice home for the pathogen.
Pseudo is also responsible for over 10% of all hospital infections. In addition to dermatitis, pseudomonas also causes gastrointestinal, urinary and respiratory infections. It’s a very opportunistic bugger, exploiting hosts with a variety of entry points.
In a hot tub that is poorly filtered and sanitized, pseudomonas can thrive, and as you soak in the water, your pores open up, and the pseudo just swims right inside, and makes a home near the root of the tiny hair follicles.
The rash usually appears on legs, buttocks and back, but hot tub rash can appear nearly anywhere on the body. The rash can begin to appear within a few hours, but may take up to 24 hours to become noticeable. The rash frequently appears under the swimsuit areas, due to continued exposure even after leaving the water.
To make sure we get the information correct, I went straight to the experts. Prevent hot tub rash in your spa by following these tips from the CDC’s Pseudomonas Fact Sheet.
- Remove biofilm slime regularly by scrubbing and cleaning.
- Replace the spa filter according to manufacturer’s recommendations.
- Replace the water in a hot tub regularly. Here’s how.
- Maintain pH levels in the 7.2-7.8 range.
- Maintain sanitizer levels; 2-4ppm chlorine, or 4-6ppm bromine.
Public Spas & Hot Tubs
The fact is, most cases of hot tub rash occur in public spas – hotels, resorts, rec centers, gyms. It’s much less common in well maintained home spas. Public spas have high levels of guests, which pummels the sanitizer and pH levels, and quickly allows bacteria to form, unless the operator is constantly monitoring the chemistry and filtration.
To safely use a public spa, which I do on occasion while on vacation – here’s a few tips of my own:
- I always pack some spa test strips to discreetly test the spa pH and sanitizer in a public spa.
- Limit your soak to 20 minutes, afterwards, wash yourself and your swimsuit in the shower.
- Change into dry clothes, don’t stay in your swimsuit.
Hot Tub Rash Treatment
In most cases, the rash will disappear on it’s own in otherwise healthy individuals. Itching can be reduced with a calamine lotion, or similar anti-itch ointment.
In individuals with compromised immune systems, or if symptoms persist past 3-4 days, or appear to be spreading, visit your doctor or a dermatologist, who may prescribe an antibiotic medication or antifungal cream. Lab tests could be performed to determine the exact type of bacteria or fungus.
Happy Hot Tubbin’