Hot Tub Rash

Hot tub rash is a skin condition which occurs due to bacterial infection of the hair follicles. The condition is named thus because the causative bacteria called Pseudomonas aeruginosa tend to grow and thrive in swimming pools, hot tubs, and loofah sponges, etc. The medical term for the condition is hot tub folliculitis or Pseudomonas folliculitis. As children tend to spend more time in pools and hot tubs, hot tub rash is more widespread in children than adults.

A hot tub rash is made up of many tiny reddish papules of varying sizes or wheals with a pustule in the middle. The rash may appear at any place on the body which has been exposed to water contaminated by the bacteria. The lesions are more prominent in those areas which remain in contact with wet swimwear. Some patients may suffer from fatigue in the initial few days after rash development, but fever is rare. Hot tub rash typically clears out on its own in a week to 10 days and leaves a pigmented area in its wake which also disappears after some months.

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The signs and symptoms of hot tub rash become visible 3 to 4 days after a person contracts the infection, often due to use of a hot tub that has not been maintained properly. A few common symptoms are listed below:

  • The most visible symptom of hot tub rash is the formation of bump and itchy skin rashes on different areas of the body, especially the arms, legs, torso, and buttocks.
  • The rashes are made up of red papules with a centered pustule which often form around hair follicles. Their size may range between 0.5 and 1.5 cm.
  • There may be a slight rise in the body temperature.
  • The pustules tend to become tender, dark, and reddish firm nodules. They are commonly referred to as boils or furuncles.
  • The patient may also suffer from discomfort and malaise or a general feeling of being ill or unwell.
  • The hot tub rash may be mildly or severely itchy during the first few days after the skin infection.
  • Progression of the bacterial infection may eventually cause the sensitive and tender pustules and blisters to develop pus.
  • Patients may also experience mild to severe fatigue; uncommonly fever-like ailments may also occur.

Unlike other kinds of skin infection disorders, hot tub rash is not contagious. Hence, even direct contact with the skin of an infected person may not result in the transfer of the pathogens. Transmission of the bacteria also does not occur due to sharing of washcloths, towels, or other personal items. However, it is advisable to avoid direct and close contact with the patients.

Skin problems and eruption of the rashes is mostly prevalent in those areas of the body that are covered by swimwear. This is due to the fact that swimsuits allows contaminated water to remain in contact with the skin for prolonged periods of time, thereby increasing the risk of infection.

People who experience severe, persistent, or recurrent forms of hot tub rash must consult a doctor for medical treatment. It is important for patients to seek medical treatment as the skin infection can trigger the onset of health complications such as development of abscesses.

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Causes of hot tub rash

  • Hot tub rash is caused due to contact with contaminated or dirty water which are home to the Pseudomonas aeruginosa bacterium.
  • Individuals with a compromised or weak immune system, diabetes, other underlying skin conditions, and occurrence of sores, cuts, or wounds on the skin are at increased risk to developing hot tub rash than others.


  • A doctor will ask questions about the activities of the patient for the past few days, check the family history and the personal medical history of the patient, as well as carry out a physical examination of the skin rashes before arriving at a diagnosis of hot tub rash. The appearance and location of the blisters and lesions and the history of exposure to pools, hot tubs, spas, or water slides are also helpful in effective diagnosis. The diagnosis is confirmed by a few other lab tests.

Treatment of hot tub rash

Most cases of hot tub rash, including the accompanying symptoms, tend to disappear on their own in about 7 to 10 days, or after a maximum of 12 days. The blisters clear out with minimal scarring which in turn may also return to normal skin color after a few months. Hence, medical treatment for the condition is usually not necessary.

Patients who want a faster remedy to the skin infection may visit a doctor. He/she will prescribe antibiotics to treat the bacterial infection as well as anti-itching creams or pills for alleviation from itchiness. Medical treatment of hot tub rash will also help prevent recurrent episodes of the infection. A dermatologist needs to be consulted for treatment of painful abscesses.

A few home remedies for hot tub rash are listed below:

  • Apply vinegar compresses two times a day for about 20 minutes to ease the itchiness.
  • Clean the skin rashes and the surrounding areas with a mild unscented soap.
  • OTC anti-itch topical medications with hydrocortisone as an ingredient can help find relief from severe itching and discomfort.

It is important to note that showering after exposure to dirty or contaminated water cannot prevent skin infections. Listed below are some preventive guidelines that can help avoid bacterial infection and hot tub rash formation:

  • Checking and maintaining the levels of chlorine and acid of the water source that is used frequently.
  • Frequent monitoring and maintenance of the levels of disinfectants in water.
  • Removal of dead skin via continuous filtration of water.
  • Changing the water in the pool or hot tub on a regular basis.

People who use a private hot tub can visit a pool store and get information about the different chemicals that can help control and eliminate Pseudomonas aeruginosa bacteria from the pool waters. It is important to remember that even the most lavish of hot tubs can allow the bacteria to grow and flourish if it is not maintained properly. Hence, religiously follow all the maintenance guidelines to prevent cases of hot tub rash.

Hot tub rash pictures

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