Hot Tub Folliculitis

A hair follicle is a small cavity of the skin in which a hair develops. When one or more of these becomes inflamed or infected, it is called folliculitis. Hot tub folliculitis is an infection of the hair follicles that occurs after being in a hot tub.

What is going on in the body?

Bacteria called Pseudomonas aeruginosa can grow in hot tub water that is not adequately treated with chemicals. When a person soaks in the water, the bacteria can enter the hair follicle. This causes an infection.

What are the causes and risks of the infection?

Hot tub folliculitis is caused by exposure to contaminated water in a hot tub or spa. People with open cuts or sores, people with diabetes, or those have a history of other skin conditions are at increased risk for infection.

What are the signs and symptoms of the infection?

The signs of hot tub folliculitis usually occur within 3 days of using of a poorly chlorinated hot tub. These include:

How is the infection diagnosed?

A healthcare provider may suspect hot tub folliculitis after taking a person's health history and doing a physical exam. The presence of skin lesions and obvious exposure to a hot tub or spa usually confirm the diagnosis.

What can be done to prevent the infection?

To prevent hot tub folliculitis, the pH and chlorine need to be closely monitored in hot tubs and spas. This will help to decrease the growth of Pseudomonas aeruginosa.

What are the long-term effects of the infection?

Long term effects of folliculitis include furuncles, which are boils, abscesses or deep skin infections, known as cellulitis. With treatment these complications are rare.

What are the risks to others?

Folliculitis is contagious. It may be spread from one person to another. Individuals with folliculitis should wash their hands thoroughly. They should also use separate towels and washcloths. People with this condition should not use a hot tub until the infection has cleared up.

What are the treatments for the infection?

Treatment for hot tub folliculitis usually consists of cleansing the infected area thoroughly with soap and water Warm water soaks can be used. Antibiotic ointment should be applied to the skin rash. If symptoms do not go away, oral antibiotics may be needed. The person should not scratch the pustules. This can make symptoms worse.

What are the side effects of the treatments?

Antibiotic ointments may cause skin irritation. Oral antibiotics may cause stomach upset, diarrhea or allergic reaction.

What happens after treatment for the infection?

Treatment is usually effective and the condition clears up.

How is the infection monitored?

A person should monitor the folliculitis rash and contact a healthcare provider if symptoms progress or do not improve.

Author:Eileen McLaughlin, RN, BSN
Date Written:
Editor:Slon, Stephanie, BA
Edit Date:06/30/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:07/13/01

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