Hot Tub Rash

Hot tub rash, also known as ‘folliculitis’, is an infection in hair follicles. It can occur in any part of the body that has hair growth. However it is more common on face, scalp and areas that are often rubbed by clothing like groin, armpits and thighs.  There are many types of folliculitis, most common of which is hot tub folliculitis or pseudomonas folliculitis.

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Hot tub folliculitis is an infection that occurs on the lower part of hair i.e. hair follicles. It occurs when the person comes in contact with bacteria that live in warm and wet areas. Hot tub rash or folliculitis appears after 3 days of person being in hot tub or spa. These rashes or pimples generally appear on stomach, legs and arms. Usually these pimples go away on their own in 8 to 12 days.

These rashes or pimples look like acne and may turn into red, delicate nodules. The rash may be thicker especially in the area that was covered by swimsuit and where water contact with the skin was for longer duration. It is possible that person who shares the same hot tub will also develop the rash. But the rashes do not spread from one person to the other through contact with rash.

Generally the symptoms of hot tub rash go away with time without any treatment. But the problem may come back or become worse if the person continues to use same hot tub before it gets cleaned.

Causes of folliculitis

Folliculitis is caused due to bacteria, yeast and other type of fungus. Hot tub rash is caused by bacteria Pseudomonas aeruginosa which survive in hot tubs particularly wooden tubs. This bacterium is most commonly found in contaminated swimming pools, whirlpools, water slides, loofah sponges and physiotherapy pools. Children are most commonly affected by folliculitis because they usually remain in water for longer duration.

Anyone who has damaged or infected hair follicle is likely to get folliculitis. Also it can be caused from shaving or wearing anything that rubs against the skin and thus irritate hair follicles. Additionally infection in follicles occur when hair follicles are blocked or injured because of machine oils, sweat, makeup or any other factor.


The symptoms appear from few hours to 3 days after the person comes in contact with the bacteria. Following are some of the symptoms of hot tub rash:

  • Red pimples appear on the skin with a hair present at the centre of each pimple. These pimples may also have pus, cause itching and burning sensation. When these pimples break they may drain off pus, blood or even both of them.
  • Several small 0.3 to 3 cm red papules with central pustule.
  • Mild fever
  • Upset stomach


The physician will check the skin and ask about recent activities that may affect your health. The doctor may also ask to take up few tests to confirm that it is actually folliculitis and what is the cause of rashes. These tests will be conducted mostly with the pus or blood coming from pimples.

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Is Hot Tub Rash Contagious?

Yes, it does spread through physical contact with a person who is infected.  Therefore, it is advisable to avoid sharing clothes, towels etc with someone who already has folliculitis . Also avoid using hot tubs, until you are fully recovered.


Although folliculitis does not require any treatment and go away on its own within 15 days but there are few ways to treat hot tub rash at home.

  • To prevent itching and quick healing, warm compresses of white vinegar or Burow’ solution can be applied.
  • Medicated shampoo can be used to heal up folliculitis in scalp and beard.
  • Make sure the water in hot tubs have controlled acid and chlorine level.

If the hot tub rashes do not go away, then doctor’s recommended antibiotic and antifungal creams can be applied on the affected area. Alternatively antibiotic and antifungal pills can also be used. Anti-itch medication is also used to relieve discomfort.

Who can get hot tub rash?

Individuals who live in one or more of the following conditions are most likely to develop folliculitis:

  • Using hot tubs, swimming pools or whirlpool that are not frequently treated with chlorine
  • Staying in contact with substances that may block or irritate blood follicles such as tar, cocoa butter, makeup, oils, creams etc.
  • Wearing tight-fit clothes
  • Having an infection, wound or scrape where bacteria and fungi can spread to cause infection in nearby follicles
  • Consuming steroids or antibiotic creams for longer time
  • If person is suffering from diseases like HIV and diabetes that reduces immunity to infections.

It is necessary to consult a doctor if the folliculitis spreads and/or keeps coming back time and again. Along with this if the person has fever over 101 degrees and does not seem to lower down, it is a serious matter of taking the case to the doctor. Also if the affected area becomes red, warm, swollen with increasing pain then doctor’s advice is a must.

Hot Tub Rash Pictures

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