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Hot Tub folliculitis: The Complete Guide to this disease

What is Hot Tub Folliculitis?

Hot tub folliculitis is an infection of the hair follicles caused by the bacteria Pseudomonas aeruginosa. This is a bacteria that tends to be found in warmer bodies of water, particularly water that comes into contact with a lot of different people. This means that if you have people regularly using your hot tub, or you head to a public swimming pool or water slide, then you are at risk of hot tub folliculitis. 

How Do You Know if You Have Hot Tub Folliculitis?

The problem with hot tub folliculitis is that it can take a while to develop. You may not even notice the symptoms of the condition for 5-10 days after you have become infected with it. Some people may not even have any symptoms at all. You can still spread it, though.

When you come into contact with the bacteria, it will enter your hair follicles on your body. When it does this, it will infect them. Over time, this will cause a rash. This rash will often look like chickenpox. In fact, because children are among the most at-risk group for hot tub folliculitis, a lot of parents do believe that their child is suffering from the chickenpox when they get it. Don’t worry about this. The conditions do function in much the same way, and neither of them is unlikely to be deadly.

As the infection progresses, the rash will start to change. Each of the infected hair follicles will become a pimple. At this point, it is going to look as if you are covered in acne. This is something that will happen a few days after the rash starts to develop.

We do want to point out that some people have reported suffering from a fever or nausea when infected by the bacteria. If that is the case, then disregard our advice in the next section. It is important that you talk to a doctor as soon as possible. This could indicate that your immune system is having difficulty fighting the bacteria and, as a result, may need a little bit of extra help.

Hot tub folliculitis will only develop after you have been exposed to the bacteria in a body of water (most-likely a hot tub), so if you haven’t been in a body of water recently, it is unlikely that you are suffering from hot tub folliculitis. It may be a different condition. 

How Do You Treat Hot Tub Folliculitis?

In the vast majority of cases, you do not need to do anything to treat the hot tub folliculitis. The rash is going to disappear in about 10-days, although in minor infections it may be a little less time. However, do bear in mind that there will be small marks left behind by the rash. These are not permanent. They will disappear within a few months. Do bear in mind that these marks will not cause you any hassle beyond the visual appearance of them.

If the rash doesn’t disappear after 10-days, then you may need to do talk to a doctor. They can provide you with antibiotics that will help to combat the infection. However, we would not recommend going to the doctor unless you absolutely need to do so. So, you really should leave it the full 10-days, as uncomfortable as it may be. Taking antibiotics should always be a last resort.

If the rash is causing you a bit of discomfort, then you can look into applying sulfadiazine cream directly to the rash. If you do this a couple of times per day, it should provide you with a great deal of relief!

Remember; if you want the rash to go away quickly, then it is vital you do not scratch it. This just irritates the skin, and it will make it a lot worse. If you are struggling, then you can look into home remedies for chickenpox that alleviate the itch. They won’t completely stop the discomfort, but they will make it a little bit more bearable!

How Do You Prevent Hot Tub Folliculitis?

The main way to prevent hot tub folliculitis is to reduce the chances of Pseudomonas aeruginosa being in the water in the first place. There are a few ways that you can accomplish this.

Shower before entering your hot tub

As we said; these bacteria appear in the water after somebody enters the water with Pseudomonas aeruginosa attached to them. So, if you shower before you enter the hot tub, you stand a lower chance of the bacteria somehow managing to get into the water. Remember; you do not need to be showing signs of infection to be carrying this bacteria. Some people will be carriers, and they do not even know it. So, have a full shower before entering the water. Do not leave a part of you unscrubbed. This should drastically reduce the risk of an infection occurring.

Reduce the number of people in the pool

In addition to this, you will want to reduce the number of people entering the hot tub at once. After all, the more people there are in the tub, the more chance there is of the bacteria getting into the water. It is unlikely that your sanitizer will be able to kill the bacteria off quickly enough and this will, of course, lead to an infection.

You should never be exceeding the quoted size of your hot tub. So, if your hot tub says that your brand new tub can seat four people, then make sure that you only ever have four people in it at once. No more. The risk of infection will shoot up.

Use Bromine Instead of Chlorine

Chlorine is fantastic as a sanitizer. The problem is that it does not work effectively at high temperatures. So, you could have your chlorine levels in check, but the chlorine won’t be doing a great job at removing bacteria from the pool. Bromine, on the other hand, works fantastically well at high temperatures. In fact, this is the chemical that you should always be using to sanitize your hot tub or even an outdoor pool that is exposed to UV rays.

Bromine does work in a slightly different way, and it can be a bit more expensive to purchase. However, you will find that it does a far better job of keeping your tub nice and clean. This will go beyond simply preventing hot tub folliculitis. 

Empty your hot tub regularly

At the minimum, you should be emptying your hot tub at least once every three months. If your tub is getting a lot of regular use, then you may need to empty it more frequently than this. Yes. It does take time, money, and effort to get everything nice and clean. However, we promise you that this is going to be time, money, and effort well spent if it means that you get to avoid hot tub folliculitis. 

Keep the water clean

This means that your water needs to be well-filtered. The chemical and PH levels need to be kept balanced. The water should be constantly pumped too. This will keep the water moving and, hopefully, this will provide more of an opportunity for your sanitizing chemicals to stop the bacteria in its tracks.

If you do notice that your water is getting a little bit cloudy, then it may be time to either give your hot tub a chemical shock or, perhaps, completely empty the water. Dirty, unclean water is more likely to cause hot tub folliculitis, after all.

Reduce exposure to the water

The more you are sitting in the hot tub, the more at-risk you are of suffering from hot tub folliculitis. This is especially true for children. Children should never be sitting in a hot tub for more than 10-15 minutes (this can cause heatstroke), and if the water hasn’t been changed in a while, we wouldn’t recommend the children enter the hot tub at all. Adults can, of course, spend a little bit longer in the water. However, do not spend your days lolling about in hot tub water. It isn’t good for your body to be exposed to that amount of heat.

Change your clothes once you get out of the hot tub

There is a chance that the bacteria that causes hot tub folliculitis has managed to stick to your clothing. This means that you will need to get out of your clothes as soon as you can after you leave the hot tub. The longer you are sitting in them, the more chance there is of the hair follicles becoming infected.


We hate to say it, but you will never be able to 100% prevent hot tub folliculitis from happening. Sometimes a little bit of bacteria does manage to creep through, despite your best efforts. However, we can assure you that if you follow the tips on this page, then the risk is minimal. If you do end up suffering from the condition, as painful and irritating as it can be, it is something that is going to clear up eventually. In most cases, this will be without any medical intervention.

Posted in hot tubs

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