by Terry Hollenbeck, M.D.

Hot tubs, also known as spas, Jacuzzis and soaking tubs, have long been enjoyed by people seeking relaxation, stress reduction and a way to soothe aching muscles.

In my research for this column, I could find no scientific studies relating to the safe use of hot tubs. Most literature I reviewed states that if you have health questions relating to safe use of your hot tub, you should consult your physician.

Well, folks, because of the lack of medical research data, this physician — and most of my colleagues with whom I have spoken — can’t give any scientifically proven guidelines for the safe use of hot tubs. What advice we can give falls along the lines of experience and common sense.

With that being said, here are my guidelines for the safe use of hot tubs:

• Shower with soap and water before and after use of a hot tub.
• Do not heat your tub hotter than 104 degrees Fahrenheit, and use an accurate thermometer to determine the temperature. Even if you’re in good health, do not soak longer than 20 minutes at a time.
• A temperature of 100 degrees for 10 to 15 minutes is safer for those with heart disease or chronic medical problems and during pregnancy. It would be best not to use a hot tub during the first three months of pregnancy.
• Children should be at least 5 years old and soak no longer than 10 to 15 minutes — and always under adult supervision — in a tub no hotter than 100 degrees.
• Avoid hot tub use if under the influence of alcohol or drugs such as tranquilizers, antidepressants or sleeping pills.
• Slowly exit the tub after soaking. Sit on the edge for a few minutes before standing upright. This should prevent the possibility of passing out because of the tub lowering your blood pressure.
• Keep the tub clean and well maintained.

One way to prevent overheating is to not submerge your entire body in the hot tub water. Keeping your arms and shoulders out of the water is a good way to avoid getting too hot.

If someone with heart disease has been cleared by a doctor as well enough to exercise, they are probably at no risk when using a hot tub according to the above guidelines. Contrary to popular opinion, there is no evidence for increased risk of a heart attack while relaxing in a hot tub.

Hot tub folliculitis is a common pimple-like rash that will afflict some people after the use of a tub with a low chlorine level. It can be avoided by properly maintaining the tub and by showering after tub use. Unless severe, this rash will usually heal itself without the need to seek treatment from a doctor.

Enjoy your hot tub — that’s what it’s for.

Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or e-mail him at valleydoctor@sbcglobal.net. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.