What? I can get a rash from the hot tub?
Hot tub folliculitis is a skin infection that is the direct result of – you guessed it – having spent time in a hot tub! The hair follicles of the skin can become infected when exposed to bacteria contaminated water. The infection is caused by the bacteria Pseudomonas aeruginosa which lives in wet, warm areas including hot tubs, whirlpools, and even waterslides. Children seem to be more vulnerable to this than adults but anyone who is in that environment can in fact become infected.
The skin reacts usually with red bumps that may be itchy and are commonly found on the trunk. The infection may take hours to days after the initial exposure to the contaminated water before it is apparent. The bumps can enlarge and become tender or fill with pus. The areas of the skin that were covered by the bathing suit can have a more severe degree of the rash. Systemic symptoms like fever, malaise, and fatigue are also possible but rare.
Inadequate chemical treatment of the water, prolonged water exposure, and an excess number of people in the pool can all predispose one to infection. This infection can ultimately be avoided by having proper water filtration, sufficient chlorine levels, and also by changing the water frequently. Sadly, showering immediately after exposure does not seem to prevent this condition, only avoidance of exposure can prevent it.
Hot tub folliculitis is self-limited usually and can in fact resolve without any treatment in 5-10 days. Topical antibacterial treatments like over the counter antibacterial soaps or antibiotic ointments can be used to treat this condition. Prescription topical antibiotics can prove to also be effective in eradicating this infection and may be used as a successful treatment. If the rash is in fact severe or resistant to topical treatment then oral antibiotics may be the treatment of choice. Once the condition is treated and the infection is cleared it is of note to mention that the original red bumps may leave behind a reddish-brown stain as part of the healing process that may take weeks to months to fully disappear.